Tipo de Articulo: Artículos Originales

Titulo: Desarrollo de un modelo experimental de osteonecrosis de maxilar asociada al tratamiento crnico con aminobisfosfonatos

Title: Experimental model of osteonecrosis of the jaw associated to chronic treatment with aminobisphosphonates

Actual. Osteol 13(2):104:115, 2017

Autor(es): Mario R. Davison, Leonardo Lyardet, Mariana Preliasco, Graciela Yaful, Perla Torres, Durán Francisco, Gretel Pellegrini, Walther Zabala, Susana Zeni


Vista previa en PDF
Descargar en formato PDF

La osteonecrosis de maxilar asociada a aminobisfosfonatos (BRONJ) constituye un efecto secundario del tratamiento crnico con los ms potentes. Un modelo experimental permitira determinar la patogenia de dicha alteracin. La oveja presenta caractersticas orales y del metabolismo seo similar al humano y permite realizar manipulaciones bucales. Se evaluaron cambios clnicos, remodelacin sea y masa sea maxilar en ovejas hembras adultas tratadas con zolendronato (ZOL), durante 22 meses y utilizando dosis equivalente al tratamiento de neoplasias. Seis ovariectomizadas (OVX) recibieron ZOL; 5 OVX y 4 SHAM (control) recibieron solucin fisiolgica. Al inicio, 4 y 22 meses se evalu calcemia, fosfatemia, crosslaps (CTX) y fosfatasa alcalina sea. Al final, se evalu contenido mineral seo de la hemimandbula superior (CMO: mg/cm2). Al final del estudio, CTX disminuy significativamente en ZOL (p<0,05) sin diferencias entre SHAM y OVX. En maxilar, los contenidos de Ca y P (g/g tejido) y CMO (g/cm2) disminuyeron en OVX vs. SHAM (p<0,05) y solo Ca y CMO respecto de ZOL (p<0,05). ZOL increment el contenido de Ca y CMO, mientras que el de P permaneci significativamente disminuido respecto de SHAM. La sobrevida en SHAM y OVX fue del 100% y en ZOL 77% (2 muertes); 2 ovejas del grupo ZOL presentaron necrosis de maxilar. Conclusiones: fue posible obtener desarrollo de BRONJ por tratamiento crnico con ZOL, el cual redujo notablemente la resorcin y, segn la relacin Ca/P, posiblemente haya afectado la mineralizacin sea.

Palabras clave: osteonecrosis de maxilar asociada a bisfosfonatos, ovejas, cido zoledrnico, remodelacin sea, crosslaps.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a complication of chronic treatment with the most powerful aminobisphosphonates (BPs). An experimental animal model would allow to determine the pathogenesis of this complication. Ewes exhibit similar oral cavity characteristics and bone metabolism as humans, and they are suitable for oral cavity interventions. We examined herein the clinical manifestations, bone remodeling status, and maxillary bone mass in adult female ewes treated with zoledronate (ZOL) for 22 months. Six ovariectomized (OVX) ewes received ZOL; and 5 OVX and 4 SHAM animals received saline solution. At the start of the experiment, and at the 4 and 22 month-time points serum Ca, P, crosslaps (CTX), and bone alkaline phosphatase were measured. Bone mineral content (BMC) of the superior hemimandible was measured at the end of the experiment. At this time point, CTX was significantly decreased only in the ZOL group (p<0.05). Ca and P content (g/g tissue) and BMC in the mandible were significantly decreased in the OVX group compared to SHAM animals (p<0.05) and only Ca content and BMC were decreased when compared to ZOL (p<0.05). ZOL treatment increased the Ca content and BMC, whereas the P content remained low compared to the SHAM group (p<0.05). All ewes from the SHAM and OVX groups and 77% of the animals from the ZOL group survived until the end of the experiment, whereas two ewes of ZOL group exhibited BRONJ.

Conclusion: under our experimental conditions, it was possible to induce BRONJ by the chronic ZOL administration, which in turn induced a high reduction in bone resorption as well as possibly impaired bone mineralization, based on the Ca/P ratio in the mandible.

Key words: bisphosphonates related osteonecrosis of the jaw, sheep, zoledronic acid, bone remodeling, crosslaps.

Propietario: Asociacin Argentina de Osteologa y Metabolismo Mineral (AAOMM)
Domicilio legal: 9 de Julio 1324, (2000) Rosario, Santa Fe, Argentina.
Editores responsables: Dra. Luisa Plantalech - Dra. Virginia Massheimer

Osteologia.org.ar - Todos los derechos reservados AAOMM
Derecho Nacional de Derecho de Autor (Exp N 5289263 - 16/05/2016)
Registro de la Propiedad Intelectual de la Revista online (Exp N = 5316855 - 21/10/2016)