Preventing and reversing bone loss

Osteoporosis is the most common bone disease in humans, and can put older adults at risk of fracturing a hip, wrist, vertebrae, or other bones—injuries that could require lengthy hospital stays. But more and more, people with thinning bones are taking drugs known as bisphosphonates (marketed under brand names such as Boniva, Fosamax, Actonel, and Reclast) to slow or stop the progress of the disease, and reduce the likelihood of breaking a bone. Some cancer patients, such as those with multiple myeloma or bone metastasis, also use the drugs to reduce the risk of fractures.

These drugs, however, can cause an unexpected side effect: Some patients taking them actually lose bone tissue, often in the jaw. This complication is known as bisphosphonate-related osteonecrosis of the jaw, or BRONJ.

One of the newest members of the Penn Dental Medicine faculty, Anh Le, is searching for ways that discoveries made in the lab may translate into an effective treatment for the condition. Le joined Penn Dental in July as chair of the Department of Oral & Maxillofacial Surgery/Pharmacology and the Norman Vine Endowed Professor of Oral Rehabilitation.

In her previous faculty position at the University of Southern California, Le and collaborators identified biomarkers in mice that increase the risk of developing BRONJ. Giving the mice an infusion of mesenchymal stem cells, Le found, could cure the condition—a promising breakthrough for patients with this debilitating and painful disease.

Also at USC, Le worked with oral medicine and oncology colleagues to gather blood samples from 80 cancer patients to test them for a biomarker of vulnerability to BRONJ. In her short time at Penn so far, Le has reached out to oncology researchers at Penn Medicine to potentially expand these investigations into a multi-center study. Similarly, she plans to involve her new Penn oral medicine and surgery colleagues in a symposium dedicated to osteonecrosis of the jaw, where scientists and clinicians from different specialties can share their findings and experiences with the condition.

Such a commitment to bringing bench science to clinical practice has defined Le’s career.

“If I was a basic scientist and not a clinician, I could have generated a lot of good research and it would only stay in the lab,” she says. “But my clinical training is always reminding me that the state-of-the-art of my practice can always be improved by bringing innovations directly to patients and shortening the gap between the best, evidence-based practice and what actually happens.”

Le