Keywords
Biphosphonate
Single nucleotide polymorphisms
Abstract
Biphosphonate (BPN) are widely used in clinics to treat meta- static cancer and osteoporosis thus representing a problem not only for patients but also for workers involved in their prepara- tion and administration. A similar exposure occurred years ago in match-making workers undergoing bone alterations similar to those consequent to BPN exposure. Osteonecrosis of the jaw (ONJ) is a main adverse effect related to BPN administration, which is performed in millions of patients worldwide for osteopo- rosis and cancer therapy, thus representing an emerging problem in public health. In susceptible patients, BPN induce severe, pro- gressive, and irreversible degeneration of facial bones, resulting in avascular ONJ often triggered by dental surgery. BPN induced ONJ occurs in subjects depending on lifestyle factors of both environmental and endogenous origins. Exogenous risk factors include cigarette smoke, alcohol consumption, bacterial infec- tions, and cyclosporine therapy. Endogenous risk factors include systemic diseases such as diabetes or hypertension and adverse polymorphisms of genes involved in metabolism (CYPs, MTHFR), thrombosis (Factor V, Prothrombin), and detoxification (MDR). Available molecular findings provide evidence that ONJ is related to risk-factors associated with environmental mutagenesis and gene-environment interactions. This issues may be useful to iden- tify susceptible subjects by molecular analyses in order to prevent ONJ occurrence.References
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