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Recent Stem-Cell-Based and Stem-Cell-Free Possibilities for the Therapeutic Management of the Osteonecrosis of the
Merita Mazreku1, L'uboš Danišovič1, Martin Klein2
1Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia.
Abstract:
Osteonecrosis of the jaw (ONJ), including the maxilla and mandible, is considered a challenging therapeutic problem, mainly due to the lack of understanding of its pathogenesis. It is well known that ONJ is a severe side effect caused by certain medications used to treat bone metastasis and osteoporosis, such as bisphosphonates, which inhibit bone resorption. Other therapeutics with similar side effects are, for instance, receptor activators of nuclear factor kappa-B ligand (RANK-L) inhibitor (denosumab), tyrosine kinase inhibitors (sunitinib), and antiangiogenics (bevacizumab). The conservative or surgical treatment of these medication-related osteonecroses of the jaw (MRONJs) is generally effortful and still not entirely effective. Therefore, the research seeks alternative treatment options like tissue engineering and stem cell therapy, which predominantly represent mesenchymal stem cells (MSCs) and their derivatives, such as extracellular vesicles. Moreover, it was published that novel stem cell therapy could even prevent the onset of MRONJ. On the other hand, the administration of stem cells may also be accompanied by some other health risks, such as an increased chance of cancer metastasis occurrence in cancer patients. The current review paper summarizes the most recent progress in stem-cell-based and stem-cell-free treatment options for the ONJ. Similarly, we discuss this novel approach's future perspectives and possible obstacles.
Insights
Medication-related osteonecrosis of the jaw (MRONJ) presents treatment challenges. Stem cell therapies, including mesenchymal stem cells (MSCs), offer promising alternatives but require further research into efficacy and safety for MRONJ management.
Area of Science:
- Oral and Maxillofacial Surgery
- Regenerative Medicine
- Pharmacology
Background:
- Osteonecrosis of the jaw (ONJ) is a complex condition, often linked to medications like bisphosphonates and denosumab.
- Current treatments for medication-related osteonecrosis of the jaw (MRONJ) are often insufficient.
- Understanding ONJ pathogenesis is crucial for developing effective therapies.
Purpose of the Study:
- To review recent advancements in stem cell-based and stem cell-free treatments for ONJ.
- To explore the potential of mesenchymal stem cells (MSCs) and their derivatives for MRONJ.
- To discuss future perspectives and challenges in stem cell therapy for ONJ.
Main Methods:
- Literature review of recent scientific publications.
- Analysis of stem cell-based therapeutic strategies for ONJ.
- Evaluation of stem cell-free approaches and their potential.
Main Results:
- Stem cell therapy, particularly using MSCs and extracellular vesicles, shows potential for ONJ treatment and prevention.
- Novel therapies may offer alternatives to conservative or surgical interventions for MRONJ.
- Potential risks associated with stem cell administration, such as increased cancer metastasis, need consideration.
Conclusions:
- Stem cell-based and stem cell-free therapies represent a promising frontier for managing ONJ.
- Further research is essential to optimize efficacy and mitigate risks of stem cell therapies for MRONJ.
- Addressing the challenges in stem cell therapy will pave the way for improved patient outcomes in ONJ treatment.
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