Actinomyces in infected osteoradionecrosis—underestimated?

Hansen, Torsten; Kunkel, Martin; Kirkpatrick, Charles James; Weber, Achim

doi:10.1016/j.humpath.2005.09.018

Cited by 71 publications

(63 citation statements)

References 19 publications

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“…Since then, the association between infection with Actinomyces and osteolysis has been demonstrated [15,35]. This association could be of major interest since several recent studies verified large numbers of Actinomyces-positive biopsies in patients suffering from either IORN or BON [7,13,14,31]. Although only of marginal significance due to the small number of Actinomycesnegative BON/IORN lesions, the higher recruitment of osteoclasts in Actinomyces-positive osteonecrosis as shown in the present study argues for a stimulatory effect of Actinomyces or its associated microbes.…”

Section: Discussionmentioning

confidence: 95%

“…The mean radiation dose was 63.2 Gy. For diagnostic classification, IORN was defined according to established criteria: bone necrosis following irradiation of osseous tissue (i.e., the jaws) [10,13,29]. The clinical symptoms were as follows: signs of infection or sequester formation, local abscess formation, chronic fistula, and necrotic bone exposed to the oral cavity.…”

Section: Patient Data From the Bon Groupmentioning

confidence: 99%

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Increased numbers of osteoclasts expressing cysteine proteinase cathepsin K in patients with infected osteoradionecrosis and bisphosphonate-associated osteonecrosis—a paradoxical observation?

2006

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Erosion of the bone is a common problem in patients suffering from infected osteoradionecrosis (IORN) or bisphosphonate-associated osteonecrosis (BON). Besides inflammatory mechanisms and infectious agents, osteoclasts were recently suggested to be specifically involved in the osteolytic mechanisms. We therefore investigated the immunohistochemical labeling of the cysteine proteinase cathepsin K, which plays a central role in osteoclast-mediated bone resorption, in tissue specimens of patients with BON (n=9; four male, five female; mean age=69.2 years) and IORN (n=10; nine male, one female; mean age=60.5 years), and compared the results with control specimens (n=8; six male, two female; mean age=60 years). In all cases, osteoclasts were the predominant cell type expressing cathepsin K. For semiquantitative analysis, we therefore defined osteoclasts as multinuclear giant cells attached to the bone and expressing cathepsin K. Significantly higher numbers of osteoclasts were found for both types of osteonecrosis when compared with the control group (BON+IORN vs controls: P=0.0000036). Within the pathological lesions, IORN cases exhibited significantly less osteoclasts than BON (P=0.00097). Our study verified increased numbers of osteoclasts in patients suffering from BON and IORN. Although it is known that bisphosphonates (and to a lesser extent, irradiation, too) decrease osteoclast function, these findings suggest a critical involvement of osteoclasts in the mechanisms of bone destruction in the respective lesions.

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Section: Discussionmentioning

confidence: 95%

Section: Patient Data From the Bon Groupmentioning

confidence: 99%

Increased numbers of osteoclasts expressing cysteine proteinase cathepsin K in patients with infected osteoradionecrosis and bisphosphonate-associated osteonecrosis—a paradoxical observation?

2006

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“…The disease can also appear as cutaneous actinomycosis, musculoskeletal disease, pericarditis, infection of the central nervous system (CNS), or disseminated disease. Moreover, some actinomycosis cases have been linked to specific conditions, such as osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaws (53,54), the use of anti-inflammatory drugs (55,56), or some hereditary diseases (57,58). Also, unusual presentations of human actinomycosis have been reported, which presents a diagnostic challenge (59).…”

Section: Actinomycosismentioning

confidence: 99%

Actinomyces and Related Organisms in Human Infections

2015

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SUMMARY Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces -like organisms is widening accordingly; for example, Actinomyces meyeri , Actinomyces neuii , and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum ) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.

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“…There are some studies related to the microscopic features of osteochemonecrosis, each with strengths and weaknesses [56][57][58][59][60][61][62][63][64][65]. Most of the specimens received in a Fig.…”

Section: Microscopic Featuresmentioning

confidence: 99%

Osteochemonecrosis: An Overview

Hellstein

2014

Head and Neck Pathol

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Actinomyces in infected osteoradionecrosis—underestimated?

Cited by 71 publications

References 19 publications

Increased numbers of osteoclasts expressing cysteine proteinase cathepsin K in patients with infected osteoradionecrosis and bisphosphonate-associated osteonecrosis—a paradoxical observation?

Increased numbers of osteoclasts expressing cysteine proteinase cathepsin K in patients with infected osteoradionecrosis and bisphosphonate-associated osteonecrosis—a paradoxical observation?

Actinomyces and Related Organisms in Human Infections

Osteochemonecrosis: An Overview

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