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Schwartzman JD, McCall M, Ghattas Y, Pugazhendhi AS, Wei F, Ngo C, Ruiz J, Seal S, Coathup MJ. Multifunctional scaffolds for bone repair following age-related biological decline: Promising prospects for smart biomaterial-driven technologies. Biomaterials 2024; 311:122683. [PMID: 38954959 DOI: 10.1016/j.biomaterials.2024.122683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/09/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
The repair of large bone defects due to trauma, disease, and infection can be exceptionally challenging in the elderly. Despite best clinical practice, bone regeneration within contemporary, surgically implanted synthetic scaffolds is often problematic, inconsistent, and insufficient where additional osteobiological support is required to restore bone. Emergent smart multifunctional biomaterials may drive important and dynamic cellular crosstalk that directly targets, signals, stimulates, and promotes an innate bone repair response following age-related biological decline and when in the presence of disease or infection. However, their role remains largely undetermined. By highlighting their mechanism/s and mode/s of action, this review spotlights smart technologies that favorably align in their conceivable ability to directly target and enhance bone repair and thus are highly promising for future discovery for use in the elderly. The four degrees of interactive scaffold smartness are presented, with a focus on bioactive, bioresponsive, and the yet-to-be-developed autonomous scaffold activity. Further, cell- and biomolecular-assisted approaches were excluded, allowing for contemporary examination of the capabilities, demands, vision, and future requisites of next-generation biomaterial-induced technologies only. Data strongly supports that smart scaffolds hold significant promise in the promotion of bone repair in patients with a reduced osteobiological response. Importantly, many techniques have yet to be tested in preclinical models of aging. Thus, greater clarity on their proficiency to counteract the many unresolved challenges within the scope of aging bone is highly warranted and is arguably the next frontier in the field. This review demonstrates that the use of multifunctional smart synthetic scaffolds with an engineered strategy to circumvent the biological insufficiencies associated with aging bone is a viable route for achieving next-generation therapeutic success in the elderly population.
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Affiliation(s)
| | - Max McCall
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Yasmine Ghattas
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Abinaya Sindu Pugazhendhi
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Fei Wei
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Christopher Ngo
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Jonathan Ruiz
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Sudipta Seal
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA; Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), Materials Science and Engineering, College of Medicine, University of Central Florida, USA, Orlando, FL
| | - Melanie J Coathup
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA.
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Flanagan D. Horizontal Alveolar Ridge Splitting and Expansion. J ORAL IMPLANTOL 2024; 50:200-210. [PMID: 38624042 DOI: 10.1563/aaid-joi-d-23-00186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
When considering placing dental implants in atrophic edentulous sites, there may be inadequate site width and little or no vertical bone loss. Any of several surgical procedures can augment these sites. Extracortical augmentation is done by applying graft material against the cortical bone. This technique expects progenitor cells to migrate outside the bony ridge's confines and form new bone. Another method entails ridge splitting and expansion to create space for osteogenesis and, when possible, implant placement. This may be a better method for horizontal ridge augmentation. The ridge is split, separating the facial and lingual cortices for a complete bone fracture. The patient's osseous cells can then migrate into the created space from the exposed medullary bone to form bone. The technique can be preferably performed flapless so the intact periosteum maintains a blood supply to ensure appropriate healing.
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Lee C, Kates SL, Graves ML, Jeray KJ, Javedan H, Firoozabadi R, Schemitsch E. Geriatric trauma: there is more to it than just the implant! OTA Int 2024; 7:e327. [PMID: 38487398 PMCID: PMC10936161 DOI: 10.1097/oi9.0000000000000327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/30/2023] [Accepted: 01/01/2024] [Indexed: 03/17/2024]
Abstract
Geriatric trauma continues to rise, corresponding with the continuing growth of the older population. These fractures continue to expand, demonstrated by the incidence of hip fractures having grown to 1.5 million adults worldwide per year. This patient population and their associated fracture patterns present unique challenges to the surgeon, as well as having a profound economic impact on the health care system. Pharmacologic treatment has focused on prevention, with aging adults having impaired fracture healing in addition to diminished bone mineral density. Intraoperatively, novel ideas to assess fracture reduction to facilitate decreased fracture collapse have recently been explored. Postoperatively, pharmacologic avenues have focused on future fracture prevention, while shared care models between geriatrics and orthopaedics have shown promise regarding decreasing mortality and length of stay. As geriatric trauma continues to grow, it is imperative that we look to optimize all phases of care, from preoperative to postoperative.
