Abstract
BackgroundFatty degenerative osteonecrosis in the medullary spaces of the jawbone (FDOJ) may be identified as a lesser known source of RANTES/CCL5 (R/C) overexpression. The chemokine R/C also interferes with bone metabolism leading to osteolysis in areas affected by FDOJ. Many dental surgeries require functioning repair mechanisms and these may be disrupted by R/C overexpression.ObjectiveTo clarify the way in which R/C expression from adipocytes in FDOJ causes a disturbance in osteogenesis and impacts on medullary stem cells by investigating the detection of R/C expression with immunochemical staining.Materials and methodsWe examined the tissue samples of 449 patients with FDOJ to assess the level of the chemokine R/C using bead-based Luminex® analysis. In six clinical case studies of FDOJ, we compared bone density, histological findings, R/C expression, and immunohistochemical staining.ResultsR/C is overexpressed by up to 30-fold in the 449 FDOJ cases when compared with healthy jawbone samples. The comparison of the six clinical cases consistently shows greatly reduced bone density, (i.e., osteolysis), but varies in terms of the level of agreement across the other three parameters.DiscussionR/C from FDOJ sources may be implicated in several immune responses and considered a key pathogenetic pathway for increased adipogenesis rather than desirable osteogenesis. Adipocytes pathogenetically act via R/C expression in local FDOJ and systemically on the immune system.ConclusionR/C may be regarded as an important trigger for possible pathological developments in the fate of hematopoietic stem cells. FDOJ is not a rigidly uniform process but reflects changing stages of development. The absence of correlating findings should not be interpreted as a misdiagnosis. It seems appropriate to direct further research in the field of “maxillo–mandibular osteoimmunology” focusing on R/C overexpression in FDOJ areas. This may contribute to the development of personalized strategies in preventive medicine.
Highlights
Fatty degenerative osteonecrosis in the medullary spaces of the jawbone (FDOJ) may be identified as a lesser known source of RANTES/CCL5 (R/C) overexpression
Multiplex analysis of 449 fatty degenerative osteolyses of the jawbone (FDOJ) cases: RANTES/CCL5 expression when compared with healthy jawbone
To perform individual comparisons of dental radiography, we employed light microscopy, multiplex analysis, and the immunohistochemistry of R/C expression in the areas affected by FDOJ, and compiled three groups of clinical cases from the entire collection of samples: (a) Two clinical cases of FDOJ with similar histology and R/C overexpression; (b) Two clinical cases of FDOJ with inconsistent histology, and R/C overexpression; and (c) Two clinical cases of FDOJ with inconsistent findings in terms of both histology, and a lack of R/C expression
Summary
Fatty degenerative osteonecrosis in the medullary spaces of the jawbone (FDOJ) may be identified as a lesser known source of RANTES/CCL5 (R/C) overexpression. The long-term success of any oral surgery depends on the interactions of these two different cell systems which significantly control the regeneration process and are essential components of bone metabolism. Bone remodeling is a spatially coordinated, lifelong process in which an old bone is removed by OCs and replaced with bone-forming OBs. The refilling of cavities which form due to resorption is incomplete in many pathological conditions, resulting in a net loss of bone mass during each remodeling cycle. A unique bone remodeling situation appears to occur in the case of fatty degenerative osteonecrosis in the medullary cavity of the jawbone (FDOJ), as previously described by our team and other authors [1, 2]. Since any manipulation of the jawbone—e.g., implantation, tooth, and wisdom tooth removal—activates multiple inflammatory processes, this is followed by physiological bone repair mechanisms
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