Clinical values of serum Semaphorin 4D (Sema4D) in medication‑related osteonecrosis of the jaw

Abstract

Background Bisphosphonates (BPs) are widely used in clinical practice to prevent and treat bone metabolism-related diseases. Medication-related osteonecrosis of the jaw (MRONJ) is one of the major sequelae of BPs use. Early prediction and intervention of MRONJ are of great significance. Methods Ninety-seven patients currently on treatment with BPs or with a history of BPs usage and 45 healthy volunteers undergoing dentoalveolar surgery were included in this study. Participants' serum Semaphorin 4D (Sema4D) levels were measured and analyzed before participants underwent surgery (T0) and after a 12-month follow-up (T1). Kruskal–Wallis test and ROC analysis were used to examine the predictive effect of Sema4D on MRONJ. Results Sema4D levels in serum of patients corresponding to confirmed MRONJ were significantly lower at both T0 and T1 time points compared to non-MRONJ and healthy controls. Sema4D has a statistically predictive effect on the occurrence and diagnosis of MRONJ. Serum Sema4D levels were significantly reduced in MRONJ class 3 patients. MRONJ patients who received intravenous BPs had significantly lower Sema4D levels than those who received oral BPs. Conclusion Serum Sema4D level has predictive value for the onset of MRONJ in BPs users within 12 weeks after dentoalveolar surgery.

Osteonecrosis como complicación postquirúrgica en cirugía oral en pacientes sometidos a tratamientos con antirresortivos. Revisión integrativa

“…Han sido utilizados para tratar pacientes con enfermedades óseas, entre ellas: la osteoporosis, cáncer óseo metastásico, enfermedad de Paget, mieloma multiple. (Mu et al, 2023;Ruggiero et al, 2022;Otsuru et al, 2022;Sacco et al, 2021). Además se han utilizado para el control sintomático de osteogénesis imperfecta (OI).…”

“…Además se han utilizado para el control sintomático de osteogénesis imperfecta (OI). (Shibahara, 2019) así como para para aumentar la densidad ósea y disminuir la incidencia de fracturas óseas (Contaldo et al, 2020;Mu et al, 2023).…”

“…Osteonecrosis de la mandíbula relacionada con medicamentos (MRONJ) reconocida a partir del 2023 es un efecto adverso grave que está relacionado mayormente con el uso de estos fármacos enre ellos los antirresortivos, aprobados para ser utilizados como tratamiento de enfermedades como el cáncer, hipercalcemia, mieloma múltiple, enfermedad de Paget, (Ruggiero et al, 2014;Mu et al, 2023) Los medicamentos intravenosos por consiguiente tienen mayor potencia. (Schwech et al, 2023;Otsuru et al, 2022) En experimentos invitro se ha observado una disminución en la angiogénesis como respuesta en casos donde se administraba ácido zoledrónico además de niveles dismnuídos de factor de crecimiento epitelial vascular circundante, afectando así al suministro vascular lo que puede explicar la aparición de esta afectación.…”

Mitigating jaw osteonecrosis: bioactive glass and pericardial membrane combination in a rat model

“…Since its initial report nearly two decades ago, there has been an increasing number of publications focused on BRONJ, and some progress has been made in understanding its pathophysiology mechanisms (9,10). However, significant knowledge gaps still remain.…”