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Affiliation(s)
- Christopher Lee
- Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA
| | - Stephen L. Kates
- Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA
| | - Matthew L. Graves
- Department of Orthopaedic Surgery, University of Mississippi, Jackson, MI
| | - Kyle J. Jeray
- Department of Orthopaedic Surgery, Univeristy of South Carolina School of Medicine, Greenville, SC
| | | | - Reza Firoozabadi
- Department of Orthopaedic Surgery, Univeristy of Washington, Seattle, WA
| | - Emil Schemitsch
- Department of Orthopaedic Surgery, Western University, Bone and Joint Institute, London, ON, Canada
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Hong YR, Kim TH, Lee K, Lim JO, Oh CW. Bioactive Bone Substitute in a Rabbit Ulna Model: Preclinical Study. Tissue Eng Regen Med 2023; 20:1205-1217. [PMID: 37815697 PMCID: PMC10645865 DOI: 10.1007/s13770-023-00591-4] [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: 07/04/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Current therapies to effectively treat long-bone defects and extensive bone tissue loss remains limited. In this study, we created a new bone substitute by integrating advanced technologies such as structure patterning, controlled release of a bone growth factor and conjugation system for clinically effective bone regeneration. This novel bioactive bone substitute was evaluated for its safety and efficacy using a rabbit ulna model. METHODS A three dimensional bone patterned cylindrical structure with 1.5 cm in length and 5 mm in diameter was printed using poly(L-lactic acid)(PLLA) as a weight-bearing support and space-filling scaffold. And a bone morphogenetic protein 2 (BMP2) was employed to enhance bone regeneration, and coated to a 3D PLLA using alginate catechol and collagen to prolong the release kinetics. This novel bone substitute (BS)was evaluated for its physico-chemical and biological properties in vitro, and histological analysis and radiographical analysis such as X-ray, CT and micro-CT image analysis were performed to evaluate new bone formation in vivo. RESULTS The BS possesses an ideal shape and mechanically suitable proeperties for clinical use, with an easy-to-grab and break-resistant design at both ends, 80 ± 10 MPa of compression strength, and BMP2 release for two months. Histological analysis demonstrated the biocompability of BS with minimal inflammation and immune response, and X-ray, CT and micro-CT demonstrated effective new bone formation in rabbit ulna defect model. CONCLUSION The preclinical study of a novel bioactive bone substitute has shown its safe and effective properties in an animal model suggesting its clinical potential.
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Affiliation(s)
- Yu Ri Hong
- Bio-Medical Research Institute, Kyungpook National University Hospital, Daegu, 41940, Republic of Korea
- Joint Institute for Regenerative Medicine, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Tae-Ho Kim
- Bio-Medical Research Institute, Kyungpook National University Hospital, Daegu, 41940, Republic of Korea
- Joint Institute for Regenerative Medicine, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Kyueui Lee
- Department of Chemistry and Green-Nano Materials Research Center, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Jeong Ok Lim
- Bio-Medical Research Institute, Kyungpook National University Hospital, Daegu, 41940, Republic of Korea.
- School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
- Joint Institute for Regenerative Medicine, Kyungpook National University, Daegu, 41940, Republic of Korea.
| | - Chang-Wug Oh
- School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea.
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Menger MM, Tobias AL, Bauer D, Bleimehl M, Scheuer C, Menger MD, Histing T, Laschke MW. Parathyroid hormone stimulates bone regeneration in an atrophic non-union model in aged mice. J Transl Med 2023; 21:844. [PMID: 37996876 PMCID: PMC10668449 DOI: 10.1186/s12967-023-04661-y] [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: 08/21/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Non-union formation still represents a major burden in trauma and orthopedic surgery. Moreover, aged patients are at an increased risk for bone healing failure. Parathyroid hormone (PTH) has been shown to accelerate fracture healing in young adult animals. However, there is no information whether PTH also stimulates bone regeneration in atrophic non-unions in the aged. Therefore, the aim of the present study was to analyze the effect of PTH on bone regeneration in an atrophic non-union model in aged CD-1 mice. METHODS After creation of a 1.8 mm segmental defect, mice femora were stabilized by pin-clip fixation. The animals were treated daily with either 200 mg/kg body weight PTH 1-34 (n = 17) or saline (control; n = 17) subcutaneously. Bone regeneration was analyzed by means of X-ray, biomechanics, micro-computed tomography (µCT) imaging as well as histological, immunohistochemical and Western blot analyses. RESULTS In PTH-treated animals bone formation was markedly improved when compared to controls. This was associated with an increased bending stiffness as well as a higher number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts and CD31-positive microvessels within the callus tissue. Furthermore, PTH-treated aged animals showed a decreased inflammatory response, characterized by a lower number of MPO-positive granulocytes and CD68-positive macrophages within the bone defects when compared to controls. Additional Western blot analyses demonstrated a significantly higher expression of cyclooxygenase (COX)-2 and phosphoinositide 3-kinase (PI3K) in PTH-treated mice. CONCLUSION Taken together, these findings indicate that PTH is an effective pharmacological compound for the treatment of non-union formation in aged animals.
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Affiliation(s)
- Maximilian M Menger
- Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Trauma Center Tuebingen, 72076, Tuebingen, Germany.
- Institute for Clinical and Experimental Surgery, Saarland University, 66421, Homburg/Saar, Germany.
| | - Anne L Tobias
- Institute for Clinical and Experimental Surgery, Saarland University, 66421, Homburg/Saar, Germany
| | - David Bauer
- Institute for Clinical and Experimental Surgery, Saarland University, 66421, Homburg/Saar, Germany
| | - Michelle Bleimehl
- Institute for Clinical and Experimental Surgery, Saarland University, 66421, Homburg/Saar, Germany
| | - Claudia Scheuer
- Institute for Clinical and Experimental Surgery, Saarland University, 66421, Homburg/Saar, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, 66421, Homburg/Saar, Germany
| | - Tina Histing
- Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Trauma Center Tuebingen, 72076, Tuebingen, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, 66421, Homburg/Saar, Germany
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Moheghi A, Noori Mougehi SMH, Amini A, Mostafavinia A, Rezaei F, Bagheri Tadi F, Chien S, Bayat M. Anti-inflammatory, Antioxidant, and Wound-Healing Effects of Photobiomodulation on Type-2 Diabetic Rats. J Lasers Med Sci 2023; 14:e45. [PMID: 38028880 PMCID: PMC10658114 DOI: 10.34172/jlms.2023.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/10/2023] [Indexed: 12/01/2023]
Abstract
Introduction: In the current study, the effects of photobiomodulation (PBM) treatments were examined based on biomechanical and histological criteria and mRNA levels of catalase (CAT), superoxide dismutase (SOD), and NADPH oxidase (NOX) 1 and 4 in a postponed, ischemic, and infected wound repair model (DIIWHM) in rats with type 2 diabetes (DM2) during the inflammation (day 4) and proliferation (day 8) stages. Methods: To study ischemic wound repair in a diabetic rat model (DIIWHM), 24 rats with type-2 diabetes were randomly divided into four groups and infected with methicillin-resistant Staphylococcus aureus (MRSA). The control groups consisted of CG4 (control group on day 4) and CG8 (control group on day 8), while the PBM groups comprised PBM4 (PBM treatment group on day 4) and PBM8 (PBM treatment group on day 8). These group assignments allowed for comparisons between the control groups and the PBM-treated groups at their respective time points during the study. Results: On days 4 and 8 of wound restoration, the PBM4 and PBM8 groups showed substantially modulated inflammatory responses and improved formation of fibroblast tissue compared with the CG groups (P<0.05). Concurrently, the effects of PBM8 were significantly superior to those of PBM4 (P<0.05). The antioxidant results on days 4 and 8 revealed substantial increases in CAT and SOD in the PBM groups compared with the CGs (P<0.05). Substantial decreases were observed in the antioxidant agents NOX1 and NOX4 of the PBM4 and PBM8 groups compared with both CGgroups (P<0.05). Conclusion: PBM treatments significantly sped up the inflammatory and proliferating processes in a DHIIWM in DM2 animals by modifying the inflammatory reaction and boosting fibroblast proliferation. Overall, the current findings indicated substantially better results in the PBM groups than in the CG groups.
