Diagnostic analysis of toxic damage due to a dose of zoledronic acid

Abstract

Introduction: Comprehensive analysis is necessary to analyze the widespread use of bisphosphonate drugs in the treatment and prevention of various diseases of connective tissue structures. The relevance of the study depends on the impact they have on the patient’s somatic condition, given the number of early and late complications diagnosed by domestic and foreign clinicians. Materials and methods: The methodology used was developed on Stavropol Regional Clinical Hospital from 2010 to 2022. A randomized and observational study of the state of connective tissue structures was conducted in 186 patients who had a history of taking zoledronic acid and developed bisphosphonate osteonecrosis of the jawbone. At the diagnostic and treatment stages, patients were tested using laboratory methods to monitor amino acids in biological fluids (blood), as well as bone blocks extracted intraoperatively using highly effective gas-liquid chromatography on AAA 500. Results and discussion: Aminograms obtained in the pre-operative period indicate toxic effects of zoledronic acid on neuro, endocrine, and other human systems. The initiation and progression of aseptic inflammatory processes in tissue structures is correlated with the deteriorating general ocular status of patients when amino acids, such as alanine, serine, taurine, phenylalanine, tyrosine, proline, histidine, glycine, and valine, against a background of 90.4±2.1 mmol/L ammonia are reduced critically. Conclusion: Zoledronic acid initiates an aseptic chronic inflammatory process in the jaw bones, accompanied by toxic acidosis, which worsens osteoporotic symptoms.

Keywords

• amino acids
• highly effective gas-liquid chromatography
• jawbone resection