7 More recently, the findings of a bioassay showed that the ZOL concentrations found in the oral
cavity of patients under treatment with this drug ranged from 0.4 to 5 μM.17 Thereafter, some authors have demonstrated that this drug can be toxic to different cell types, such as osteoblasts, endothelial cells and fibroblasts.10, 11 and 16 This cytotoxic effect could be due to contact of high concentrations of bisphosphonates released from the mineralized tissues to the adjacent cells. A recent study5 evaluating the cytotoxicity of ZOL to pulp cells in vitro showed that this drug caused a significant decrease of the viability, proliferation Erastin datasheet and TP production of these cells. These data were confirmed in the present study in which ZOL
concentrations (1 μM and 5 μM) simulating those found in the alveolar bone tissue of patients under treatment with this drug, 17 caused reduction of cell viability. In addition to HIF inhibitor the analysis of odontoblast-like cell viability, TP production and ALP activity, molecular biology experiments were also carried out in the present study, which indicated that Col-I and ALP expression can be inhibited in a dose-dependent by the action of ZOL. This inhibitory effect of ZOL could affect negatively the repair of the pulpo-dentin complex in vivo, as Col-I is the main component of reactionary dentin matrix, which is produced by odontoblasts not that suffer aggressions 12 and 27 and ALP is directly involved in the mineralization of this newly formed dentin matrix. 28 and 29 The present study demonstrated that ZOL at concentration of 1 μM increase Col-I expression. Similar result was also reported in previous studies that revealed an increase in the expression of this gene in vitro within the first days after contact of the drug with the cells. 30 and 31 However, Col-I expression decreased over time,
suggesting that the inhibitory effect of ZOL was both dose- and time-dependent. 31 The results of ZOL cytotoxicity to the odontoblast-like MDPC-23 cells demonstrated by the in vitro cellular and molecular biology protocols used in the present study were confirmed in the analysis of cell morphology by SEM. The cells incubated in contact with both ZOL concentrations presented size reduction, probably due to cytoskeletal shrinkage. This cell response pattern in contact with low toxic agents has been extensively described in the literature, 19 and 21 which helps establishing the effects of the tested drug. This is because the decrease of cell viability indicated by the MTT assay might be due to a direct inhibitory effect of the drug on cell activity, which results in reversible morphological alterations, or to necrotic or apoptotic cell death, which represents an irreversible condition. In both situations, the MTT assay provides values that represent a smaller number of formazan crystals formed.