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Abdolrahmani A, Epstein JB, Samim F. Medication-related osteonecrosis of the jaw: evolving research for multimodality medical management. Support Care Cancer 2024; 32:212. [PMID: 38443685 DOI: 10.1007/s00520-024-08388-4] [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: 09/30/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating side effect of antiresorptive and antiangiogenic agents that can lead to progressive bone destruction in the maxillofacial region. Dental surgery, including tooth extractions, commonly trigger the onset of MRONJ. While guidelines suggest avoiding extraction when possible, complete avoidance is not always feasible, as necrosis can develop from dental and periodontal disease without dental procedures. The goal of this article is to provide an update review of current preventive and therapeutic approaches for MRONJ. METHODS A comprehensive electronic search was conducted on PubMed/MEDLINE, Embase, and Scopus databases. All English articles encompassing randomized controlled trials, systematic reviews, observational studies, and case studies were reviewed. The current medical treatments and adjuvant therapies for managing MRONJ patients were critically assessed and summarized. RESULTS Pentoxifylline and alpha tocopherol (PENT-E), teriparatide, photobiomodulation (PBM), photodynamic therapy (PDT), and the use of growth factors have shown to enhance healing in MRONJ patients. Implementing these methods alone or in conjunction with surgical treatment has been linked to reduced discomfort and improved wound healing and increased new bone formation. DISCUSSION While several adjuvant treatment modalities exhibit promising results in facilitating the healing process, current clinical practice guidelines predominantly recommend antibiotic therapy as a non-surgical approach, primarily addressing secondary infections in necrotic areas. However, this mainly addresses the potential infectious complication of MRONJ. Medical approaches including PENT-E, teriparatide, PBM, and PDT can result in successful management and should be considered prior to taking a surgical approach. Combined medical management for both preventing and managing MRONJ holds potential for achieving optimal clinical outcomes and avoiding surgical intervention, requiring further validation through larger studies and controlled trials.
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Affiliation(s)
- Ali Abdolrahmani
- Oral Medicine & Oral Pathology Clinic, Montreal General Hospital, Montreal, QC, Canada
| | - Joel B Epstein
- Department of Surgery, City of Hope National Cancer Center, Duarte, CA, USA
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Firoozeh Samim
- Faculty of Dental Medicine and Oral Health, McGill University, Montreal, QC, Canada.
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Calderipe CB, Soares AC, Dos Santos Giorgis R, Fogaça ACM, Torriani MA, Grave LQ, Schuch LF, Vasconcelos ACU. What is the effect of lactoferrin on oral and jawbone tissue repair? A systematic review. Br J Oral Maxillofac Surg 2024; 62:4-14. [PMID: 38042716 DOI: 10.1016/j.bjoms.2023.10.019] [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: 08/20/2023] [Revised: 09/26/2023] [Accepted: 10/26/2023] [Indexed: 12/04/2023]
Abstract
Currently, there is growing interest in the potential use of lactoferrin (LTF), a member of the transferrin family, for the improvement of tissue healing. In this sense, a literature search was conducted to integrate data published on the effect of LTF on jawbone repair. PubMed/MEDLINE, Scopus, Embase, Web of Science, LILACS, and Cochrane databases were retrieved according to the PRISMA 2020 statement. Articles in English, Spanish, and Portuguese were recovered, with no year restriction. In vitro, in vivo, and clinical studies were selected. A total of 742 articles were retrieved, 11 of which met the inclusion criteria (5 in vitro and 5 in vivo studies, and one clinical trial). The included data demonstrated wide variations in study design and LTF therapy protocols. Cell proliferation and viability were the primary outcomes evaluated in the in vitro studies, all of which reported a potential effect of LTF on the repair process. Of three in vivo studies, one reported a reduction in the overall healing rate, whereas the other two showed that LTF inhibited bone resorption and increased bone formation. The clinical trial's findings showed that LTF is a potential promoter of wound repair in patients with medication-related osteonecrosis of the jaws. Overall, data from the studies support a potential effect of LTF therapy on the process of jawbone repair.
