阿仑膦酸钠局部给药调节骨代谢在口腔医学中的应用

Application of alendronate locally applied regulates bone metabolism in stomatology

阿仑膦酸钠(ALN)作为经典的含氮双膦酸盐药物,对治疗骨质流失引起的疾病非常有效,主要通过下调破骨细胞活性,抑制骨吸收,发挥成骨作用。成骨细胞促进骨生成与破骨细胞介导骨吸收在体内形成的平衡被破坏,可能是导致颌骨骨吸收性疾病的唯一原因。尽管ALN在颌骨骨吸收性疾病中应用时具有优势,但长期静脉或口服应用ALN会导致相关性颌骨骨坏死、肾功能衰竭、食道损害等副作用。能否通过改变给药途径减少ALN的不良反应,将其安全有效地应用于颌骨骨吸收疾病中,是目前亟待突破的难点。因此,本文将ALN对骨代谢的作用机制进行简单的阐述,并对其在颌骨骨吸收疾病中应用的优劣进行探讨,以期为ALN局部给药治疗颌骨骨吸收性疾病提供理论指导。

As a classic nitrogen-containing bisphosphonate drug,alendronate(ALN)is very effective in preventing diseases caused by bone loss,mainly by down-regulating osteoclast activity and inhibiting bone resorption,thereby promoting osteogenesis.In the oral bone-resorption diseases,the destruction of the balance between osteoblast-promoting bone formation and osteoclast-mediated bone resorption in the body is considered to be the only possible reason.Although ALN has advantages in the application of oral bone-resorption diseases,long-term intravenous or oral application of ALN can lead to side effects such as bisphosphonate-related osteonecrosis of the jaw(BRONJ),renal failure and esophageal damage.Whether ALN can be safely and effectively applied to oral bone-resorption diseases by changing the route of administration to reduce its adverse reactions is a difficult problem that needs to be solved in the short term.Therefore,this paper briefly expounds the mechanism of ALN on bone metabolism,and discusses the advantages and disadvantages of its application in the oral bone-resorption diseases,to provide theoretical guidance for the application of ALN as a local drug to treat oral bone-resorption disease.