Oxidative stress in bisphosphonate-related osteonecrosis of the jaws.
OBJECTIVE
To analyze whether oxidative stress (OS) changes are present in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ) versus controls.


METHODS
Oxidative stress was analyzed in serum and unstimulated saliva of three groups: Group 1 consisted of 24 patients who had been treated with intravenous bisphosphonates (ivBPs) and developed BRONJ, group 2 consisted of 20 patients who had received ivBPs and did not develop BRONJ, and group 3 comprised 17 control subjects. Reduced glutathione (GSH), malondialdehyde (MDA), oxidized glutathione (GSSG), and 8-oxo-7,8-dihydro-2-deoxyguanosine (8-oxo-dG) levels, as well as the GSSG/GSH ratio, were measured.


RESULTS
Mean serum and saliva levels of MDA, GSSG, and 8-oxo-dG and the GSSG/GSH ratio were significantly higher in patients with BRONJ than in controls. We found no significant difference in OS according to BRONJ stage, sex, or location in the jaws. Logistic regression analysis revealed that the GSSG/GSH ratio was a significant factor predicting the development of BRONJ (P = 0.01).


CONCLUSIONS
Oxidative stress was detected in patients with BRONJ, and the GSSG/GSH ratio was the most significant OS variable found; it was a significant factor predicting the development of BRONJ.
Department of Oral Medicine, Valencia University, Valencia, Spain; Service of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain.
Jose
J
Bagan
Guillermo T
GT
Sáez
M Carmen
MC
Tormos
Carmen
C
Gavalda-Esteve
Leticia
L
Bagan
Manuel
M
Leopoldo-Rodado
Javier
J
Calvo
Carlos
C
Camps
D000080242:8-Hydroxy-2'-Deoxyguanosine; D061605:Administration, Intravenous; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000097:blood / Q000378:metabolism*; D001943:Breast Neoplasms / Q000188:drug therapy; D016022:Case-Control Studies; D004245:DMF Index; D003774:Dental Plaque Index; D003849:Deoxyguanosine / Q000031:analogs & derivatives / Q000032:analysis / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage; D005260:Female; D005978:Glutathione / Q000032:analysis / Q000097:blood; D019803:Glutathione Disulfide / Q000032:analysis / Q000097:blood; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000032:analysis / Q000097:blood; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy; D009911:Oral Hygiene Index; D018384:Oxidative Stress / Q000502:physiology*; D012463:Saliva / Q000737:chemistry; D012737:Sex Factors
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D015415:Biomarkers; D004164:Diphosphonates; D008315:Malondialdehyde; D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine; D005978:Glutathione; D019803:Glutathione Disulfide
8-oxo-dG; GSH; GSSG; MDA; bisphosphonate-related osteonecrosis; oxidative stress