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Zheng M, Liu Z, He Y. Radiation-induced fibrosis: Mechanisms and therapeutic strategies from an immune microenvironment perspective. Immunology 2024; 172:533-546. [PMID: 38561001 DOI: 10.1111/imm.13788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
Radiation-induced fibrosis (RIF) is a severe chronic complication of radiotherapy (RT) manifested by excessive extracellular matrix (ECM) components deposition within the irradiated area. The lung, heart, skin, jaw, pelvic organs and so on may be affected by RIF, which hampers body functions and quality of life. There is accumulating evidence suggesting that the immune microenvironment may play a key regulatory role in RIF. This article discussed the synergetic or antagonistic effects of immune cells and mediators in regulating RIF's development. Several potential preventative and therapeutic strategies for RIF were proposed based on the immunological mechanisms to provide clinicians with improved cognition and clinical treatment guidance.
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Affiliation(s)
- Mengting Zheng
- 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, Shanghai, China
| | - Zhonglong Liu
- 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, Shanghai, China
| | - Yue He
- 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, Shanghai, China
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Borges JS, Paula IS, de Araújo Reis NT, de Lima Oliveira AP, Soares CJ, Soares PBF. Effects of different doses of ionizing radiation on alveolar bone repair in post-extraction tooth socket: an experimental study in rats. Clin Oral Investig 2023; 27:7583-7593. [PMID: 37906304 DOI: 10.1007/s00784-023-05348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study aimed to evaluate the dose-response effects of ionizing radiation (IR) on alveolar bone repair and bone strength after tooth extraction. MATERIALS AND METHODS A total of 32 male Wistar rats were used in the study, 28 animals were included in the final analysis, and n = 7 for each experimental group. Mandibular first molars were extracted. After 7 days, the animals were randomly divided into four groups according to single-dose irradiation: NIr, control group; Ir15, irradiated at 15 Gy; Ir20, irradiated at 20 Gy; and Ir30, irradiated at 30 Gy. The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric, and biomechanical analyses 14 days after extraction. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test (α = 0.05). RESULTS Micro-CT analysis revealed that IR led to lower values of bone volume (BV, in mm3) (0.68 ± 0.08, P < 0.001) and bone volume fraction, ratio of the segmented bone volume to the total volume of the region of interest (BV/TV, in %) (44.1 ± 8.3, P < 0.001) for the Ir30 group compared to the control group. A significantly lower amount of newly formed bone was observed in the Ir30 (P = 0.005) than in the Ir15 group. The histomorphometric results of quantification of bone matrix neoformation and the micro-CT were in agreement, demonstrating greater damage to the Ir30 group. IR30 cells showed a lower percentage of densely packed collagen than control cells. No significant differences were found in the biomechanical parameters. CONCLUSION IR affects alveolar bone repair. A dose of 30 Gy reduced the bone healing process owing to a smaller amount of newly formed bone and a lower percentage of densely packed collagen. Therefore, a dose of 30 Gy can be used to successfully establish an animal model of an irradiated mandible that mimics the irradiated clinical conditions. CLINICAL RELEVANCE Radiotherapy can lead to severe side effects and tooth extraction is a major risk factor. A proper understanding of the pathological mechanisms of radiation in alveolar bone repair requires the establishment of a suitable animal model of clinical conditions.
