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Kaliya-Perumal AK, Celik C, Carney TJ, Harris MP, Ingham PW. Genetic regulation of injury-induced heterotopic ossification in adult zebrafish. Dis Model Mech 2024; 17:dmm050724. [PMID: 38736327 DOI: 10.1242/dmm.050724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/05/2024] [Indexed: 05/14/2024] Open
Abstract
Heterotopic ossification is the inappropriate formation of bone in soft tissues of the body. It can manifest spontaneously in rare genetic conditions or as a response to injury, known as acquired heterotopic ossification. There are several experimental models for studying acquired heterotopic ossification from different sources of damage. However, their tenuous mechanistic relevance to the human condition, invasive and laborious nature and/or lack of amenability to chemical and genetic screens, limit their utility. To address these limitations, we developed a simple zebrafish injury model that manifests heterotopic ossification with high penetrance in response to clinically emulating injuries, as observed in human myositis ossificans traumatica. Using this model, we defined the transcriptional response to trauma, identifying differentially regulated genes. Mutant analyses revealed that an increase in the activity of the potassium channel Kcnk5b potentiates injury response, whereas loss of function of the interleukin 11 receptor paralogue (Il11ra) resulted in a drastically reduced ossification response. Based on these findings, we postulate that enhanced ionic signalling, specifically through Kcnk5b, regulates the intensity of the skeletogenic injury response, which, in part, requires immune response regulated by Il11ra.
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Affiliation(s)
- Arun-Kumar Kaliya-Perumal
- Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive 636921, Singapore
| | - Cenk Celik
- Department of Genetics, Evolution and Environment, Genetics Institute, University College London, London WC1E 6BT, UK
| | - Tom J Carney
- Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive 636921, Singapore
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Proteos 138673, Singapore
| | - Matthew P Harris
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
- Department of Orthopedic Research, Boston Children's Hospital, Boston, MA 02115, USA
| | - Philip W Ingham
- Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive 636921, Singapore
- Department of Life Sciences, University of Bath, Bath BA2 7AY, UK
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Epperson RT, Isaacson BM, Rothberg DL, Olsen RE, Kawaguchi B, Rasmussen RM, Dickerson M, Pasquina PF, Shero J, Williams DL. Determining Which Combinatorial Combat-Relevant Factors Contribute to Heterotopic Ossification Formation in an Ovine Model. Bioengineering (Basel) 2024; 11:350. [PMID: 38671772 PMCID: PMC11048030 DOI: 10.3390/bioengineering11040350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Traumatic heterotopic ossification (HO) is frequently observed in Service Members following combat-related trauma. Estimates suggest that ~65% of wounded warriors who suffer limb loss or major extremity trauma will experience some type of HO formation. The development of HO delays rehabilitation and can prevent the use of a prosthetic. To date there are limited data to suggest a standard mechanism for preventing HO. This may be due to inadequate animal models not producing a similar bone structure as human HO. We recently showed that traumatic HO growth is possible in an ovine model. Within that study, we demonstrated that 65% of sheep developed a human-relevant hybrid traumatic HO bone structure after being exposed to a combination of seven combat-relevant factors. Although HO formed, we did not determine which traumatic factor contributed most. Therefore, in this study, we performed individual and various combinations of surgical/traumatic factors to determine their individual contribution to HO growth. Outcomes showed that the presence of mature biofilm stimulated a large region of bone growth, while bone trauma resulted in a localized bone response as indicated by jagged bone at the linea aspera. However, it was not until the combinatory factors were included that an HO structure similar to that of humans formed more readily in 60% of the sheep. In conclusion, data suggested that traumatic HO growth can develop following various traumatic factors, but a combination of known instigators yields higher frequency size and consistency of ectopic bone.
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Affiliation(s)
- Richard T. Epperson
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (B.M.I.); (D.L.R.); (R.E.O.); (B.K.); (R.M.R.); (D.L.W.)
- Bone & Biofilm Research Laboratory, University of Utah, Salt Lake City, UT 84112, USA
| | - Brad M. Isaacson
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (B.M.I.); (D.L.R.); (R.E.O.); (B.K.); (R.M.R.); (D.L.W.)
- The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD 20814, USA; (P.F.P.); (J.S.)
- The Geneva Foundation, Tacoma, WA 98402, USA
| | - David L. Rothberg
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (B.M.I.); (D.L.R.); (R.E.O.); (B.K.); (R.M.R.); (D.L.W.)
| | - Raymond E. Olsen
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (B.M.I.); (D.L.R.); (R.E.O.); (B.K.); (R.M.R.); (D.L.W.)
| | - Brooke Kawaguchi
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (B.M.I.); (D.L.R.); (R.E.O.); (B.K.); (R.M.R.); (D.L.W.)