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Affiliation(s)
- Atefeh Moheghi
- Department of Anatomical Sciences & Cognitive Neuroscience, Faculty of Medicine, Tehran Medical sciences, Islamic Azad university, Tehran, Iran
| | | | - Abdollah Amini
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atarodalsadat Mostafavinia
- Department of Anatomical Sciences & Cognitive Neuroscience, Faculty of Medicine, Tehran Medical sciences, Islamic Azad university, Tehran, Iran
| | | | - Fatemeh Bagheri Tadi
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sufan Chien
- Price Institute of Surgical Research, University of Louisville, and Noveratech LLC of Louisville, Louisville, USA
| | - Mohammad Bayat
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Price Institute of Surgical Research, University of Louisville, and Noveratech LLC of Louisville, Louisville, USA
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7
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Yang J, Zhang L, Ding Q, Zhang S, Sun S, Liu W, Liu J, Han X, Ding C. Flavonoid-Loaded Biomaterials in Bone Defect Repair. Molecules 2023; 28:6888. [PMID: 37836731 PMCID: PMC10574214 DOI: 10.3390/molecules28196888] [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: 08/29/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Skeletons play an important role in the human body, and can form gaps of varying sizes once damaged. Bone defect healing involves a series of complex physiological processes and requires ideal bone defect implants to accelerate bone defect healing. Traditional grafts are often accompanied by issues such as insufficient donors and disease transmission, while some bone defect implants are made of natural and synthetic polymers, which have characteristics such as good porosity, mechanical properties, high drug loading efficiency, biocompatibility and biodegradability. However, their antibacterial, antioxidant, anti-inflammatory and bone repair promoting abilities are limited. Flavonoids are natural compounds with various biological activities, such as antitumor, anti-inflammatory and analgesic. Their good anti-inflammatory, antibacterial and antioxidant activities make them beneficial for the treatment of bone defects. Several researchers have designed different types of flavonoid-loaded polymer implants for bone defects. These implants have good biocompatibility, and they can effectively promote the expression of angiogenesis factors such as VEGF and CD31, promote angiogenesis, regulate signaling pathways such as Wnt, p38, AKT, Erk and increase the levels of osteogenesis-related factors such as Runx-2, OCN, OPN significantly to accelerate the process of bone defect healing. This article reviews the effectiveness and mechanism of biomaterials loaded with flavonoids in the treatment of bone defects. Flavonoid-loaded biomaterials can effectively promote bone defect repair, but we still need to improve the overall performance of flavonoid-loaded bone repair biomaterials to improve the bioavailability of flavonoids and provide more possibilities for bone defect repair.
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Affiliation(s)
- Jiali Yang
- College of Traditional Chinese Medicine, Jilin Agricultural University, Changchun 130118, China; (J.Y.); (L.Z.); (Q.D.); (S.Z.); (S.S.); (W.L.)
- Jilin Agriculture Science and Technology College, Jilin 132101, China
| | - Lifeng Zhang
- College of Traditional Chinese Medicine, Jilin Agricultural University, Changchun 130118, China; (J.Y.); (L.Z.); (Q.D.); (S.Z.); (S.S.); (W.L.)
- Jilin Agriculture Science and Technology College, Jilin 132101, China
| | - Qiteng Ding
- College of Traditional Chinese Medicine, Jilin Agricultural University, Changchun 130118, China; (J.Y.); (L.Z.); (Q.D.); (S.Z.); (S.S.); (W.L.)
| | - Shuai Zhang
- College of Traditional Chinese Medicine, Jilin Agricultural University, Changchun 130118, China; (J.Y.); (L.Z.); (Q.D.); (S.Z.); (S.S.); (W.L.)
| | - Shuwen Sun
- College of Traditional Chinese Medicine, Jilin Agricultural University, Changchun 130118, China; (J.Y.); (L.Z.); (Q.D.); (S.Z.); (S.S.); (W.L.)
| | - Wencong Liu
- College of Traditional Chinese Medicine, Jilin Agricultural University, Changchun 130118, China; (J.Y.); (L.Z.); (Q.D.); (S.Z.); (S.S.); (W.L.)