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Affiliation(s)
- Juliana Simeão Borges
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Isabella Santos Paula
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Nayara Teixeira de Araújo Reis
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Ana Paula de Lima Oliveira
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Priscilla Barbosa Ferreira Soares
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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Zhuang X, Lin X, Xu R, Zhang Z, Zhou B, Deng F. ATG7-mediated autophagy protects human gingival myofibroblasts from irradiation-induced apoptosis. J Oral Pathol Med 2023; 52:996-1003. [PMID: 37876026 DOI: 10.1111/jop.13490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Apoptosis resistance of myofibroblasts is critical in pathology of irradiation-induced fibrosis and osteoradionecrosis of the jaw (ORNJ). However, molecular mechanism of apoptosis resistance induced by irradiation in oral myofibroblasts remains largely obscure. METHODS Matched ORNJ fibroblasts and normal fibroblasts pairs from gingival were primarily cultured, and myofibroblast markers of α-SMA and FAP were evaluated by qRT-PCR and western blot. CCK8 assay and flow cytometric analysis were performed to investigate the cell viability and apoptosis under irradiation treatment. Autophagy-related protein LC3 and ATG7, and punctate distribution of LC3 localization were further detected. After inhibition of autophagy with inhibitor CQ and 3-MA, as well as transfected ATG7-siRNA, cell viability and apoptosis of ORNJ and normal fibroblasts were further assessed. RESULTS Compared with normal fibroblasts, ORNJ fibroblasts exhibited significantly higher α-SMA and FAP expression, increased cell, viability and decreased apoptosis under irradiation treatment. LC3-II and ATG7 were up-regulated in ORNJ fibroblasts with irradiation stimulation. After inhibition of irradiation-induced autophagic flux with lysosome inhibitor CQ, LC3-II protein was accumulated and punctate distribution of LC3 localization was increased in ORNJ fibroblasts. Moreover, autophagy inhibitor CQ and 3-MA enhanced the irradiation-induced apoptosis but inhibited viability of ORNJ fibroblasts. Silencing ATG7 with siRNA could obviously weaken irradiation-induced LC3-II expression, and promoted irradiation-induced apoptosis of ORNJ fibroblasts. After knockdown of ATG7, finally, p-AKT(Ser473) and p-mTOR(Ser2448) levels of ORNJ fibroblasts were significantly increased under irradiation. CONCLUSION Compared with normal fibroblasts, human gingival myofibroblasts are resistant to irradiation-induced apoptosis via autophagy activation. Silencing ATG7 may evidently inhibit activation of autophagy, and promote apoptosis of gingival myofibroblasts via Akt/mTOR pathway.
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Affiliation(s)
- Xiumei Zhuang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxuan Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ruogu Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Bin Zhou
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Gao X, Xue S, Yang F, Wu B, Yu X, An B. Methyl-CpG binding protein 2 is associated with the prognosis and mortality of elderly patients with hip fractures. Clinics (Sao Paulo) 2022; 77:100034. [PMID: 35436701 PMCID: PMC9036098 DOI: 10.1016/j.clinsp.2022.100034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To investigate the expression level and clinical significance of Methyl-CpG binding Protein 2 (MECP2) in elderly patients with hip fractures. METHODS This prospective observational study included 367 elderly patients with hip fractures between April 2016 and December 2018. All the patients were treated with internal fixation or joint replacement. In addition, 50 healthy elderly individuals were enrolled as healthy controls. The serum levels of MECP2 and inflammatory factors Interleukin (IL)-1β, IL-6, IL-8, and Tumor Necrosis Factor (TNF)-α was determined by enzyme-linked immunosorbent assay. Data on patients' basic characteristics and postoperative complications were collected. The Harris score was used to assess hip function at 1-month, 3-months, and 6-months after surgery. Patient quality of life was measured using the Barthel Index (BI) score 3-months after surgery. The 1-year mortality was analyzed using the Kaplan-Meier curve, and logical regression was used to analyze the risk factors for mortality. RESULTS No significant differences were observed in the basic clinical characteristics of all patients. The serum MECP2 levels were remarkably high in patients with hip fractures and negatively correlated with serum IL-1β, IL-6, and TNF-α levels. Patients with higher MECP2 predicted higher dynamic Harris scores, lower postoperative complications, lower 1-year mortality, and higher BI scores. Logical regression showed that age was the only independent risk factor for postoperative 1-year mortality in elderly patients with hip fractures. CONCLUSION Lower MECP2 predicted poor prognosis and higher 1-year mortality in elderly patients with hip fractures.
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Affiliation(s)
- Xuejian Gao
- Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China
| | - Shan Xue
- Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China
| | - Fuqiang Yang
- Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China
| | - Baoling Wu
- Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China
| | - Xiaojing Yu
- Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China
| | - Baoquan An
- Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China.
