Effect of anti-angiogenesis induced by chemotherapeutic monotherapy, chemotherapeutic/bisphosphonate combination therapy and anti-VEGFA mAb therapy on tooth extraction socket healing in mice

Osteonecrosis of the jaw (ONJ), which is a rare but severe adverse effect, mainly occurs in oncology patients receiving chemotherapeutic agents and bisphosphonates. However, the combined impact of chemotherapy and bisphosphonates on wound healing after tooth extraction remains unknown. The aim of th...

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Veröffentlicht in:Journal of bone and mineral metabolism 2018-09, Vol.36 (5), p.547-559
Hauptverfasser: Akita, Yuri, Kuroshima, Shinichiro, Nakajima, Kazunori, Hayano, Hiroki, Kanai, Riho, Sasaki, Muneteru, Sawase, Takashi
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container_issue 5
container_start_page 547
container_title Journal of bone and mineral metabolism
container_volume 36
creator Akita, Yuri
Kuroshima, Shinichiro
Nakajima, Kazunori
Hayano, Hiroki
Kanai, Riho
Sasaki, Muneteru
Sawase, Takashi
description Osteonecrosis of the jaw (ONJ), which is a rare but severe adverse effect, mainly occurs in oncology patients receiving chemotherapeutic agents and bisphosphonates. However, the combined impact of chemotherapy and bisphosphonates on wound healing after tooth extraction remains unknown. The aim of this study was to determine the precise etiology of ONJ induced by chemotherapy and bisphosphonate combination therapy. Mice received zoledronate (ZA) monotherapy, cyclophosphamide (CY) monotherapy or CY/ZA combination therapy. The maxillary first molars were extracted 3 weeks after the initiation of drug treatment. Moreover, antivascular endothelial growth factor A (VEGFA) monoclonal antibody (mAb) was administered once every 2 days just after tooth extraction for 2 weeks. Soft and hard tissue wound healing was evaluated 2 and 4 weeks post-extraction using histomorphometry, microcomputed tomography and immunohistochemistry. ZA monotherapy did not induce impaired oral wound healing and ONJ-like lesions 2 and 4 weeks post-extraction, respectively. Tooth extraction socket healing worsened with severe anti-angiogenesis by CY monotherapy and CY/ZA combination therapy 2 weeks post-extraction. However, CY monotherapy rarely induced ONJ-like lesions with severe angiogenesis suppression, whereas CY/ZA combination therapy frequently induced ONJ-like lesions with severe angiogenesis inhibition 4 weeks post-extraction. Interestingly, anti-VEGFA mAb therapy delayed osseous wound healing with normal soft tissue wound healing of tooth extraction sockets, although this therapy significantly suppressed blood vessel formation. Our findings suggest that anti-angiogenesis alone is not the main cause of ONJ-like lesions induced by CY/ZA combination therapy. The combination of suppressed osteoclasts and anti-angiogenesis, in addition to other risk factors such as chemotherapy, may contribute to the development of ONJ.
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However, the combined impact of chemotherapy and bisphosphonates on wound healing after tooth extraction remains unknown. The aim of this study was to determine the precise etiology of ONJ induced by chemotherapy and bisphosphonate combination therapy. Mice received zoledronate (ZA) monotherapy, cyclophosphamide (CY) monotherapy or CY/ZA combination therapy. The maxillary first molars were extracted 3 weeks after the initiation of drug treatment. Moreover, antivascular endothelial growth factor A (VEGFA) monoclonal antibody (mAb) was administered once every 2 days just after tooth extraction for 2 weeks. Soft and hard tissue wound healing was evaluated 2 and 4 weeks post-extraction using histomorphometry, microcomputed tomography and immunohistochemistry. ZA monotherapy did not induce impaired oral wound healing and ONJ-like lesions 2 and 4 weeks post-extraction, respectively. Tooth extraction socket healing worsened with severe anti-angiogenesis by CY monotherapy and CY/ZA combination therapy 2 weeks post-extraction. However, CY monotherapy rarely induced ONJ-like lesions with severe angiogenesis suppression, whereas CY/ZA combination therapy frequently induced ONJ-like lesions with severe angiogenesis inhibition 4 weeks post-extraction. Interestingly, anti-VEGFA mAb therapy delayed osseous wound healing with normal soft tissue wound healing of tooth extraction sockets, although this therapy significantly suppressed blood vessel formation. Our findings suggest that anti-angiogenesis alone is not the main cause of ONJ-like lesions induced by CY/ZA combination therapy. The combination of suppressed osteoclasts and anti-angiogenesis, in addition to other risk factors such as chemotherapy, may contribute to the development of ONJ.</description><identifier>ISSN: 0914-8779</identifier><identifier>EISSN: 1435-5604</identifier><identifier>DOI: 10.1007/s00774-017-0872-1</identifier><identifier>PMID: 29043461</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject><![CDATA[Angiogenesis ; Angiogenesis Inhibitors - administration & dosage ; Angiogenesis Inhibitors - pharmacology ; Animals ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - pharmacology ; Antineoplastic Agents - pharmacology ; Antineoplastic Agents - therapeutic use ; Bisphosphonates ; Blood Vessels - drug effects ; Bone Density Conservation Agents - therapeutic use ; Chemotherapy ; Combination therapy ; Computed tomography ; Cyclophosphamide ; Diphosphonates - administration & dosage ; Diphosphonates - pharmacology ; Drug Therapy, Combination ; Etiology ; Histomorphometry ; Imidazoles - administration & dosage ; Imidazoles - pharmacology ; Immunohistochemistry ; Jaw ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Mice, Inbred C57BL ; Molars ; Monoclonal antibodies ; Original Article ; Orthopedics ; Osteoclasts ; Osteonecrosis ; Risk factors ; Teeth ; Tooth Extraction ; Tooth Socket - drug effects ; Tooth Socket - pathology ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Vascular Endothelial Growth Factor A - pharmacology ; Wound healing ; Wound Healing - drug effects ; X-Ray Microtomography ; Zoledronic Acid]]></subject><ispartof>Journal of bone and mineral metabolism, 2018-09, Vol.36 (5), p.547-559</ispartof><rights>The Japanese Society for Bone and Mineral Research and Springer Japan KK 2017</rights><rights>Journal of Bone and Mineral Metabolism is a copyright of Springer, (2017). 