Oral Medicine, Oral Surgery and Implantology Unit, School of Dentistry, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain; GI-1319 Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Oral Medicine, Oral Surgery and Implantology Unit, School of Dentistry, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain; GI-1319 Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Med Hypotheses. 2018 Jul;116:79-83. doi: 10.1016/j.mehy.2018.04.023. Epub 2018 Apr 30.
Vitamin D is an important nutrient for bone health and skeleton growth. Few foods are natural sources of this secosteroid; this is the reason why the consumption of vitamin D as a dietary supplement is becoming common in developed countries. For many years vitamin D has been considered crucial in the treatment and prevention of the Global Burden of Disease and in a reduction in mortality among elder people. Many health care providers prescribe these supplements in the management of osteoporosis and metabolic bone diseases; specifically in the primary prevention of fractures. Recently medication-related osteonecrosis of the jaw (MRONJ) has been reported as severe late sequelae of antiresorptive therapies (i.e., bisphosphonates and some monoclonal antibodies). Although MRONJ-related pathophysiology is not fully understood, there are three fundamental theories to explain it: (1) the inhibition of osteoclasts, (2) the inhibition of angiogenesis and (3) the processes of inflammation-infection. Recent advances in Vitamin D research have shown that this secosteroid can play a potential pivotal role in many of the different etiological pathways of MRONJ. Furthermore, there are a large number of co-morbidities between the deficit of this vitamin and other MRONJ concomitant outcomes. Our hypothesis argues that the low-risk and low-cost vitamin D dietary supplementation may prove to be suitable for use as a practical MRONJ prevention strategy. The described framework gives more insight into the study of disease mechanisms, search of potential biomarkers, and therapeutic targets in MRONJ.
维生素 D 是骨骼健康和生长的重要营养物质。很少有食物是这种甾体的天然来源；这就是为什么在发达国家，维生素 D 作为膳食补充剂的消费变得很普遍。多年来，维生素 D 一直被认为是治疗和预防全球疾病负担以及降低老年人死亡率的关键。许多医疗保健提供者在骨质疏松症和代谢性骨疾病的管理中开这些补充剂；特别是在骨折的一级预防中。最近，药物相关性颌骨坏死（MRONJ）已被报道为抗吸收疗法（即双膦酸盐和一些单克隆抗体）的严重晚期后遗症。尽管 MRONJ 相关的病理生理学尚未完全了解，但有三种基本理论可以解释它：（1）破骨细胞的抑制，（2）血管生成的抑制，（3）炎症-感染的过程。最近的维生素 D 研究进展表明，这种甾体可以在 MRONJ 的许多不同病因途径中发挥潜在的关键作用。此外，这种维生素的缺乏与其他 MRONJ 同时发生的结果之间存在大量的合并症。我们的假设认为，低风险和低成本的维生素 D 饮食补充可能被证明是一种合适的实用 MRONJ 预防策略。所描述的框架更深入地研究了 MRONJ 的疾病机制、潜在生物标志物的研究和治疗靶点。
