Department of Prosthodontics, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China.
Oral Dis. 2020 Apr;26(3):609-620. doi: 10.1111/odi.13275. Epub 2020 Jan 22.
This study aimed to investigate the therapeutic effect of different doses of teriparatide (TPTD) on bisphosphonate-related osteonecrosis of the jaw (BRONJ).
To establish the BRONJ model, 20 mice were randomly divided into two groups: a group that received tail vein administration of zoledronic acid with dexamethasone (ZA-125 µg/kg, DEX 5 mg/kg) and a group that received saline weekly. The mice subsequently underwent bilateral maxillary first molar extraction. After 8 weeks of modelling administration, the maxilla samples were examined by micro-computed tomography and histological staining (haematoxylin and eosin, Masson's trichrome and tartrate-resistant acid phosphatase) and the cytokine level was measured (enzyme-linked immunosorbent assay and Western blot). To determine the role of TPTD in BRONJ, the same protocol as previously described was applied in 100 mice (80 received ZA + DEX, and 20 received saline). After 8 weeks of modelling administration, 80 ZA + DEX mice were randomly divided into four groups: three groups with subcutaneous administration of TPTD (i.e. T1-3, T2-10 and T3-30 µg kg day ) and one group with saline daily for the next 8 weeks. The other 20 saline mice continued to receive saline daily.
In Part 1, the level of receptor activator of nuclear factor-kappa Β ligand and the numbers of osteoclasts differed between the model and control groups. In Part 2, we found that TPTD had a positive effect on BRONJ in a mouse model based on clinical and histomorphological observations. Among the three treatment groups, the T1 and T2 groups significantly differed from the model group, whereas the T3 group showed no statistical differences.
Subcutaneous administration of TPTD has a beneficial effect on BRONJ in mice. Nevertheless, further studies are needed to determine whether the therapeutic effect on BRONJ is dose-dependent.
本研究旨在探讨不同剂量特立帕肽(TPTD)治疗双膦酸盐相关性颌骨坏死(BRONJ)的疗效。
为建立 BRONJ 模型,将 20 只小鼠随机分为两组:一组接受尾静脉注射唑来膦酸加地塞米松(ZA-125µg/kg,DEX 5mg/kg),一组接受每周生理盐水注射。随后两组小鼠均进行双侧上颌第一磨牙拔除。建模后 8 周,对颌骨样本进行微计算机断层扫描和组织学染色(苏木精和伊红、马松三色和耐酒石酸酸性磷酸酶),并测量细胞因子水平(酶联免疫吸附试验和 Western blot)。为确定 TPTD 在 BRONJ 中的作用,将相同方案应用于 100 只小鼠(80 只接受 ZA+DEX,20 只接受生理盐水)。建模后 8 周,80 只 ZA+DEX 小鼠随机分为四组:三组皮下注射 TPTD(即 T1-3、T2-10 和 T3-30µg·kg-1·day-1),一组每日注射生理盐水,持续 8 周。其余 20 只生理盐水组继续每日注射生理盐水。
第 1 部分结果显示,模型组和对照组核因子κB 受体激活物配体水平和破骨细胞数量存在差异。第 2 部分结果显示,在小鼠模型中,TPTD 对 BRONJ 有积极作用,基于临床和组织形态学观察。在三个治疗组中,T1 组和 T2 组与模型组差异有统计学意义,而 T3 组则无统计学差异。
TPTD 皮下给药对小鼠 BRONJ 有治疗作用。然而,仍需进一步研究以确定对 BRONJ 的治疗效果是否与剂量相关。