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However, the combined impact of chemotherapy and bisphosphonates on wound healing after tooth extraction remains unknown. The aim of this study was to determine the precise etiology of ONJ induced by chemotherapy and bisphosphonate combination therapy. Mice received zoledronate (ZA) monotherapy, cyclophosphamide (CY) monotherapy or CY/ZA combination therapy. The maxillary first molars were extracted 3 weeks after the initiation of drug treatment. Moreover, antivascular endothelial growth factor A (VEGFA) monoclonal antibody (mAb) was administered once every 2 days just after tooth extraction for 2 weeks. Soft and hard tissue wound healing was evaluated 2 and 4 weeks post-extraction using histomorphometry, microcomputed tomography and immunohistochemistry. ZA monotherapy did not induce impaired oral wound healing and ONJ-like lesions 2 and 4 weeks post-extraction, respectively. Tooth extraction socket healing worsened with severe anti-angiogenesis by CY monotherapy and CY/ZA combination therapy 2 weeks post-extraction. However, CY monotherapy rarely induced ONJ-like lesions with severe angiogenesis suppression, whereas CY/ZA combination therapy frequently induced ONJ-like lesions with severe angiogenesis inhibition 4 weeks post-extraction. Interestingly, anti-VEGFA mAb therapy delayed osseous wound healing with normal soft tissue wound healing of tooth extraction sockets, although this therapy significantly suppressed blood vessel formation. Our findings suggest that anti-angiogenesis alone is not the main cause of ONJ-like lesions induced by CY/ZA combination therapy. 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However, the combined impact of chemotherapy and bisphosphonates on wound healing after tooth extraction remains unknown. The aim of this study was to determine the precise etiology of ONJ induced by chemotherapy and bisphosphonate combination therapy. Mice received zoledronate (ZA) monotherapy, cyclophosphamide (CY) monotherapy or CY/ZA combination therapy. The maxillary first molars were extracted 3 weeks after the initiation of drug treatment. Moreover, antivascular endothelial growth factor A (VEGFA) monoclonal antibody (mAb) was administered once every 2 days just after tooth extraction for 2 weeks. Soft and hard tissue wound healing was evaluated 2 and 4 weeks post-extraction using histomorphometry, microcomputed tomography and immunohistochemistry. ZA monotherapy did not induce impaired oral wound healing and ONJ-like lesions 2 and 4 weeks post-extraction, respectively. Tooth extraction socket healing worsened with severe anti-angiogenesis by CY monotherapy and CY/ZA combination therapy 2 weeks post-extraction. However, CY monotherapy rarely induced ONJ-like lesions with severe angiogenesis suppression, whereas CY/ZA combination therapy frequently induced ONJ-like lesions with severe angiogenesis inhibition 4 weeks post-extraction. Interestingly, anti-VEGFA mAb therapy delayed osseous wound healing with normal soft tissue wound healing of tooth extraction sockets, although this therapy significantly suppressed blood vessel formation. Our findings suggest that anti-angiogenesis alone is not the main cause of ONJ-like lesions induced by CY/ZA combination therapy. The combination of suppressed osteoclasts and anti-angiogenesis, in addition to other risk factors such as chemotherapy, may contribute to the development of ONJ.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>29043461</pmid><doi>10.1007/s00774-017-0872-1</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-9891-9987</orcidid></addata></record>
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subjects Angiogenesis
Angiogenesis Inhibitors - administration & dosage
Angiogenesis Inhibitors - pharmacology
Animals
Antibodies, Monoclonal - administration & dosage
Antibodies, Monoclonal - pharmacology
Antineoplastic Agents - pharmacology
Antineoplastic Agents - therapeutic use
Bisphosphonates
Blood Vessels - drug effects
Bone Density Conservation Agents - therapeutic use
Chemotherapy
Combination therapy
Computed tomography
Cyclophosphamide
Diphosphonates - administration & dosage
Diphosphonates - pharmacology
Drug Therapy, Combination
Etiology
Histomorphometry
Imidazoles - administration & dosage
Imidazoles - pharmacology
Immunohistochemistry
Jaw
Male
Medicine
Medicine & Public Health
Metabolic Diseases
Mice, Inbred C57BL
Molars
Monoclonal antibodies
Original Article
Orthopedics
Osteoclasts
Osteonecrosis
Risk factors
Teeth
Tooth Extraction
Tooth Socket - drug effects
Tooth Socket - pathology
Vascular Endothelial Growth Factor A - antagonists & inhibitors
Vascular Endothelial Growth Factor A - pharmacology
Wound healing
Wound Healing - drug effects
X-Ray Microtomography
Zoledronic Acid
title Effect of anti-angiogenesis induced by chemotherapeutic monotherapy, chemotherapeutic/bisphosphonate combination therapy and anti-VEGFA mAb therapy on tooth extraction socket healing in mice
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