ABSTRACT
Proton pump inhibitors (PPIs) are among the most commonly prescribed medicines for the management of acid-related gastrointestinal diseases. Osteonecrosis of the jaw (ONJ) is a serious adverse event that is associated with the use of antiresorptive and antiangiogenic agents. According to previous clinical reports, the use of PPIs contributes to the pathogenesis of severe ONJ that requires surgery. Here, we investigated the effects of lansoprazole (LP) or LP in combination with zoledronate (ZOL) on ONJ development in mice. C57BL/6J mice were administered ZOL (125 µg/kg intravenously, twice weekly) and/or LP (10 mg/kg intraperitoneally; 3 weeks of 3 consecutive days followed by 1 day off). One week after initiation of the study, the first molar was atraumatically extracted. Concurrently with ZOL administration, dexamethasone (Dex) was administered (5 mg/kg intraperitoneally, twice weekly). Micro-computed tomography and histological evaluation were performed to characterize femoral structures, tooth extraction sockets, and osteonecrosis areas. The results showed that ZOL/Dex significantly increased bone mass compared to saline/Dex, while the simultaneous administration of LP and ZOL/Dex diminished the ZOL-induced enhancement of bone mass. In the alveolar bone around the tooth extraction socket, necrotic bone was significantly increased in the LP/Dex group compared to the saline/Dex group. However, no signs of more severe ONJ-like lesions were observed following combined administration of LP and ZOL/Dex, other than an increase in the number of non-attached TRAP-positive cells. Our findings in a mouse model suggest that LP use can be a risk factor for the development of ONJ.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Density Conservation Agents , Animals , Bisphosphonate-Associated Osteonecrosis of the Jaw/drug therapy , Bisphosphonate-Associated Osteonecrosis of the Jaw/etiology , Bisphosphonate-Associated Osteonecrosis of the Jaw/pathology , Bone Density Conservation Agents/pharmacology , Dexamethasone/adverse effects , Diphosphonates/pharmacology , Imidazoles , Lansoprazole/pharmacology , Mice , Mice, Inbred C57BL , Tooth Extraction/adverse effects , Tooth Socket/pathology , X-Ray Microtomography , Zoledronic Acid/pharmacologyABSTRACT
Osteonecrosis of the jaw (ONJ) is a serious adverse event that is associated with antiresorptive agents, and it manifests as bone exposure in the maxillofacial region. Previous clinical reports suggest that mechanical trauma would trigger ONJ in a manner that is similar to tooth extractions. To the best of our knowledge, there have been few detailed pathophysiological investigations of the mechanisms by which occlusal/mechanical trauma influences ONJ. Here, we developed a novel mouse model that exhibits ONJ following experimental hyperocclusion and nitrogen-containing bisphosphonate (N-BP) treatment. This in vivo model exhibited ONJ in alveolar bone, particularly in the mandible. Moreover, the experimental hyperocclusion induced remarkable alveolar bone resorption in both mouse mandible and maxilla, whereas N-BP treatment completely prevented alveolar bone resorption. In this study, we also modeled trauma by exposing clumps of mesenchymal stem cells (MSCs)/extracellular matrix complex to hydrostatic pressure in combination with N-BP. Hydrostatic pressure loading induced lactate dehydrogenase (LDH) release by calcified cell clumps that were differentiated from MSCs; this LDH release was enhanced by N-BP priming. These in vivo and in vitro models may contribute further insights into the effect of excessive mechanical loading on ONJ onset in patients with occlusal trauma.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Density Conservation Agents , Bone Resorption , Dental Occlusion, Traumatic , Osteonecrosis , Animals , Bisphosphonate-Associated Osteonecrosis of the Jaw/drug therapy , Bone Density Conservation Agents/adverse effects , Bone Resorption/drug therapy , Dental Occlusion, Traumatic/drug therapy , Diphosphonates/therapeutic use , Humans , Mandible , MiceABSTRACT
Oral candidiasis presents with multiple clinical manifestations. Among known pathogenic Candida species, Candida albicans is the most virulent and acts as the main causative fungus of oral candidiasis. Novel treatment modalities are needed because of emergent drug resistance and frequent candidiasis recurrence. Here, we evaluated the ability of Lacticaseibacillus rhamnosus L8020, isolated from healthy and caries-free volunteers, to prevent against the onset of oral candidiasis in a mouse model. Mice were infected with C. albicans, in the presence or absence of L. rhamnosus L8020. The mice were treated with antibiotics and corticosteroid to disrupt the oral microbiota and induce immunosuppression. We demonstrated that oral consumption of L. rhamnosus L8020 by C. albicans-infected mice abolished the pseudomembranous region of the mouse tongue; it also suppressed changes in the expression levels of pattern recognition receptor and chemokine genes. Our results suggest that L. rhamnosus L8020 has protective or therapeutic potential against oral candidiasis, which supports the potential use of this probiotic strain for oral health management.