- School of Food and Pharmaceutical Engineering, Wuzhou University, Wuzhou 543002, China
| | - Jinhui Liu
- Huashikang (Shenyang) Health Industrial Group Corporation, Shenyang 110031, China;
| | - Xiao Han
- Looking Up Starry Sky Medical Research Center, Siping 136001, China;
| | - Chuanbo Ding
- Jilin Agriculture Science and Technology College, Jilin 132101, China
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Roldan L, Isaza C, Ospina J, Montoya C, Domínguez J, Orrego S, Correa S. A Comparative Study of HA/DBM Compounds Derived from Bovine and Porcine for Bone Regeneration. J Funct Biomater 2023; 14:439. [PMID: 37754853 PMCID: PMC10532284 DOI: 10.3390/jfb14090439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/25/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023] Open
Abstract
This comparative study investigated the tissue regeneration and inflammatory response induced by xenografts comprised of hydroxyapatite (HA) and demineralized bone matrix (DBM) extracted from porcine (P) and bovine (B) sources. First, extraction of HA and DBM was independently conducted, followed by chemical and morphological characterization. Second, mixtures of HA/DBM were prepared in 50/50 and 60/40 concentrations, and the chemical, morphological, and mechanical properties were evaluated. A rat calvarial defect model was used to evaluate the tissue regeneration and inflammatory responses at 3 and 6 months. The commercial allograft DBM Puros® was used as a clinical reference. Different variables related to tissue regeneration were evaluated, including tissue thickness regeneration (%), amount of regenerated bone area (%), and amount of regenerated collagen area (%). The inflammatory response was evaluated by quantifying the blood vessel area. Overall, tissue regeneration from porcine grafts was superior to bovine. After 3 months of implantation, the tissue thickness regeneration in the 50/50P compound and the commercial DBM was significantly higher (~99%) than in the bovine materials (~23%). The 50/50P and DBM produced higher tissue regeneration than the naturally healed controls. Similar trends were observed for the regenerated bone and collagen areas. The blood vessel area was correlated with tissue regeneration in the first 3 months of evaluation. After 6 months of implantation, HA/DBM compounds showed less regenerated collagen than the DBM-only xenografts. In addition, all animal-derived xenografts improved tissue regeneration compared with the naturally healed defects. No clinical complications associated with any implanted compound were noted.
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Affiliation(s)
- Lina Roldan
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19122, USA; (C.M.); (S.O.)
| | - Catalina Isaza
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
| | - Juan Ospina
- Centro de Investigación y Desarrollo Cárnico, Industrias de Alimentos Zenú S.A.S., Grupo Nutresa, Medellín 050044, Colombia;
| | - Carolina Montoya
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19122, USA; (C.M.); (S.O.)
| | - José Domínguez
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
| | - Santiago Orrego
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19122, USA; (C.M.); (S.O.)
- Bioengineering Department, College of Engineering, Temple University, Philadelphia, PA 191122, USA
| | - Santiago Correa
- Grupo de Investigación en Bioingeniería (GIB), Universidad EAFIT, Medellín 050022, Colombia; (L.R.); (C.I.)
- Escuela de Ciencias Aplicadas e Ingeniería, Universidad EAFIT, Medellín 050022, Colombia
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Ebrahimpour-Malekshah R, Amini A, Mostafavinia A, Ahmadi H, Zare F, Safaju S, Shahbazi A, Chien S, Rezaei F, Hasan A, Bayat M. The stereological, immunohistological, and gene expression studies in an infected ischemic wound in diabetic rats treated by human adipose-derived stem cells and photobiomodulation. Arch Dermatol Res 2023; 315:1717-1734. [PMID: 36808225 DOI: 10.1007/s00403-023-02563-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/06/2023] [Accepted: 02/01/2023] [Indexed: 02/23/2023]
Abstract
We investigated the impacts of photobiomodulation (PBM) and human allogeneic adipose-derived stem cells (ha-ADS) together and or alone applications on the stereological parameters, immunohistochemical characterizing of M1 and M2 macrophages, and mRNA levels of hypoxia-inducible factor (HIF-1α), basic fibroblast growth factor (bFGF), vascular endothelial growth factor-A (VEGF-A) and stromal cell-derived factor-1α (SDF-1α) on inflammation (day 4) and proliferation phases (day 8) of repairing tissues in an infected delayed healing and ischemic wound model (IDHIWM) in type 1 diabetic (DM1) rats. DM1 was created in 48 rats and an IDHIWM was made in all of them, and they were distributed into 4 groups. Group1 = control rats with no treatment. Group2 = rats received (10 × 100000 ha-ADS). Group3 = rats exposed to PBM (890 nm, 80 Hz, 3.46 J/cm2). Group4 = rats received both PBM and ha-ADS. On day 8, there were significantly higher neutrophils in the control group than in other groups (p < 0.01). There were substantially higher macrophages in the PBM + ha-ADS group than in other groups on days 4 and 8 (p < 0.001). Granulation tissue volume, on both days 4 and 8, was meaningfully greater in all treatment groups than in the control group (all, p = 0.000). Results of M1 and M2 macrophage counts of repairing tissue in the entire treatment groups were considered preferable to those in the control group (p < 0.05). Regarding stereological and macrophage phenotyping, the results of the PBM + ha-ADS group were better than the ha-ADS and PBM groups. Results of the tested gene expression of repairing tissue on inflammation and proliferation steps in PBM and PBM + ha-ADS groups were meaningfully better than the control and ha-ADS groups (p < 0.05). We showed that PBM, ha-ADS, and PBM plus ha-ADS, hastened the proliferation step of healing in an IDHIWM in rats with DM1 by regulation of the inflammatory reaction, macrophage phenotyping, and augmented granulation tissue formation. In addition PBM and PBM plus ha-ADS protocols hastened and increased mRNA levels of HIF-1α, bFGF, SDF-1α, and VEGF-A. Totally, in terms of stereological and immuno-histological tests, and also gene expression HIF-1α and VEGF-A, the results of PBM + ha-ADS were superior (additive) to PBM, and ha-ADS alone treatments.
