Reduction of Inflammatory RANTES/CCL5 Serum Levels by Surgery in Patients with Bone Marrow Defects of the Jawbone

Abstract

Joé Diederich,1 Hendrik Schwagten,2 Georges Biltgen,3 Johann Lechner,4 Kurt E Müller5 1Center for General, Clinical Environmental and Functional Medicine, Colmar-Berg, Luxembourg; 2Private Practice, Center for Biological Dentistry, Luxembourg-City, Luxembourg; 3Private Practice, Center for Biological Dentistry, Diekirch, Luxembourg; 4Private Practice, Centre for Integrative Dentistry, Munich, Germany; 5Dermatology, Clinical Environmental Medicine, Functional Medicine, Preventive Medicine, Dresden International University, Kempten, GermanyCorrespondence: Joé Diederich, 4b, Avenue G. Smith, Colmar-Berg, L-7740, Luxembourg, Tel [phone], Fax [phone], Email [email protected]: The presence of bone marrow defects of the jawbone (BMDJ) is associated with increased levels of inflammatory cytokines such as RANTES/CCL5. The purpose of this study was to analyze if BMDJ therapy under real-world conditions reduces RANTES/CCL5 serum levels in BMDJ patients.Patients and Methods: During this retrospective study, 113 BMDJ patients received either no treatment (n = 57), BMDJ surgery (n = 25), tooth extraction (n = 20), or root canal treatment (n = 11). Serum concentrations of RANTES/CCL5, C-reactive protein (CRP), and Tumor Necrosis Factor-α (TNF-α) were assessed before and after treatment (interventional group) and at the beginning and end of the study period (control group). Statistical analyses of the results were performed by the two-sample t-test and Bonferroni post hoc test with ANOVA for multiple comparisons.Results: BMDJ were detected in all patients with 4.42 ± 2.75 BMDJ findings per patient. RANTES/CCL5 levels were significantly reduced by any treatment when compared to no treatment (p < 0.001; effect size d = 0.90). This effect was most pronounced in the BMDJ surgery group (p < 0.001; effect size d = 1.30). In contrast, RANTES/CCL5 serum concentrations further increased in untreated patients. Mean duration between pre- and post-treatment RANTES/CCL5 measurements was 22.86 ± 19.36 weeks, with no correlation with RANTES/CCL5 levels in any interventional group or in the total sample (p = 0.104).Conclusion: BMDJ surgery, tooth extraction, and root canal treatment significantly reduce RANTES/CCL5 serum concentrations in BMDJ patients, with surgery being most beneficial. Further research is required to establish regular RANTES/CCL5 assessments as part of an improved diagnosis, monitoring, and evaluation of therapy success in BMDJ patients.Keywords: bone marrow defect of the jawbone, osteolysis, osteonecrosis of the jaw, RANTES, dental

Keywords

• bone marrow defect of the jawbone
• osteolysis
• osteonecrosis of the jaw
• rantes
• dental