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Affiliation(s)
- Camila Barcellos Calderipe
- Department of Oral Diagnosis, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brazil
| | - Alini Cardoso Soares
- Diagnostic Center of Oral Diseases, Dental School, Federal University of Pelotas - UFPel, Pelotas, Rio Grande do Sul, Brazil
| | - Rafael Dos Santos Giorgis
- Oral Surgery Department, Dental School, Federal University of Pelotas - UFPel, Pelotas, Rio Grande do Sul, Brazil
| | | | - Marcos Antonio Torriani
- Oral Surgery Department, Dental School, Federal University of Pelotas - UFPel, Pelotas, Rio Grande do Sul, Brazil
| | - Luisa Quevedo Grave
- Diagnostic Center of Oral Diseases, Dental School, Federal University of Pelotas - UFPel, Pelotas, Rio Grande do Sul, Brazil
| | - Lauren Frenzel Schuch
- Molecular Pathology Area, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay
| | - Ana Carolina Uchoa Vasconcelos
- Diagnostic Center of Oral Diseases, Dental School, Federal University of Pelotas - UFPel, Pelotas, Rio Grande do Sul, Brazil.
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Salafutdinov II, Gatina DZ, Markelova MI, Garanina EE, Malanin SY, Gazizov IM, Izmailov AA, Rizvanov AA, Islamov RR, Palotás A, Safiullov ZZ. A Biosafety Study of Human Umbilical Cord Blood Mononuclear Cells Transduced with Adenoviral Vector Carrying Human Vascular Endothelial Growth Factor cDNA In Vitro. Biomedicines 2023; 11:2020. [PMID: 37509661 PMCID: PMC10377014 DOI: 10.3390/biomedicines11072020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The biosafety of gene therapy remains a crucial issue for both the direct and cell-mediated delivery of recombinant cDNA encoding biologically active molecules for the pathogenetic correction of congenital or acquired disorders. The diversity of vector systems and cell carriers for the delivery of therapeutic genes revealed the difficulty of developing and implementing a safe and effective drug containing artificial genetic material for the treatment of human diseases in practical medicine. Therefore, in this study we assessed changes in the transcriptome and secretome of umbilical cord blood mononuclear cells (UCB-MCs) genetically modified using adenoviral vector (Ad5) carrying cDNA encoding human vascular endothelial growth factor (VEGF165) or reporter green fluorescent protein (GFP). A preliminary analysis of UCB-MCs transduced with Ad5-VEGF165 and Ad5-GFP with MOI of 10 showed efficient transgene expression in gene-modified UCB-MCs at mRNA and protein levels. The whole transcriptome sequencing of native UCB-MCs, UCB-MC+Ad5-VEGF165, and UCB-MC+Ad5-GFP demonstrated individual sample variability rather than the effect of Ad5 or the expression of recombinant vegf165 on UCB-MC transcriptomes. A multiplex secretome analysis indicated that neither the transduction of UCB-MCs with Ad5-GFP nor with Ad5-VEGF165 affects the secretion of the studied cytokines, chemokines, and growth factors by gene-modified cells. Here, we show that UCB-MCs transduced with Ad5 carrying cDNA encoding human VEGF165 efficiently express transgenes and preserve transcriptome and secretome patterns. This data demonstrates the biosafety of using UCB-MCs as cell carriers of therapeutic genes.