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Affiliation(s)
| | - Abdollah Amini
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atarodalsadat Mostafavinia
- Department of Anatomy, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Houssein Ahmadi
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zare
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sobhan Safaju
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Shahbazi
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sufan Chien
- Price Institute of Surgical Research, University of Louisville, Noveratech LLC of Louisville, Louisville, KY, USA
| | - Fatemehalsadat Rezaei
- College of Pharmacy, University of Kentucky, 789 South Limestone, Lexington, KY, 40536, USA
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar.
- Biomedical Research Centre, Qatar University, 2713, Doha, Qatar.
| | - Mohammad Bayat
- Price Institute of Surgical Research, University of Louisville, Noveratech LLC of Louisville, Louisville, KY, USA.
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Clark D, Doelling J, Hu D, Miclau T, Nakamura M, Marcucio R. Age-related decrease in periostin expression may be associated with attenuated fracture healing in old mice. J Orthop Res 2023; 41:1022-1032. [PMID: 36058631 PMCID: PMC10411536 DOI: 10.1002/jor.25439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/16/2022] [Accepted: 08/29/2022] [Indexed: 02/04/2023]
Abstract
Older adults suffer more bone fractures with higher rates of healing complications and increased risk of morbidity and mortality. An improved understanding of the cellular and molecular mechanism of fracture healing and how such processes are perturbed with increasing age may allow for better treatment options to manage fractures in older adults. Macrophages are attractive therapeutics due to their role in several phases of fracture healing. After injury, bone marrow-derived macrophages are recruited to the injury and propagate the inflammatory response, contribute to resolution of inflammation, and promote bone regeneration. A tissue resident population of macrophages named osteal macrophages are present in the periosteum and are directly associated with osteoblasts and these cells contribute to bone formation. Here, we utilized bulk RNA sequencing to analyze the transcriptional activity of osteal macrophages from old and young mice present in primary calvarial cultures. Macrophages demonstrated a diverse transcriptional profile, expressing genes involved in immune function as well as wound healing and regeneration. Periostin was significantly downregulated in macrophages from old mice compared to young. Periostin is an extracellular matrix protein with important functions that promote osteoblast activity during bone regeneration. An age-related decrease of periostin expression was verified in the fracture callus of old mice compared to young. Young periostin knockout mice demonstrated attenuated fracture healing outcomes that reflected what is observed in old mice. This study supports an important role of periostin in fracture healing, and therapeutically targeting the age-related decrease in periostin may improve healing outcomes in older populations.
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Affiliation(s)
- Daniel Clark
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh. 335 Sutherland Dr. Pittsburgh, PA 15261, USA
| | - Jeffrey Doelling
- College of Medicine, California Northstate University, 9700 West Taron Dr. Elk Grove, CA 95758, USA
| | - Diane Hu
- Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, School of Medicine, University of California San Francisco, Zuckerberg San Francisco General Hospital, 2550 23rd St. San Francisco, CA, 94110, USA
| | - Theodore Miclau
- Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, School of Medicine, University of California San Francisco, Zuckerberg San Francisco General Hospital, 2550 23rd St. San Francisco, CA, 94110, USA
| | - Mary Nakamura
- Division of Rheumatology, Department of Medicine, San Francisco VA Health Care System, 4150 Clement St. San Francisco, California, 94121 USA
| | - Ralph Marcucio
- Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, School of Medicine, University of California San Francisco, Zuckerberg San Francisco General Hospital, 2550 23rd St. San Francisco, CA, 94110, USA
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11
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Ebrahimi S, Navabazam A, Salemi F, Khaleghi F, Barzegar M, Saghafi F, Fallahzadeh H. The efficacy of teriparatide (Cinnopar®) on bone repair in mandibular fractures: A single blinded randomized clinical trial. J Craniomaxillofac Surg 2022; 50:923-928. [PMID: 36646571 DOI: 10.1016/j.jcms.2022.12.002] [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: 01/28/2022] [Revised: 12/12/2022] [Accepted: 12/27/2022] [Indexed: 01/07/2023] Open
Abstract
This study focused on the effects of teriparatide (CinnoPar) on healing and postoperative complications in mandibular bone fractures. In this single-blind randomized controlled trial, 30 patients with a mandibular fracture hospitalized for open reduction internal fixation were randomly assigned to the intervention (I) (n = 15) and control (C) (n = 15) groups. Both groups received daily acetaminophen and cephalexin for 1 week. For 1 month, Group I received daily subcutaneous teriparatide injections. The Radiographic Union Scale of the Mandible (RUSM) was used to assess mandibular bone fusion subjectively, and the Hounsfield unit (HU) was used to objectively assess radiodensity in a computed tomography (CT) scan. In both groups, the visual analog scale (VAS) score was used to assess postoperative complications such as pain, swelling, wound opening, pus secretion, and bitter taste. There was no significant difference in bone repair between the two groups in this study (P > 0.05). Teriparatide also had no effect on the postoperative complication rate in the control group (P > 0.05). Within the limitations of the study it seems that in mandibular fractures, teriparatide did not affect bone fusion or postoperative complications, so its use is not recommended for better bone fusion and fewer postoperative complications of mandibular fracture during the first month.
