Oxidative stress in bisphosphonate-related osteonecrosis of the jaws

• Published in: Journal of oral pathology & medicine Vol. 43; no. 5; pp. 371 - 377
• Main Authors: Bagan, Jose, Sáez, Guillermo T., Tormos, M. Carmen, Gavalda-Esteve, Carmen, Bagan, Leticia, Leopoldo-Rodado, Manuel, Calvo, Javier, Camps, Carlos
• Format: Journal Article
• Language: English
• Published: Frederiksberg Blackwell Publishing Ltd 01-05-2014; Wiley
• Subjects: 8-oxo-dG; Administration, Intravenous; Adrenal Cortex Hormones - therapeutic use; Aged; Antineoplastic Agents - administration & dosage; Biological and medical sciences; Biomarkers - analysis; Biomarkers - blood; Bisphosphonate-Associated Osteonecrosis of the Jaw - blood; Bisphosphonate-Associated Osteonecrosis of the Jaw - metabolism; bisphosphonate-related osteonecrosis; Bones, joints and connective tissue. Antiinflammatory agents; Breast Neoplasms - drug therapy; Case-Control Studies; Dental Plaque Index; Dentistry; Deoxyguanosine - analogs & derivatives; Deoxyguanosine - analysis; Deoxyguanosine - blood; Diphosphonates - administration & dosage; Diseases of the osteoarticular system; DMF Index; Female; Glutathione - analysis; Glutathione - blood; Glutathione Disulfide - analysis; Glutathione Disulfide - blood; GSH; GSSG; Humans; Male; Malondialdehyde - analysis; Malondialdehyde - blood; MDA; Medical sciences; Middle Aged; Multiple Myeloma - drug therapy; Oral Hygiene Index; Otorhinolaryngology. Stomatology; oxidative stress; Oxidative Stress - physiology; Pharmacology. Drug treatments; Saliva - chemistry; Sex Factors; Vascular bone diseases; Jaw; Oxidative stress; GSSG; Antiosteoporotic; Stomatology; Diseases of the osteoarticular system; ENT; Osteonecrosis; MDA; Bisphosphonates; 8-oxo-dG; bisphosphonate-related osteonecrosis; Antiosteoclastic agent; GSH; oxidative stress
• ISSN: 0904-2512; 1600-0714
• DOI: 10.1111/jop.12151

Objectives
To analyze whether oxidative stress (OS) changes are present in patients with bisphosphonate‐related osteonecrosis of the jaw (BRONJ) versus controls.
Materials and Methods
Oxidative stress was analyzed in serum and unstimulated saliva of three groups: Group 1 consisted of 24 patients who had been treated with intravenous bisphosphonates (ivBPs) and developed BRONJ, group 2 consisted of 20 patients who had received ivBPs and did not develop BRONJ, and group 3 comprised 17 control subjects. Reduced glutathione (GSH), malondialdehyde (MDA), oxidized glutathione (GSSG), and 8–oxo‐7,8‐dihydro‐2‐deoxyguanosine (8‐oxo‐dG) levels, as well as the GSSG/GSH ratio, were measured.
Results
Mean serum and saliva levels of MDA, GSSG, and 8‐oxo‐dG and the GSSG/GSH ratio were significantly higher in patients with BRONJ than in controls. We found no significant difference in OS according to BRONJ stage, sex, or location in the jaws. Logistic regression analysis revealed that the GSSG/GSH ratio was a significant factor predicting the development of BRONJ (P = 0.01).
Conclusions
Oxidative stress was detected in patients with BRONJ, and the GSSG/GSH ratio was the most significant OS variable found; it was a significant factor predicting the development of BRONJ.