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Imaging mass cytometry unveils functional and spatial remodeling of peri-lesional cells in jaw osteonecrosis

Jiazheng Cai1, Ying Xue2, Stian Tornaas3

  • 1Department of Medical Biology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.

Communications Biology
|February 16, 2026
PubMed

Insights

Medication-related osteonecrosis of the jaw (MRONJ) involves altered immune cell organization and tissue dysfunction. This study reveals key cellular changes in MRONJ lesions, offering insights for new therapeutic approaches.

Area of Science:

  • Biomedical Science
  • Pathophysiology
  • Immunology

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive therapy.
  • The precise tissue-level mechanisms driving MRONJ remain unclear.

Purpose of the Study:

  • To investigate the cellular functions and spatial organization within MRONJ lesions.
  • To provide a detailed spatial and functional atlas of the affected tissues.

Main Methods:

  • Utilized imaging mass cytometry to profile MRONJ lesions at single-cell resolution.
  • Analyzed epithelial, stromal, and vascular regions within the lesions.

Main Results:

  • Observed significant immune cell infiltration, including regulatory T cells, M2-like macrophages, exhausted T cells, and natural killer cells.
  • Identified shifts in immune cell spatial patterns from dispersed to clustered arrangements.
  • Detected disrupted epithelial architecture, activated fibroblasts and endothelial cells, and concurrent proliferative, apoptotic, and stress signatures across cell types.

Conclusions:

  • The study provides a comprehensive spatial and functional understanding of MRONJ pathophysiology.
  • Findings suggest potential therapeutic targets for restoring tissue homeostasis and promoting healing in MRONJ patients.

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