Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.
Department of Radiotherapy, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 280 Mohe Road, Shanghai, 201900, China.
Cell Tissue Res. 2023 May;392(2):413-430. doi: 10.1007/s00441-023-03743-z. Epub 2023 Feb 4.
Osteoradionecrosis of the jaws (ORNJ) is a severe complication that occurs after radiotherapy of head and neck malignancies. Clinically, conservative treatments and surgeries for ORNJ exhibited certain therapeutic effects, whereas the regenerative disorder of the post-radiation jaw remains a pending problem to be solved. In recent years, the recognition of the role of the immune microenvironment has led to a shift from an osteoblasts (OBs) or bone marrow mesenchymal stromal cells (BMSCs)-centered view of bone regeneration to the concept of a complicated microecosystem that supports bone regeneration. Current advances in osteoimmunology have uncovered novel targets within the immune microenvironment to help improve various regeneration therapies, notably therapies potentiating the interaction between BMSCs and immune cells. However, these researches lack a thorough understanding of the immune microenvironment and the interaction network of immune cells in the course of bone regeneration, especially for the post-operative defect of ORNJ. This review summarized the composition of the immune microenvironment during bone regeneration, how the immune microenvironment interacts with the skeletal system, and discussed existing and potential strategies aimed at targeting cellular and molecular immune microenvironment components.
颌骨放射性骨坏死（ORNJ）是头颈部恶性肿瘤放射治疗后发生的一种严重并发症。临床上，ORNJ 的保守治疗和手术治疗均显示出一定的疗效，而放射性颌骨再生的再生障碍仍是一个待解决的问题。近年来，人们对免疫微环境作用的认识，促使人们从以成骨细胞（OBs）或骨髓间充质基质细胞（BMSCs）为中心的骨再生观点转变为支持骨再生的复杂微生态系统的概念。骨免疫学的最新进展揭示了免疫微环境中的新靶点，有助于改善各种再生治疗方法，特别是增强 BMSCs 与免疫细胞相互作用的治疗方法。然而，这些研究对骨再生过程中免疫微环境和免疫细胞的相互作用网络缺乏深入了解，特别是对于 ORNJ 术后缺损。本综述总结了骨再生过程中免疫微环境的组成，免疫微环境与骨骼系统的相互作用，并讨论了针对细胞和分子免疫微环境成分的现有和潜在策略。
