Serum levels of RANKL and OPG, and the RANKL/OPG ratio in bisphosphonate-related osteonecrosis of the jaw: Are they useful biomarkers for the advanced stages of osteonecrosis?

Abstract

BackgroundWe determined whether serum levels of Receptor Activator for Nuclear Factor κ B Ligand (RANKL), Osteoprotegerin (OPG), and the RANKL/OPG ratio could be useful biomarkers for the severity of oral lesions in bisphosphonate-related osteonecrosis of the jaw (BRONJ).Material and MethodsA case-control study in which Group 1 consisted of 41 patients with BRONJ due to intravenous bisphosphonates, and Group 2 consisted of 44 healthy control cases. The plasma levels of RANKL and OPG were analyzed by an ELISA assay. The OPG/RANKL ratio was also calculated. We determined if the mean serum values differed among the different stages of BRONJ. ResultsSerum levels of RANKL were lower in Group 1 than in Group 2 (p =0.01), and serum levels of OPG were higher in patients with BRONJ than in the controls (p =0.006). The ratio of RANKL/OPG was greater in the controls than in Group 1 (P >0.01). There were no significant differences in the serum levels of RANKL and OPG among the different stages of osteonecrosis (P > 0.05).ConclusionsSerum levels of RANKL and OPG, and the RANKL/OPG ratio were not valuable biomarkers for determining the severity of oral lesions in patients with BRONJ. Key words:Bisphosphonates, RANKL, OPG, Osteonecrosis.

Circulating microRNA Panel as a Novel Biomarker to Diagnose Bisphosphonate-Related Osteonecrosis of the Jaw

“…Emerging evidences showed genetic association of diverse genes dysregulation with BRONJ7-9, suggesting that altered gene expressions might be potential biomarkers for BRONJ diagnosis. In addition, since BRONJ is closely related with bone metabolic disorders, bone turnover markers have been emerging to support diagnosis of BRONJ10-13. Nevertheless, inconsistent diagnostic performances were observed in various researches and no approved clinical guide has been established to manage BRONJ.…”

Association between biomarkers and medication-related osteonecrosis of the jaws: a systematic review

“…their apoptosis, inhibiting bone resorption by depleting mature osteoclasts 11 . However, two studies 1,28 showed that the serum levels of RANKL and OPG and the RANKL/OPG ratio were not valuable biomarkers to determine the severity of oral lesions in MRONJ patients.…”

“…Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication that can occur in patients who have been treated with antiresorptive medication 1 . Bisphosphonate (BP) medications are the most frequently used class of anti-resorptive drugs for the treatment of bone disorders such as osteoporosis and cancer-associated skeletal complications 2 .…”

“…Bisphosphonate (BP) medications are the most frequently used class of anti-resorptive drugs for the treatment of bone disorders such as osteoporosis and cancer-associated skeletal complications 2 . However, more recently, other drugs such as denosumab 1,3 and antiangiogenic drugs 4 have been implicated in MRONJ.…”

“…Previous studies have attempted to identify useful biomarkers for prediction [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , diagnosis 28 and severity 1 .…”