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A Potential Role in Osteoradionecrosis

T. J. Gal, MD; Teresita Munoz-Antonia, PhD; Carlos A. Muro-Cacho, MD, PhD; Douglas W. Klotch, MD

Arch Otolaryngol Head Neck Surg. 2000;126:1124-1128.

Objective  To evaluate the factors involved in bone remodeling and wound healing that may be altered by radiation therapy.

Design  A prospective, controlled study of biochemical activity in vitro.

Subjects  MC3T3-E1 mouse osteoblasts.

Interventions  Cells were irradiated at 0, 2, 4, or 6 Gy. Specimens were harvested at 1, 7, 14, 28, and 42 days following irradiation for immunohistochemical analysis of transforming growth factor ₁ expression and transforming growth factor ₁ type I and II receptor expression. Collagen production was measured at 1, 7, 28, 35, and 49 days after irradiation. The effects of dexamethasone on collagen production and cell proliferation were also examined.

Results  Irradiated cells demonstrated decreased cell proliferation and a dose-dependent, sustained reduction in collagen production when compared with control cells. An increase in transforming growth factor ₁ type I and II receptor expression was noted in irradiated cells when compared with controls.

Conclusion  Radiation-induced alterations of factors related to bone remodeling and wound healing have a potential role in the pathogenesis of osteoradionecrosis.

From the Department of Otolaryngology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa. Dr Gal is now with the Division of Otolaryngology, 74th Medical Operation Squadron, Medical Corps, US Air Force, Wright-Patterson Air Force Base, Ohio.

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