Abstract：
Medication Related Osteonecrosis of the Jaw (MRONJ) has traditionally been mostly attributed to the exposure to antiresorptive agents such as bisphosphonates and denosumab. Nevertheless, following the development of new medications in oncology, the spectrum of drugs associated with MRONJ widened, with, for example, tyrosine kinase inhibitors, mTOR inhibitor, or monoclonal antibodies against VEGF. To date, MRONJ has not been assessed or reported in patients treated with guselkumab so far. Guselkumab is a fully human IgG1λ monoclonal antibody that selectively targets the p19 protein subunit of extracellular human IL-23 and inhibits its intracellular and downstream signalling. It consists of two identical light chains and two identical heavy chains. The four chains are linked together by covalent disulfide bonds and noncovalent protein-protein interactions. The aim of this article is to report a case of a patient with severe psoriasic arhtritis and plaque psoriasis who presented with a clinical condition that could resemble a MRONJ following guselkumab therapy and a dental root extraction.
摘要：
药物相关的颌骨坏死（MRONJ）传统上主要归因于暴露于抗吸收剂，例如双膦酸盐和denosumab。然而，随着肿瘤学新药的发展，与MRONJ相关的药物谱扩大了，with,例如,酪氨酸激酶抑制剂，mTOR抑制剂,或抗VEGF的单克隆抗体。迄今为止,到目前为止，MRONJ尚未在使用guselkumab治疗的患者中进行评估或报告。Guselkumab是一种全人IgG1λ单克隆抗体，选择性靶向细胞外人IL-23的p19蛋白亚基并抑制其细胞内和下游信号传导。它由两条相同的轻链和两条相同的重链组成。这四条链通过共价二硫键和非共价蛋白质-蛋白质相互作用连接在一起。本文的目的是报告一例患有严重银屑病性关节炎和斑块状银屑病的患者，该患者在guselkumab治疗和牙根拔除后表现出类似于MRONJ的临床状况。
