Wound healing protein profiles in the postoperative exudate of bisphosphonate-related osteonecrosis of mandible.
Kim. Soung Min SM; Eo. Mi Young MY; Cho. Yun Ju YJ; Kim. Yeon Sook YS; Lee. Suk Keun SK
Key Findings
- LL‑37 levels were lower in the first 6 hours after surgery in BRONJ patients compared to chronic mandibular osteomyelitis controls.
- By day two, LL‑37 and another antimicrobial peptide (β‑defensin‑1) were higher in the BRONJ group.
- The postoperative fluid showed a mix of increased inflammatory, angiogenic, and bone‑forming signals, suggesting active wound healing.
Practical Outcomes
- For most self‑experimenters, this research doesn’t change daily supplement or lifestyle routines because it focuses on a specific jaw bone disease and surgical context. It does, however, reinforce that LL‑37 naturally rises during later stages of bone wound healing, hinting that boosting this peptide might be more relevant after the initial inflammatory phase. Until targeted LL‑37 therapies are available, the findings are mainly of academic interest rather than a direct protocol to apply.
Summary
The study looked at the levels of the antimicrobial peptide LL‑37 (and other proteins) in fluid that drains from jaw bone wounds after surgery for bisphosphonate‑related osteonecrosis. It found that LL‑37 was low early after surgery but rose by day two, while other inflammation and healing signals were also different compared to regular bone infections.
Abstract
Recurrent bacterial infections in cases of bisphosphonate-related osteonecrosis of jaw (BRONJ) frequently occur. Therefore, BRONJ are usually treated by radical saucerization followed by intensive antibiotic medications without bisphosphonate therapy. The postoperative exudate (POE) from BRONJ lesions may directly indicate the inflammatory status of osteomyelitis in patients, but so far, the POE has rarely been examined for its expression of various cytokines and wound healing proteins. A total of 27 cases of BRONJ, which involved the mandible, were selected and their individual POE collected 6 h, 1 day, and 2 days after surgical intervention was analyzed by immunoprecipitation high performance liquid chromatography (IP-HPLC). The different protein expressions in the BRONJ POE were compared with findings from ten cases of chronic mandibular osteomyelitis (CMO) exudate as the control group. For the protein expressions for inflammation, osteogenesis, and angiogenesis, in the 6 h POE sample, the BRONJ exudate exhibited more expression of IL-10, IL-28, OPG, and osteocalcin, but less expression of TNFα and LL-37 than the control. In the 1 day POE sample, the BRONJ exudate showed more expression of TNFα, IL-6, 8, 12, 28, α1-antitrypsin, VEGF-A, and VEGF-C, but less expression of CD68, lysozyme, bFGF, RANKL, bFGF, and ALP than the control. In the 2 day POE sample, the BRONJ exudate consistently showed more expression of LL-37, β-defensin-1, and VEGF-A than the control. The present BRONJ POE revealed the rapid progress of bony wound healing through increased molecular signaling for inflammation, angiogenesis, and osteogenesis compared to the control. Therefore, it was suggested that the POE obtained from the postoperative bony lesions should be collected and analyzed by the IP-HPLC method to predict the prognosis of seriously complicated inflammatory bony diseases such as BRONJ.
Study Information
pubmed
2017
2017-06-24T00:00:00.000Z
10.1007/s00405-017-4657-x
11
25