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Identification of Potential Core Genes in Medication-Related Osteonecrosis of the Jaw via Bioinformatics Analysis

Xinliang Duan1,2, Yifu Bian1,2, Sichen Han1,2

  • 1Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Changchun, China.

Oral Diseases
|July 19, 2026
PubMed
Abstract

Insights

This study identifies key immune and inflammation genes linked to medication-related osteonecrosis of the jaw (MRONJ). A four-gene signature in peripheral blood shows high accuracy for diagnosing MRONJ.

Area of Science:

  • Biomedical research
  • Bioinformatics
  • Genomics

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive/antiangiogenic therapies.
  • The molecular mechanisms underlying MRONJ remain poorly understood, hindering effective treatment strategies.

Purpose of the Study:

  • To identify core genes involved in MRONJ pathogenesis using integrative bioinformatics.
  • To explore potential diagnostic biomarkers for MRONJ in peripheral blood.

Main Methods:

  • Analysis of gene expression data from patients with and without MRONJ.
  • Identification of differentially expressed genes (DEGs) and pathway enrichment analysis.
  • Construction of protein-protein interaction (PPI) networks, hub gene identification, and diagnostic evaluation using ROC analysis, followed by qRT-PCR validation.

Main Results:

  • 241 DEGs were identified, primarily enriched in immune/inflammatory pathways (NOD-like receptor/NF-κB).
  • Ten hub genes were identified, with four (HSP90AB1, RHOA, CXCL8, IL1B) demonstrating high diagnostic accuracy (AUC 0.864-0.936).
  • These four genes were validated by qRT-PCR, confirming their role in MRONJ.

Conclusions:

  • Integrative bioinformatics and validation reveal immune- and inflammation-related hub genes are central to MRONJ.
  • A four-gene signature (HSP90AB1, RHOA, CXCL8, IL1B) offers a promising peripheral blood-based diagnostic panel for MRONJ.
  • Downregulation of inflammatory genes suggests systemic immunosuppression in MRONJ, opening avenues for immunomodulatory therapies.
Keywords:
bioinformatics analysisdifferentially expressed geneshub genesimmune‐inflammatory responsemedication‐related osteonecrosis of the jaw

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