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Assessment of irradiated socket healing in the rabbit's mandible: Experimental study. Res Vet Sci 2020; 133:226-231. [PMID: 33032109 DOI: 10.1016/j.rvsc.2020.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/24/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022]
Abstract
As bone healing is altered after external radiation therapy, its evaluation is mandatory and lacks in clinical practice. The aim of the pilot study was to validate micro computed tomography (microCT) as a simple and reliable technique for assessing irradiated bone healing in the rabbit's mandible and compare with histologic findings. Nineteen rabbits (female New Zealand white) were used. The radiation protocol consisted of 5 sessions delivering 8.5 Gy each. MicroCT was performed at D0, D7, D14, D28 and D42 for the control group and D0, D28 and D42 for the irradiated group. A modified Perry's score was determined on histologic samples, and comparison between microCT and histological findings was performed. The main differences between irradiated and non-irradiated rabbits were observed at Day 28 and 42. There was a strong correlation between imaging and histologic findings. Radiation decreases bone quality and bone mineral density. As the correlation was strong between microCT and histologic findings, micro imaging could be considered as a simple and reliable technique to assess bone healing after radiation therapy and allows an easy comparison between samples, without invasive procedures. Great attention should be kept on the parameters and on the region of interest. The development of in-vivo microCT enlarges the perspectives of microCT use in experimental studies, avoiding invasive procedures, and preserving animal lives and well-being, and furthermore lead to clinical applications.
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Zhuang XM, Zhou B. Exosome secreted by human gingival fibroblasts in radiation therapy inhibits osteogenic differentiation of bone mesenchymal stem cells by transferring miR-23a. Biomed Pharmacother 2020; 131:110672. [PMID: 32889404 DOI: 10.1016/j.biopha.2020.110672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 02/08/2023] Open
Abstract
Radiation-induced fibrosis is recently established as a main reason for osteoradionecrosis of the jaw (ORNJ), anti-eradiation fibrosis drugs achieve satisfactory therapeutic effects. However, the molecular mechanism remain to be fully elucidated. In this study, we found the inhibitory effect of irradiation activated gingival fibroblasts on osteogenic differentiation of human bone mesenchymal stem cells (hBMSCs). Moreover, irradiation-activated-fibroblasts significantly increased miR‑23a expression in hBMSCs. Decreased miR‑23a enhanced osteogenic differentiation of BMSCs, and elevated miR‑23a inhibited this process via directly targeting CXCL12. Finally, exosome released from irradiation-activated-fibroblasts inhibited osteogenic differentiation of BMSCs, and these exosome mediated delivery of miR-23a and further regulated miR-23a/CXCL12 axis in hBMSCs. Therefore, our findings suggest that by transferring miR-23a, exosome secreted by human gingival fibroblasts in radiation therapy serves a vital role in osteogenic differentiation of hBMSCs, which may provide novel clinical treatments for ORNJ.
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Affiliation(s)
- Xiu-Mei Zhuang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China; Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Bin Zhou
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China; Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
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7
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Chen Y, Zong C, Jia J, Liu Y, Zhang Z, Cai B, Tian L. A study on the protective effect of molecular hydrogen on osteoradionecrosis of the jaw in rats. Int J Oral Maxillofac Surg 2020; 49:1648-1654. [PMID: 32451233 DOI: 10.1016/j.ijom.2020.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/04/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022]
Abstract
The aim of this study was to investigate the protective effect of hydrogen in a rat model of osteoradionecrosis of the jaw (ORNJ). The rats and bone marrow-derived mesenchymal stem cells (BMSCs) were pre-treated with hydrogen before receiving irradiation (7Gy per fraction, five fractions in total once a day for rats, 4Gy for BMSCs). Reactive oxygen species (ROS) and cell differentiation were measured in the BMSCs. Also, the radioprotective effect of hydrogen for ORNJ in Sprague-Dawley rats was examined by gross clinical manifestations, micro-computed tomography, and histology. Hydrogen significantly reduced the production of ROS in BMSCs after irradiation. The cell viability was significantly decreased after irradiation (P= 0.001), but pre-treatment with hydrogen before irradiation increased the cell viability (P= 0.025). Hydrogen considerably increased the cellular differentiation potential of the irradiated cells. Comparing with the rats underwent irradiaton only, those rats treated by hydrogen-rich saline significantly appeared improved occlusion, salivation, alopecia, oral ulcer, and less bone necrosis. Myofibroblasts accumulated overwhelmingly in the fibrosis medulla and around the sequestrum after irradiation, and this was decreased in the group pre-treated with hydrogen. Hydrogen may represent a strategy for the prevention and treatment of ORNJ. Its high efficacy and low toxicity suggest possible therapeutic application.
