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Updated: Jan 12, 2026

Stimulation of Notch Signaling in Mouse Osteoclast Precursors
Published on: February 28, 2017
Osteoclast-Derived Exosomes Promote MRONJ via the VEGFR2-Caspase9 and Notch1-Hes1/Hey Signaling Pathways
Kun Zhang1,2, Jiankang Zhang1, Qizhang Wang1
1State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Objective:
To elucidate the mechanism of medication-related osteonecrosis of the jaw (MRONJ), which is challenging to prevent and treat, to facilitate the development of precise prevention and treatment strategies.
Materials And Methods:
Osteoclast-derived exosomes were extracted and their roles in cell migration, osteogenesis, angiogenesis, and the mechanism of MRONJ were investigated.
Results:
Osteoclast-derived exosomes were taken up by human umbilical vein endothelial cells and osteoblasts. Cell migration and vascularization decreased in cells treated with zoledronic acid (ZA)-induced exosomes. VEGFR2 mRNA and protein expression decreased, while Caspase9 mRNA and protein expression increased. The migration and osteogenic differentiation of osteoblasts induced by exosomes from ZA-treated osteoclasts decreased, and the mRNA and protein expression of Notch1-Hes1/Hey increased. In vivo, ZA-treated osteoclast-derived exosomes caused decreased trabecular volume, number, and thickness and increased trabecular separation in the extraction sockets. Alkaline phosphatase and tartrate-resistant acid phosphatase activities decreased, and the number of H-type vessels decreased in the ZA-treated group.
Conclusion:
ZA may contribute to MRONJ by affecting the exocytotic components produced by osteoclasts through the VEGFR2-Caspase9 and Notch1-Hes1/Hey signaling pathways.
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