Dynamic polarization shifting from M1 to M2 macrophages in reduced osteonecrosis of the jaw-like lesions by cessation of anti-RANKL antibody in mice

Copyright © 2020 Elsevier Inc. All rights reserved..

Denosumab-related osteonecrosis of the jaw (DRONJ), which mainly occurs in cancer patients receiving anti-receptor activator NF-kappaB ligand (RANKL) antibody, reduces oral health-related quality of life. However, the exact mechanisms of and definitive treatment strategies for DRONJ remain unknown. We hypothesized that cessation of denosumab heals and/or ameliorates DRONJ, since it is a protein-based antibody agent, although stopping denosumab should be avoided in clinical situations. Therefore, the aims of this study were: 1) to create a healing and/or amelioration murine model of DRONJ-like lesions induced by chemotherapy/anti-RANKL antibody (mAb) combination therapy and tooth extraction; and 2) to investigate histopathology and immunopathology in the extraction sockets by comparing the murine model of DRONJ-like lesions with the amelioration/healing model of DRONJ-like lesions. Eight-week-old, female C57B/6J mice received chemotherapeutic drug (cyclophosphamide: CY) and mAb combination therapy (CY/mAb) with tooth extraction. Open wounds were sustained in CY/mAb-treated mice at 2 and 4 weeks post-extraction. Impaired socket healing was diagnosed as CY/mAb-related ONJ-like lesions at 3 weeks post-extraction in this study. Next, mAb was discontinued for 2 and 4 weeks after diagnosis of CY/mAb-related ONJ-like lesions. mAb cessation for 2 weeks induced partial osseous wound healing and significantly improved soft tissue wound healing of the extraction sockets. Anti-angiogenesis and normal lymphangiogenesis with CY/mAb combination therapy was not changed by mAb discontinuation. However, mAb cessation for 2 weeks significantly increased the number of CD38+F4/80+ M1 and CD163+F4/80+ M2 macrophages, which significantly increased the M2/M1 ratio in the connective tissue of extraction sockets. No direct effects of mAb on macrophages were noted both in vivo and in vitro. Therefore, the developed healing and/or amelioration murine model of CY/mAb-related ONJ-like lesions is a useful tool to investigate the histopathology and immunopathology of DRONJ in humans. Dynamic polarization shifting from M1 to M2 macrophages induced by mAb cessation may play an important role in wound healing, rather than angiogenesis and lymphangiogenesis, in DRONJ.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:141

Enthalten in:

Bone - 141(2020) vom: 01. Dez., Seite 115560

Sprache:

Englisch

Beteiligte Personen:

Tamaki, Saki [VerfasserIn]
Kuroshima, Shinichiro [VerfasserIn]
Hayano, Hiroki [VerfasserIn]
Nakajima, Kazunori [VerfasserIn]
Kakehashi, Hiroe [VerfasserIn]
Ishisaki, Akira [VerfasserIn]
Sawase, Takashi [VerfasserIn]

Links:

Volltext

Themen:

4EQZ6YO2HI
Anti-RANKL antibody
Bone Density Conservation Agents
Denosumab
Journal Article
Ligands
Macrophage
NF-kappa B
Osteonecrosis of the jaw
RANK Ligand
Research Support, Non-U.S. Gov't
Tnfsf11 protein, mouse
Tooth extraction
Wound healing

Anmerkungen:

Date Completed 17.06.2021

Date Revised 31.05.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.bone.2020.115560

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM313064776