Clinic for Integrative Dentistry, Munich, Germany.
Residual Infection In Bone (RIIB) Project, Indiana University, Indianapolis, IN, USA.
Int J Immunopathol Pharmacol. 2024 Jan-Dec;38:3946320241265265. doi: 10.1177/03946320241265265.
Exceedingly high levels of the chemokine CCL5/RANTES have been found in fatty degenerated osteonecrotic alveolar bone cavities (FDOJ) and aseptic ischemic osteolysis of the jaw (AIOJ) from toothless regions. Because CCL5/RANTES seems to have a prominent role in creating the COVID-19 "cytokine storm", some researchers have used the monoclonal antibody Leronlimab to block the CCR5 on inflammatory cells. Is preexisting FDOJ/AIOJ jaw marrow pathology a "hidden" co-morbidity affecting some COVID-19 infections? To what extent does the chronic CCL5/RANTES expression from preexisting FDOJ/AIOJ areas contribute to the progression of the acute cytokine storm in COVID-19 patients? Authors report on reducing the COVID-19 "cytokine storm" by treating infected patients through targeting the chemokine receptor 5 (CCR5) with Leronlimab and interrupting the activation of CCR5 by high CCL5/RANTES signaling, thus dysregulating the inflammatory phase of the viremia. Surgical removal of FDOJ/AIOJ lesions with high CCL5/RANTES from patients with inflammatory diseases may be classified as a co-morbid disease. Both multiplex analysis of 249 FDOJ/AIOJ bone tissue samples as well as serum levels of CCL5/RANTES displayed exceedingly high levels in both specimens. By the results the authors hypothesize that chronic CCL5/RANTES induction from FDOJ/AIOJ areas may sensitize CCR5 throughout the immune system, thus, enabling it to amplify its response when confronted with the virus. As conventional intraoral radiography does little to assess the quality of the alveolar bone, ultrasonography units are available to help dentists locate the FDOJ/AIOJ lesions in an office setting. The authors propose a new approach to containment of the COVID-19 cytokine storm by a prophylactic focus for future viral-related pandemics, which may be early surgical clean-up of CCL5/RANTES expression sources in the FDOJ/AIOJ areas, thus diminishing a possible pre-sensitization of CCR5. A more complete dental examination includes trans-alveolar ultrasono-graphy (TAU) for hidden FDOJ/AIOJ lesions.
在无牙区的脂肪变性坏死性牙槽骨腔（FDOJ）和无菌性缺血性颌骨溶解（AIOJ）中，发现趋化因子 CCL5/RANTES 的水平极高。由于 CCL5/RANTES 似乎在引发 COVID-19“细胞因子风暴”中发挥了重要作用，一些研究人员使用单克隆抗体 Leronlimab 来阻断炎症细胞上的 CCR5。预先存在的 FDOJ/AIOJ 颌骨髓病理是否是影响某些 COVID-19 感染的“隐藏”合并症？预先存在的 FDOJ/AIOJ 区域中慢性 CCL5/RANTES 表达在多大程度上促进了 COVID-19 患者中急性细胞因子风暴的进展？作者报告说，通过用 Leronlimab 靶向趋化因子受体 5（CCR5）并阻断高 CCL5/RANTES 信号传导对 CCR5 的激活来治疗感染患者，从而减少 COVID-19 的“细胞因子风暴”，从而扰乱病毒血症的炎症阶段。患有炎症性疾病的患者中，通过手术切除 FDOJ/AIOJ 病变并清除高 CCL5/RANTES，可能被归类为合并症。对 249 个 FDOJ/AIOJ 骨组织样本的多重分析以及 CCL5/RANTES 的血清水平均显示两种标本中均存在极高水平。作者根据结果假设，来自 FDOJ/AIOJ 区域的慢性 CCL5/RANTES 诱导可能会使整个免疫系统中的 CCR5 致敏，从而使其在遇到病毒时能够放大其反应。由于常规口腔内放射照相术对评估牙槽骨的质量作用不大，因此超声设备可帮助牙医在办公室环境中定位 FDOJ/AIOJ 病变。作者提出了一种新的方法来控制 COVID-19 细胞因子风暴，作为未来病毒相关大流行的预防性重点，这可能是早期清除 FDOJ/AIOJ 区域中 CCL5/RANTES 表达源，从而减少 CCR5 可能的预致敏。更完整的牙科检查包括牙槽骨内超声检查（TAU）以发现隐藏的 FDOJ/AIOJ 病变。
