The cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is poorly understood.
However, since nitrogen-containing bisphosphonates (NBPs) have been shown to reduce
bone remodeling and angiogenesis, the suppression of bone turnover and jaw angiogenesis
by NBPs has been proposed as an underlying mechanism for BRONJ. Although innate immunity
has a critical role in the inflammation process, few studies have investigated the
possibility that BRONJ might reflect an immune response. However, in 2012 it was reported
that gd T cells, which are a subset of T cells, showed a significant and permanent
decline, both in proportion and in absolute number, following infusion of an NBP.
Regarding the treatment of BRONJ, although teriparatide, which is a recombinant form
of parathyroid hormone that promotes bone growth, has not been widely used in the
treatment of BRONJ, there have been a few reports of teriparatide use for the treatment
of BRONJ. Administration of teriparatide for the resolution of BRONJ was first described
by Harper and Fung in 2007. Subsequently, the administration of teriparatide has been
documented in independent case reports. In this study, we analyzed lymphocytes including
gd T cells, which are of the same origin as osteoclasts, like all typical immune cells,
and we focused on the relationship between innate immunity and NBP and teriparatide
treatments, and their effects on inflammatory cytokine production.
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© 2016 Published by Elsevier Inc.