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Affiliation(s)
- Y Chen
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, Xi'an, China; State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - C Zong
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, Xi'an, China; State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - J Jia
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Y Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Z Zhang
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - B Cai
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, Xi'an, China; State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - L Tian
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, School of Stomatology, the Fourth Military Medical University, Xi'an, China.
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Li J, Yin P, Chen X, Kong X, Zhong W, Ge Y, She Y, Xian X, Qi L, Lin Z, Moe J, Fang S. Effect of α2‑macroglobulin in the early stage of jaw osteoradionecrosis. Int J Oncol 2020; 57:213-222. [PMID: 32377713 PMCID: PMC7252453 DOI: 10.3892/ijo.2020.5051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/30/2020] [Indexed: 12/17/2022] Open
Abstract
Advanced osteoradionecrosis (ORN) is one of the most serious complications in patients with head and neck cancer, resulting in poor prognosis. Numerous studies have therefore focused on the pathogenesis and interventions of ORN early stage. The present study aimed to investigate whether α2-macroglobulin (α2M) could prevent early-stage jaw osteoradionecrosis caused by radiotherapy (RT). Following local injection of α2M, a single dose of 30 Gy was delivered to rats for pathological exploration. For 28 days, the irradiated mandible and soft tissues were examined for potential changes. Furthermore, primary human bone marrow mesenchymal stem cells pretreated with α2M followed by 8 Gy irradiation (IR) were also used. Tartrate-resistant acid phosphatase assay, terminal uridine deoxynucleotidyl nick end labeling assay and immunohistochemical staining were performed on irradiated mandibular bone, tongue or buccal mucosa tissues from rats. Cell proliferation was assessed by evaluating the cell morphology by microscopy and by using the cell counting kit-8. Fluorescence staining, flow cytometry and western blotting were conducted to detect the reactive oxygen species level, cell apoptosis and protein expression of superoxide dismutase 2 (SOD2), heme oxygenase-1 (HO-1) and phosphorylated Akt following irradiation. The results demonstrated that α2M attenuated physical inflammation, osteoclasts number and fat vacuole accumulation in mandibular bone marrow and bone marrow cell apoptosis following IR in vivo. Furthermore, α2M pretreatment suppressed the expression of 8-hydroxy-2′-deoxyguanosine in mandibular bone and tongue paraffin embedded sections, which is a marker of oxidative damage, and increased SOD2 expression in mucosa and tongue paraffin embedded sections. The present study demonstrated the efficient regulation of antioxidative enzymes, including SOD2 and heme oxygenase-1, and reduction in oxidative damage by α2M. In addition, in vitro results confirmed that α2M may protect cells from apoptosis and suppress reactive oxygen species accumulation. Overall, the present study demonstrated that α2M treatment may exert some radioprotective effects in early-stage ORN via antioxidant mechanisms, and may therefore be considered as a potential alternative molecule in clinical prophylactic treatments.
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Affiliation(s)
- Jie Li
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Ping Yin
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Xueying Chen
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Xiangbo Kong
- Department of Stomatology, Sun Yat‑sen Memorial Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Wanzhen Zhong
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Yaping Ge
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Yangyang She
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Xuehong Xian
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Lei Qi
- Department of Oral and Cranio‑maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai 200001, P.R. China
| | - Zhi Lin
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Justine Moe
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Silian Fang
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
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Piotrowski SL, Wilson L, Maldonado KL, Tailor R, Hill LR, Bankson JA, Lai S, Kasper FK, Young S. Effect of Radiation on DCE-MRI Pharmacokinetic Parameters in a Rabbit Model of Compromised Maxillofacial Wound Healing: A Pilot Study. J Oral Maxillofac Surg 2020; 78:1034.e1-1034.e10. [PMID: 32147226 DOI: 10.1016/j.joms.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Osteoradionecrosis (ORN), a potentially debilitating complication of maxillofacial radiation, continues to present a challenging clinical scenario, with limited treatment options that often fail. Translational animal models that can accurately mimic the human characteristics of the condition are lacking. In the present pilot study, we aimed to characterize the effects of radiation on the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters in a rabbit model of compromised maxillofacial wound healing to determine its potential as a translational model of ORN. MATERIALS AND METHODS An experimental group underwent fractionated radiation of the mandible totaling 36 Gy. At 4 weeks after irradiation, the experimental and control groups (n = 8 rabbits each) underwent a surgical procedure to create a critical size defect in the mandibular bone. DCE-MRI scans were acquired 1 week after arrival (baseline; time point 1), 4 weeks after completion of irradiation in the experimental group (just before surgery, time point 2), and 4 weeks after surgery (time point 3). RESULTS No differences in the analyzed DCE-MRI parameters were noted within the experimental or control group between the baseline values (time point 1) and those after irradiation (time point 2). The whole blood volume fraction (vb) in the experimental group was increased compared with that in the control group after irradiation (time point 2; P < .05). After surgery (time point 3), both the forward flux rate of contrast from blood plasma and the extracellular extravascular space and the vb were increased in the control group compared with the experimental group (P < .05). CONCLUSIONS The results of the present study suggest that DCE-MRI of a rabbit model of compromised maxillofacial wound healing could reflect the DCE-MRI characteristics of human patients with ORN and those at risk of developing the condition. Future studies will focus on further characterization of this rabbit model as a translational preclinical model of ORN.
