Comparative analysis of the mineral composition of the leukocyte, erythrocyte fraction and PRP plasma in patients with bisphosphonate osteonecrosis of the jaw bones

Abstract

A complication of the use of bisphosphonate drugs is the development of bisphosphonate osteonecrosis. There is not enough information about the state of the microelement composition of the blood and the dynamics of metabolic processes for various bisphosphonate drugs. There are 184 patients under observation for bisphosphonate osteonecrosis of the jaw bones. The mineral components of three blood fractions were monitored: sulfur (S2-), chlorine (Cl-), potassium (K+), calcium (Ca2+), phosphorus (P3+) at the preoperative and postoperative stages. At the preoperative stage, the negative dynamics of indicators of bone metabolites (Ca2+ and P3+) contributed to the development of osteomalacia, followed by a jaw fracture due to local loads. Hypercalcemia developed against the background of acidosis in the bone tissue (Ca2+ ions were replaced by H+ ions, with partial diffusion into the liquid fraction, due to disorganization of the synthesis of chondroitinsulfuric acid). Hyperphosphatemia is due to the pharmacokinetics of bisphosphonate drugs. Violation of the metabolism of sulfur-containing amino acids leads to the accumulation of S2- in blood fractions. The decrease in Cl- is due to metabolic acidosis against the background of an atrabiliary gas exchange function of erythrocytes, which enhances the pathological focus of tissues with the migration of Cl- to the lesion. A decrease in K+ was noted against the background of severe muscle atony. The dynamics of the studied parameters correlates with the clinical picture of bisphosphonate osteonecrosis. The trace element composition of blood fractions, starting from the 7th day of the postoperative period, was characterized by a trend towards positive dynamics. With further observation at the 3rd and 6th months, the content of the studied trace elements in the reference values. The clinical picture corresponds to the scope and timing of surgery in 100% of patients.