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Affiliation(s)
- Somayyeh Ebrahimi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, 8914815667, Iran.
| | - Alireza Navabazam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, 8914815667, Iran.
| | - Fateme Salemi
- Islamic Azad University of Medical Sciences, School of Medicine, Yazd, 19395/1495, Iran.
| | - Fatemeh Khaleghi
- Department of Radiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, 8916978477, Iran
| | - Mohsen Barzegar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, 8914815667, Iran.
| | - Fatemeh Saghafi
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173149, Iran.
| | - Hossien Fallahzadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran
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12
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Montarele LF, Pitol DL, Pereira BF, Feldman S, Fazan VPS, Issa JPM. Histological and Immunohistochemical Analysis of the Effects of Topical Melatonin Treatment Associated with Collagen Sponge and rhBMP-2 Protein on Bone Remodeling. Biomolecules 2022; 12:biom12121738. [PMID: 36551166 PMCID: PMC9775039 DOI: 10.3390/biom12121738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022] Open
Abstract
Extensive bone defect healing is an important health issue not yet completely resolved. Different alternative treatments have been proposed but, in face of a critical bone defect, it is still very difficult to reach a complete regeneration, with the new-formed bone presenting all morphological and physiological characteristics of a normal, preinjury bone. Topical melatonin use has shown as a promising adjuvant for bone regeneration due to its positive effects on bone metabolism. Thus, to search for new, safe, biological techniques that promote bone repair and favor defect healing, we hypothesized that there is a synergistic effect of melatonin treatment associated with rhBMP-2 to guide bone regeneration. This study aimed to investigate bone repair effects of topical melatonin administration in different concentrations (1, 10, and 100 µg), associated or not with rhBMP-2. Surgical-induced bone defect healing was qualitatively evaluated through histopathological analysis by light microscopy. Additionally, quantitative stereology was performed in immunohistochemistry-prepared tissue to identify angiogenic, osteogenic, and osteoclastogenic factors. Quantification data were compared between groups by the ANOVA/Tukey test and differences were considered significant when p < 0.05. Our results showed that the presence of the scaffold in the bone defect hindered the process of bone repair because in the group treated with "blood clot + scaffold" the results of bone formation and immunolabeling were reduced in comparison with all other groups (treated with melatonin alone or in association with rhBMP-2). Statistical analysis revealed a significant difference between the control group (bone defect + blood clot), and groups treated with different concentrations of melatonin in association with rhBMP-2, indicating a positive effect of the association for bone repair. This treatment is promising once it becomes a new safe alternative technique for the clinical treatment of fractures, bone defects, and bone grafts. Our results support the hypothesis of the safe use of the association of melatonin and rhBMP-2 and have established a safe and effective dose for this experimental treatment.
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Affiliation(s)
- Leticia Ferreira Montarele
- Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo (FORP-USP), Ribeirão Preto 14040-904, Brazil
| | - Dimitrius Leonardo Pitol
- Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo (FORP-USP), Ribeirão Preto 14040-904, Brazil
| | - Bruno Fiorelini Pereira
- Department of Biological Sciences, Universidade Federeal de São Paulo—UNIFESP, Diadema 05468-901, Brazil
| | - Sara Feldman
- LABOATEM, Laboratório de Biologia e Engenharia de Tecidos, Faculdade de Medicina, Universidade Nacional de Rosário, Rosário S2002, Argentina
| | - Valéria Paula Sassoli Fazan
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto 14049-900, Brazil
| | - João Paulo Mardegan Issa
- Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo (FORP-USP), Ribeirão Preto 14040-904, Brazil
- Correspondence:
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13
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He L, Yao Y, Wang N, Nan G. Effects of electric charge on fracture healing. Sci Rep 2022; 12:15839. [PMID: 36151271 PMCID: PMC9508132 DOI: 10.1038/s41598-022-20153-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/09/2022] [Indexed: 11/19/2022] Open
Abstract
Fracture nonunion is a common and challenging complication. Although direct current stimulation has been suggested to promote fracture healing, differences in cell density near the positive and negative electrodes have been reported during direct current stimulation. This study aimed to explore the effects of these differences on osteoblast proliferation and fracture healing. MC3T3-E1 cells were stimulated by positive and negative charges to observe cell proliferation, apoptosis, and osteogenic factor expression in vitro, while positive and negative charges were connected to the Kirschner wires of the fractures in an in vivo double-toe fracture model in New Zealand white rabbits and fracture healing was assessed in digital radiography (DR) examinations performed on days 1, 15, 30. Bone tissue samples of all rabbits were analysed histologically after the last examination. The results showed that in comparison with the control group, after DC stimulation, the number of cells near the positive electrode decreased significantly (P < 0.05), apoptosis increased (P < 0.05), the expression of osteocalcin, osteoblast-specific genes, and osteonectin decreased significantly near the positive electrode (P < 0.05) and increased significantly at the negative electrode (P < 0.05). The fracture at the positive electrode junction of New Zealand white rabbits did not heal. Histomorphological analysis showed more bone trabeculae and calcified bone in the bone tissue sections of the control group and the negative electrode group than in the positive electrode group. The bone trabeculae were thick and showed good connections. However, positive charge inhibited osteoblast proliferation and a positive charge at fracture sites did not favour fracture healing. Thus, a positive charge near the fracture site may be a reason for fracture nonunion.
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Affiliation(s)
- Ling He
- Department of Orthopaedics Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.,Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing, China.,Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yingling Yao
- Department of Orthopaedics Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.,Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing, China.,Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Nan Wang
- Department of Orthopaedics Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.,Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing, China.,Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Guoxin Nan
- Department of Orthopaedics Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China. .,Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing, China. .,Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, China.
