Effects of antiresorptive agents on osteomyelitis: Novel insights into the pathogenesis of osteonecrosis of the jaw

Dan Li, Kirill Gromov, Steven T. Proulx, Chao Xie, Jie Li, Daniel P. Crane, Kjeld Søballe, Regis J. O'Keefe, Hani A. Awad, Lianping Xing, Edward M. Schwarz

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

28 Scopus citations

Abstract

The effects of antiresorptive agents (e.g., alendronate [Aln], osteoprotegerin [OPG]) on bone infection are unknown. Thus, their effects on implant-associated osteomyelitis (OM) were investigated in mice using PBS (placebo), gentamycin, and etanercept (TNFR:Fc) controls. None of the drugs affected humoral immunity, angiogenesis, or chronic infection. However, the significant (P < 0.05 vs. PBS) inhibition of cortical osteolysis and decreased draining lymph node size in Aln- and OPG-treated mice was associated with a significant (P < 0.05) increase in the incidence of high-grade infections during the establishment of OM. In contrast, the high-grade infections in TNFR:Fc-treated mice were associated with immunosuppression, as evidenced by the absence of granulomas and presence of Gram+ biofilm in the bone marrow. Collectively, these findings indicate that although antiresorptive agents do not exacerbate chronic OM, they can increase the bacterial load during early infection by decreasing lymphatic drainage and preventing the removal of necrotic bone that harbors the bacteria.

Original languageEnglish
Title of host publicationSkeletal Biology and Medicine
PublisherBlackwell Publishing Inc.
Pages84-94
Number of pages11
ISBN (Print)9781573317856
DOIs
StatePublished - Mar 2010

Publication series

NameAnnals of the New York Academy of Sciences
Volume1192
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632

Keywords

  • Antiresorptive therapy
  • Osteomyelitis
  • TNFR:Fc

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