Bisphosphonate-related osteonecrosis of the jaw and the Immune system

  • Research type

    Research Study

  • Full title

    An investigation into the role of Gamma delta T-cells and Oral bacteria in Bisphosphonate-related osteonecrosis of the jaw.

  • IRAS ID

    92597

  • Contact name

    Paul Ryan

  • Contact email

    p.l.ryan@qmul.ac.uk

  • Sponsor organisation

    Queen Mary University of London

  • Research summary

    Healthy bones are renewed through a balance of the activity of cells that build and destroy bone. Disruption of this balance can lead to excessive bone loss (osteoporosis) which can occur naturally due to ageing but also as a side effect of certain cancers.
    Bisphosphonates are drugs given to prevent bone loss and to protect the skeleton from weakening. An extremely unpleasant side effect of these drugs (in up to 10% of cases) is death and infection of the bone tissue in the jaws a condition called Bisphosphonate-related osteonecrosis of the jaw (BRONJ). This can be extremely painful and significantly affect the quality of these patients many who are also battling cancer. It is also a difficult condition to treat and cure and the cause of the condition remains poorly understood.
    This aim of this is to investigate whether the immune system is affected by bisphosphonates and oral bacteria and whether specific immune cells (gamma delta T-cells) play a role in the disease.
    This 2-year study cross-sectional clinical and laboratory study will recruit the following groups at cancer and dental clinics across Barts Health Trust.
    (1) Healthy volunteers
    (2) BRONJ patients
    (3) Patients with similar jaw disease
    (4) Patients immediately before bisphosphonate therapy
    (5) Patients taking bisphosphonates without BRONJ
    Each patient group will be invited to provide on one occasion:
    • A blood sample
    • A saliva sample
    • A plaque sample
    Specifically the study will:
    • Investigate the variation in response of blood cells taken from healthy donors to bisphosphonates and oral bacteria in the laboratory.
    • Investigate whether the immune cells of patients with BRONJ are different from comparison groups.
    • Investigate if specific bacteria are associated with BRONJ.
    The research is funded jointly by The Wellcome Trust / Royal College of Surgeons of England through a Research Fellowship.

  • REC name

    London - City & East Research Ethics Committee

  • REC reference

    13/LO/0548

  • Date of REC Opinion

    29 May 2013

  • REC opinion

    Further Information Favourable Opinion