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14
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Photobiomodulation isolated or associated with adipose-derived stem cells allograft improves inflammatory and oxidative parameters in the delayed-healing wound in streptozotocin-induced diabetic rats. Lasers Med Sci 2022; 37:3297-3308. [PMID: 36006574 DOI: 10.1007/s10103-022-03630-z] [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: 04/13/2022] [Accepted: 08/14/2022] [Indexed: 12/06/2022]
Abstract
The single and associated impressions of photobiomodulation (PBM) and adipose-derived stem cells (ADS) on stereological parameters (SP), and gene expression (GE) of some antioxidant and oxidative stressors of repairing injured skin at inflammation and proliferation steps (days 4 and 8) of a delayed healing, ischemic, and infected wound model (DHIIWM) were examined in type one diabetic (DM1) rats. DM1 was induced by administration of streptozotocin (40 mg/kg) in 48 rats. The DHIIWM was infected by methicillin-resistant Staphylococcus aureus (MRSA). The study comprised 4 groups (each, n = 6): Group 1 was the control group (CG). Group 2 received allograft human (h) ADSs transplanted into the wound. In group 3, PBM (890 nm, 80 Hz, 0.2 J/cm2) was emitted, and in group 4, a combination of PBM+ADS was used. At both studied time points, PBM+ADS, PBM, and ADS significantly decreased inflammatory cell count (p < 0.05) and increased granulation tissue formation compared to CG (p < 0.05). Similarly, there were lower inflammatory cells, as well as higher granulation tissue in the PBM+ADS compared to those of alone PBM and ADS (all, p < 0.001). At both studied time points, the GE of catalase (CAT) and superoxide dismutase (SOD) was remarkably higher in all treatment groups than in CG (p < 0.05). Concomitantly, the outcomes of the PBM+ADS group were higher than the single effects of PBM and ADS (p < 0.05). On day 8, the GE of NADPH oxidase (NOX) 1 and NOX4 was substantially less in the PBM+ADS than in the other groups (p < 0.05). PBM+ADS, PBM, and ADS treatments significantly accelerated the inflammatory and proliferative stages of wound healing in a DIIWHM with MRSA in DM1 rats by decreasing the inflammatory response, and NOX1 and 4 as well; and also increasing granulation tissue formation and SOD and CAT. The associated treatment of PBM+ADS was more effective than the individual impacts of alone PBM and ADS because of the additive anti-inflammatory and proliferative effects of PBM plus ADS treatments.
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15
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Chen L, Yu C, Xiong Y, Chen K, Liu P, Panayi AC, Xiao X, Feng Q, Mi B, Liu G. Multifunctional hydrogel enhances bone regeneration through sustained release of Stromal Cell-Derived Factor-1α and exosomes. Bioact Mater 2022; 25:460-471. [PMID: 37056272 PMCID: PMC10087917 DOI: 10.1016/j.bioactmat.2022.07.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 11/02/2022] Open
Abstract
Fracture nonunion remains a great challenge for orthopedic surgeons. Fracture repair comprises of three phases, the inflammatory, repair and remodeling stage. Extensive advancements have been made in the field of bone repair, including development of strategies to balance the M1/M2 macrophage populations, and to improve osteogenesis and angiogenesis. However, such developments focused on only one or the latter two phases, while ignoring the inflammatory phase during which cell recruitment occurs. In this study, we combined Stromal Cell-Derived Factor-1α (SDF-1α) and M2 macrophage derived exosomes (M2D-Exos) with a hyaluronic acid (HA)-based hydrogel precursor solution to synthesize an injectable, self-healing, adhesive HA@SDF-1α/M2D-Exos hydrogel. The HA hydrogel demonstrated good biocompatibility and hemostatic ability, with the 4% HA hydrogels displaying great antibacterial activity against gram-negative E. coli and gram-positive S. aureus and Methicillin-resistant Staphylococcus aureus (MRSA). Synchronously and sustainably released SDF-1α and M2D-Exos from the HA@SDF-1α/M2D-Exos hydrogel enhanced proliferation and migration of human bone marrow mesenchymal stem cell (HMSCs) and Human Umbilical Vein Endothelial Cells (HUVECs), promoting osteogenesis and angiogenesis both in vivo and in vitro. Overall, the developed HA@ SDF-1α/M2D-Exos hydrogel was compatible with the natural healing process of fractures and provides a new modality for accelerating bone repair by coupling osteogenesis, angiogenesis, and resisting infection at all stages.
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16
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Nikakhtar Y, Shafiei SS, Fathi-Roudsari M, Asadi-Eydivand M, ShiraliPour F. Preparation and characterization of electrospun polycaprolactone/brushite scaffolds to promote osteogenic differentiation of mesenchymal stem cells. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2022; 33:1102-1122. [PMID: 35144516 DOI: 10.1080/09205063.2022.2041786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/19/2021] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
Bone tissue engineering aims to develop effective strategies for repairing or replacing damaged bone tissue. In this study, composite scaffolds consisting of dicalcium phosphate dihydrate (DCDP, brushite) as a bone phase mineral precursor with different weight percentages (0%, 1%, 3%, 5%, and 10%) in combination with polycaprolactone (PCL) were fabricated by electrospinning technique. The morphology and mechanical behavior of scaffolds were characterized using scanning electron microscopy and tensile strength test, respectively. The bioactivity of scaffolds was assessed in simulated body fluid. Adhesion, viability, proliferation, and differentiation of mesenchymal stem cells derived from the human bone marrow on scaffolds were investigated using electron microscopy, MTT assay, live-dead assay, alizarin red staining, alkaline phosphatase activity and, gene expression analysis by real-time PCR. The results showed that the scaffold containing 3 wt. % of DCDP had the highest tensile strength (15.35 MPa). Furthermore, cells seeded on scaffolds showed over 80% viability after 1, 3, 7 days of incubation. Also, the results showed that the addition of DCDP to the PCL significantly increased the alkaline phosphatase activity. The osteocalcin gene expression in the composite scaffold showed a 6.1-fold increase compared to the pure PCL scaffold. It is concluded that electrospun PCL scaffolds containing DCDP with optimum concentration can be a proper candidate for bone tissue engineering applications.