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Affiliation(s)
- Ilnur I Salafutdinov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Dilara Z Gatina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Maria I Markelova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Ekaterina E Garanina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Sergey Yu Malanin
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Ilnaz M Gazizov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
| | - Andrei A Izmailov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
| | - Albert A Rizvanov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Rustem R Islamov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
| | - András Palotás
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
- Asklepios-Med (Private Medical Practice and Research Center), H-6722 Szeged, Hungary
- Tokaj-Hegyalja University, H-3910 Tokaj, Hungary
| | - Zufar Z Safiullov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
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Salafutdinov II, Gazizov IM, Gatina DK, Mullin RI, Bogov AA, Islamov RR, Kiassov AP, Masgutov RF, Rizvanov AA. Influence of Recombinant Codon-Optimized Plasmid DNA Encoding VEGF and FGF2 on Co-Induction of Angiogenesis. Cells 2021; 10:cells10020432. [PMID: 33670607 PMCID: PMC7922559 DOI: 10.3390/cells10020432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Over the past few decades, several methods have been proposed to stimulate skin wound healing. The most promising of these are gene therapy and stem cell therapy. Our present experiments have combined several approaches utilizing human umbilical cord blood mononuclear cells using cell therapy, and direct gene therapy using genetic constructs to accelerate complete healing of skin wounds in rats. Studies have shown that the transplantation of transfected cells stopped proliferative processes in regenerating wounds earlier than the transplantation of untransfected cells. The use of direct gene therapy using the VEGF and FGF2 genes stimulates the revascularization of the rat cutaneous wound. Abstract Several methods for the stimulation of skin wound repair have been proposed over the last few decades. The most promising among them are gene and stem cell therapy. Our present experiments combined several approaches via the application of human umbilical cord blood mononuclear cells (hUCB-MC) that were transfected with pBud-VEGF165-FGF2 plasmid (gene-cell therapy) and direct gene therapy using pBud-VEGF165-FGF2 plasmid to enhance healing of full thickness skin wounds in rats. The dual expression cassette plasmid pBud-VEGF165-FGF2 encodes both VEGF and FGF2 therapeutic genes, expressing pro-angiogenic growth factors. Our results showed that, with two weeks post-transplantation, some transplanted cells still retained expression of the stem cell and hematopoietic markers C-kit and CD34. Other transplanted cells were found among keratinocytes, hair follicle cells, endothelial cells, and in the derma. PCNA expression studies revealed that transplantation of transfected cells terminated proliferative processes in regenerating wounds earlier than transplantation of untransfected cells. In the direct gene therapy group, four days post-operatively, the processes of flap revascularization, while using Easy LDI Microcirculation Camera, was higher than in control wounded skin. We concluded that hUCB-MC can be used for the treatment of skin wounds and transfection these cells with VEGF and FGF2 genes enhances their regenerative abilities. We also concluded that the application of pBud-VEGF165-FGF2 plasmids is efficient for the direct gene therapy of skin wounds by stimulation of wound revascularization.
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Affiliation(s)
- Ilnur I. Salafutdinov
- Research Laboratory Omics Technology, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia;
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (A.P.K.); (R.F.M.)
- Correspondence: (I.I.S.); (A.A.R.)
| | - Ilnaz M. Gazizov
- Department of Human Anatomy, Kazan State Medical University, 420012 Kazan, Russia;
| | - Dilara K. Gatina
- Research Laboratory Omics Technology, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia;
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (A.P.K.); (R.F.M.)
| | - Ruslan I. Mullin
- Department of Orthopaedics, Republic Clinical Hospital, 420064 Kazan, Russia; (R.I.M.); (A.A.B.)
| | - Alexey A. Bogov
- Department of Orthopaedics, Republic Clinical Hospital, 420064 Kazan, Russia; (R.I.M.); (A.A.B.)
| | - Rustem R. Islamov
- Department of Medical Biology and Genetics, Kazan State Medical University, 420012 Kazan, Russia;
| | - Andrey P. Kiassov
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (A.P.K.); (R.F.M.)
- Morphology and General Pathology Department, Institute of Fundamental Medicine and Biology, Federal University, 420008 Kazan, Russia
| | - Ruslan F. Masgutov
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (A.P.K.); (R.F.M.)
- Department of Orthopaedics, Republic Clinical Hospital, 420064 Kazan, Russia; (R.I.M.); (A.A.B.)
| | - Albert A. Rizvanov
- Research Laboratory Omics Technology, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia;
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (A.P.K.); (R.F.M.)
- Correspondence: (I.I.S.); (A.A.R.)
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