- Bone & Biofilm Research Laboratory, University of Utah, Salt Lake City, UT 84112, USA
| | - Ryan M. Rasmussen
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (B.M.I.); (D.L.R.); (R.E.O.); (B.K.); (R.M.R.); (D.L.W.)
- Bone & Biofilm Research Laboratory, University of Utah, Salt Lake City, UT 84112, USA
| | - Mary Dickerson
- Office of Comparative Medicine, University of Utah, Salt Lake City, UT 84112, USA;
| | - Paul F. Pasquina
- The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD 20814, USA; (P.F.P.); (J.S.)
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20910, USA
| | - John Shero
- The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD 20814, USA; (P.F.P.); (J.S.)
- Extremity Trauma Center of Excellence, Joint Base San Antonio Fort Sam Houston, San Antonio, TX 78240, USA
| | - Dustin L. Williams
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (B.M.I.); (D.L.R.); (R.E.O.); (B.K.); (R.M.R.); (D.L.W.)
- Bone & Biofilm Research Laboratory, University of Utah, Salt Lake City, UT 84112, USA
- The Center for Rehabilitation Sciences Research, Uniformed Services University, Bethesda, MD 20814, USA; (P.F.P.); (J.S.)
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
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Rawson KB, Neuberger T, Smith TB, Bell IJ, Looper RE, Sebahar PR, Haussener TJ, Kanna Reddy HR, Isaacson BM, Shero J, Pasquina PF, Williams DL. Ex vivo comparison of V.A.C.® Granufoam Silver™ and V.A.C.® Granufoam™ loaded with a first-in-class bis-dialkylnorspermidine-terphenyl antibiofilm agent. Biofilm 2023; 6:100142. [PMID: 37484784 PMCID: PMC10359492 DOI: 10.1016/j.bioflm.2023.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023] Open
Abstract
Implementation of negative pressure wound therapy (NPWT) as a standard of care has proven efficacious in reducing both the healing time and likelihood of nosocomial infection among pressure ulcers and traumatic, combat-related injuries. However, current formulations may not target or dramatically reduce bacterial biofilm burden following therapy. The purpose of this study was to determine the antibiofilm efficacy of an open-cell polyurethane (PU) foam (V.A.C.® Granufoam™) loaded with a first-in-class compound (CZ-01179) as the active release agent integrated via lyophilized hydrogel scaffolding. An ex vivo porcine excision wound model was designed to perform antibiofilm efficacy testing in the presence of NPWT. PU foam samples loaded with a 10.0% w/w formulation of CZ-01179 and 0.5% hyaluronic acid were prepared and tested against current standards of care: V.A.C.® Granufoam Silver™ and V.A.C.® Granufoam™. We observed statistically significant reduction of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii biofilms with the CZ-01179 antibiofilm foam in comparison to current standard of care foams. These findings motivate further development of an antibiofilm PU foam loaded with CZ-01179.
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Affiliation(s)
- Kaden B. Rawson
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- Bone and Biofilm Research Lab, University of Utah, Salt Lake City, UT, USA
- Carle Illinois College of Medicine, University of Illinois, Urbana, IL, USA
| | - Travis Neuberger
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- Bone and Biofilm Research Lab, University of Utah, Salt Lake City, UT, USA
- Department of Biomedical Engineering, University of Utah, UT, USA
- Carle Illinois College of Medicine, University of Illinois, Urbana, IL, USA
| | - Tyler B. Smith
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- Bone and Biofilm Research Lab, University of Utah, Salt Lake City, UT, USA
| | - Isaac J. Bell
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- Bone and Biofilm Research Lab, University of Utah, Salt Lake City, UT, USA
| | - Ryan E. Looper
- Department of Chemistry, University of Utah, Salt Lake City, UT, USA
- Curza Global, LLC, Salt Lake City, UT, USA
| | - Paul R. Sebahar
- Department of Chemistry, University of Utah, Salt Lake City, UT, USA
- Curza Global, LLC, Salt Lake City, UT, USA
| | - Travis J. Haussener
- Department of Chemistry, University of Utah, Salt Lake City, UT, USA
- Curza Global, LLC, Salt Lake City, UT, USA
| | | | - Brad M. Isaacson
- Bone and Biofilm Research Lab, University of Utah, Salt Lake City, UT, USA
- The Center for Rehabilitation Sciences Research, Department of Physical Medicine and Rehabilitation, Uniformed Services University, Bethesda, MD, USA
- The Geneva Foundation, Tacoma, WA, USA
| | - John Shero
- Extremity Trauma and Amputation Center of Excellence, Joint Base San Antonio Fort Sam Houston, San Antonio, TX, USA
| | - Paul F. Pasquina
- The Center for Rehabilitation Sciences Research, Department of Physical Medicine and Rehabilitation, Uniformed Services University, Bethesda, MD, USA
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Dustin L. Williams
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
- Bone and Biofilm Research Lab, University of Utah, Salt Lake City, UT, USA
- Department of Biomedical Engineering, University of Utah, UT, USA
- Curza Global, LLC, Salt Lake City, UT, USA