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Affiliation(s)
- Stacey L Piotrowski
- Anatomic Pathology Resident and PhD Student, Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, IN; and Molecular Pathology Fellow, National Institutes of Health Comparative Biomedical Scientist Training Program, Bethesda, MD
| | - Lindsay Wilson
- Research Assistant III, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX
| | - Kiersten L Maldonado
- Imaging Research Technician, Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ramesh Tailor
- Associate Professor, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lori R Hill
- Associate Professor, Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - James A Bankson
- Professor, Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Stephen Lai
- Professor, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - F Kurtis Kasper
- Associate Professor, Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX
| | - Simon Young
- Assistant Professor, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX.
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10
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Piotrowski SL, Wilson L, Dharmaraj N, Hamze A, Clark A, Tailor R, Hill LR, Lai S, Kasper FK, Young S. Development and Characterization of a Rabbit Model of Compromised Maxillofacial Wound Healing. Tissue Eng Part C Methods 2020; 25:160-167. [PMID: 30747042 PMCID: PMC6457326 DOI: 10.1089/ten.tec.2018.0361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPACT STATEMENT Maxillofacial defects often present the clinical challenge of a compromised wound bed. Preclinical evaluation of tissue engineering techniques developed to facilitate healing and reconstruction typically involves animal models with ideal wound beds. The healthy wound bed scenario does not fully mimic the complex clinical environment in patients, which can lead to technology failure when translating from preclinical in vivo research to clinical use. The reported preclinical animal model of compromised wound healing enables investigation of tissue engineering technologies in a more clinically relevant scenario, potentially fostering translation of promising results in preclinical research to patients.
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Affiliation(s)
- Stacey L Piotrowski
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas.,2 Center for Laboratory Animal Medicine and Care, The University of Texas Health Science Center, Houston, Texas.,3 Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lindsay Wilson
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Neeraja Dharmaraj
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Amani Hamze
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Ashley Clark
- 4 Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
| | - Ramesh Tailor
- 5 Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lori R Hill
- 3 Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen Lai
- 6 Division of Surgery, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - F Kurtis Kasper
- 7 Department of Orthodontics, School of Dentistry, Graduate School of Biomedical Sciences, The University of Texas Health Science Center, Houston, Texas
| | - Simon Young
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center, Houston, Texas
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Desoutter A, Langonnet S, Deneuve S, Bera JC, Chaux-Bodard AG. Validation of a rabbit model of irradiated bone healing: preliminary report. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: External radiotherapy can lead to severe bone alteration. The aim of this pilot study was to validate a model for assessment of postextractional bone healing in the irradiated rabbit mandible. Material and method: The radiation protocol consisted of 5 sessions delivering 8.5 Gy each. Surgery was performed immediately after completion of radiotherapy. Sacrifices were performed from Day 0 to Day 42. Results: The bone mineral density and the trabecular number were decreased after radiotherapy whereas trabecular separation increased. The main differences between irradiated and non-irradiated rabbits were observed at Day 28 and 42. Discussion: Radiation seems to cause a delay in bone healing. It decreases bone quality and bone mineral density. Five sessions seem to be a valuable compromise between tissues effect and feasibility of the experiment. Conclusion: This model seems to be valuable for evaluating postextractional bone healing in the irradiated rabbit mandible.
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