- The Center for Rehabilitation Sciences Research, Department of Physical Medicine and Rehabilitation, Uniformed Services University, Bethesda, MD, USA
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
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Hwang CD, Pagani CA, Nunez JH, Cherief M, Qin Q, Gomez-Salazar M, Kadaikal B, Kang H, Chowdary AR, Patel N, James AW, Levi B. Contemporary perspectives on heterotopic ossification. JCI Insight 2022; 7:158996. [PMID: 35866484 PMCID: PMC9431693 DOI: 10.1172/jci.insight.158996] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Heterotopic ossification (HO) is the formation of ectopic bone that is primarily genetically driven (fibrodysplasia ossificans progressiva [FOP]) or acquired in the setting of trauma (tHO). HO has undergone intense investigation, especially over the last 50 years, as awareness has increased around improving clinical technologies and incidence, such as with ongoing wartime conflicts. Current treatments for tHO and FOP remain prophylactic and include NSAIDs and glucocorticoids, respectively, whereas other proposed therapeutic modalities exhibit prohibitive risk profiles. Contemporary studies have elucidated mechanisms behind tHO and FOP and have described new distinct niches independent of inflammation that regulate ectopic bone formation. These investigations have propagated a paradigm shift in the approach to treatment and management of a historically difficult surgical problem, with ongoing clinical trials and promising new targets.
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Affiliation(s)
- Charles D Hwang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA
| | - Chase A Pagani
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Johanna H Nunez
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Masnsen Cherief
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Qizhi Qin
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Balram Kadaikal
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Heeseog Kang
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ashish R Chowdary
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nicole Patel
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Aaron W James
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Benjamin Levi
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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DeKeyser GJ, Epperson R, Zhang C, Williams D, Olsen A, Haller JM. Articular fragment restoration is critical to mitigate post-traumatic osteoarthritis in a porcine pilon fracture model. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100266. [DOI: 10.1016/j.ocarto.2022.100266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/28/2022] [Indexed: 10/18/2022] Open
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Kay W, Hunt C, Nehring L, Barnum B, Ashton N, Williams D. Biofilm Growth on Simulated Fracture Fixation Plates Using a Customized CDC Biofilm Reactor for a Sheep Model of Biofilm-Related Infection. Microorganisms 2022; 10:microorganisms10040759. [PMID: 35456808 PMCID: PMC9031587 DOI: 10.3390/microorganisms10040759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023] Open
Abstract
Most animal models of infection utilize planktonic bacteria as initial inocula. However, this may not accurately mimic scenarios where bacteria in the biofilm phenotype contaminate a site at the point of injury. We developed a modified CDC biofilm reactor in which biofilms can be grown on the surface of simulated fracture fixation plates. Multiple reactor runs were performed and demonstrated that monomicrobial biofilms of a clinical strain of methicillin-resistant Staphylococcus aureus, S. aureus ATCC 6538, and Pseudomonas aeruginosa ATCC 27853 consistently developed on fixation plates. We also identified a method by which to successfully grow polymicrobial biofilms of S. aureus ATCC 6538 and P. aeruginosa ATCC 27853 on fixation plates. This customized reactor can be used to grow biofilms on simulated fracture fixation plates that can be inoculated in animal models of biofilm implant-related infection that, for example, mimic open fracture scenarios. The reactor provides a method for growing biofilms that can be used as initial inocula and potentially improve the testing and development of antibiofilm technologies.
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Affiliation(s)
- Walker Kay
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (W.K.); (C.H.); (L.N.); (N.A.)
| | - Connor Hunt
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (W.K.); (C.H.); (L.N.); (N.A.)
| | - Lisa Nehring
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (W.K.); (C.H.); (L.N.); (N.A.)
| | - Brian Barnum
- Purgo Scientific, LLC, South Jordan, UT 84095, USA;
| | - Nicholas Ashton
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (W.K.); (C.H.); (L.N.); (N.A.)
- Purgo Scientific, LLC, South Jordan, UT 84095, USA;
| | - Dustin Williams
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA; (W.K.); (C.H.); (L.N.); (N.A.)
- Purgo Scientific, LLC, South Jordan, UT 84095, USA;
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Correspondence:
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