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Affiliation(s)
- Yeganeh Nikakhtar
- Department of Stem Cell and Regenerative Medicine, Institute of Medical Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Seyedeh Sara Shafiei
- Department of Stem Cell and Regenerative Medicine, Institute of Medical Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Mehrnoush Fathi-Roudsari
- Department of Stem Cell and Regenerative Medicine, Institute of Medical Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Mitra Asadi-Eydivand
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Faeze ShiraliPour
- Department of Stem Cell and Regenerative Medicine, Institute of Medical Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
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17
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Pabst A, Asran A, Lüers S, Laub M, Holfeld C, Palarie V, Thiem DGE, Becker P, Hartmann A, Heimes D, Al-Nawas B, Kämmerer PW. Osseointegration of a New, Ultrahydrophilic and Nanostructured Dental Implant Surface: A Comparative In Vivo Study. Biomedicines 2022; 10:943. [PMID: 35625680 PMCID: PMC9138320 DOI: 10.3390/biomedicines10050943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 02/01/2023] Open
Abstract
This study compared the osseointegration of acid-etched, ultrahydrophilic, micro- and nanostructured implant surfaces (ANU) with non-ultra-hydrophilic, microstructured (SA) and non-ultrahydrophilic, micro- and nanostructured implant surfaces (AN) in vivo. Fifty-four implants (n = 18 per group) were bilaterally inserted into the proximal tibia of New Zealand rabbits (n = 27). After 1, 2, and 4 weeks, bone-implant contact (BIC, %) in the cortical (cBIC) and spongious bone (sBIC), bone chamber ingrowth (BChI, %), and the supra-crestal, subperiosteal amount of newly formed bone, called percentage of linear bone fill (PLF, %), were analyzed. After one week, cBIC was significantly higher for AN and ANU when compared to SA (p = 0.01 and p = 0.005). PLF was significantly increased for ANU when compared to AN and SA (p = 0.022 and p = 0.025). After 2 weeks, cBIC was significantly higher in SA when compared to AN (p = 0.039) and after 4 weeks, no significant differences in any of the measured parameters were found anymore. Ultrahydrophilic implants initially improved osseointegration when compared to their non-ultrahydrophilic counterparts. In accordance, ultrahydrophilic implants might be appropriate in cases with a necessity for an accelerated and improved osseointegration, such as in critical size alveolar defects or an affected bone turnover.
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Affiliation(s)
- Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072 Koblenz, Germany; (A.P.); (P.B.)
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Ashraf Asran
- Morphoplant GmbH, Universitätsstr. 136, 44799 Bochum, Germany; (A.A.); (S.L.); (M.L.)
| | - Steffen Lüers
- Morphoplant GmbH, Universitätsstr. 136, 44799 Bochum, Germany; (A.A.); (S.L.); (M.L.)
| | - Markus Laub
- Morphoplant GmbH, Universitätsstr. 136, 44799 Bochum, Germany; (A.A.); (S.L.); (M.L.)
| | - Christopher Holfeld
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Victor Palarie
- Laboratory of Tissue Engineering and Cellular Culture, State University of Medicine and Pharmaceutics “Nicolae Testemitanu”, Stefan cel Mare si Sfant Boulevard 165, 2004 Chisinau, Moldova;
| | - Daniel G. E. Thiem
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Philipp Becker
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072 Koblenz, Germany; (A.P.); (P.B.)
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Amely Hartmann
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Diana Heimes
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (C.H.); (D.G.E.T.); (A.H.); (D.H.); (B.A.-N.)
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18
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Lang A, Stefanowski J, Pfeiffenberger M, Wolter A, Damerau A, Hemmati-Sadeghi S, Haag R, Hauser AE, Löhning M, Duda GN, Hoff P, Schmidt-Bleek K, Gaber T, Buttgereit F. MIF does only marginally enhance the pro-regenerative capacities of DFO in a mouse-osteotomy-model of compromised bone healing conditions. Bone 2022; 154:116247. [PMID: 34743042 DOI: 10.1016/j.bone.2021.116247] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/18/2022]
Abstract
The initial phase of fracture healing is crucial for the success of bone regeneration and is characterized by an inflammatory milieu and low oxygen tension (hypoxia). Negative interference with or prolongation of this fine-tuned initiation phase will ultimately lead to a delayed or incomplete healing such as non-unions which then requires an effective and gentle therapeutic intervention. Common reasons include a dysregulated immune response, immunosuppression or a failure in cellular adaptation to the inflammatory hypoxic milieu of the fracture gap and a reduction in vascularizing capacity by environmental noxious agents (e.g. rheumatoid arthritis or smoking). The hypoxia-inducible factor (HIF)-1α is responsible for the cellular adaptation to hypoxia, activating angiogenesis and supporting cell attraction and migration to the fracture gap. Here, we hypothesized that stabilizing HIF-1α could be a cost-effective and low-risk prevention strategy for fracture healing disorders. Therefore, we combined a well-known HIF-stabilizer - deferoxamine (DFO) - and a less known HIF-enhancer - macrophage migration inhibitory factor (MIF) - to synergistically induce improved fracture healing. Stabilization of HIF-1α enhanced calcification and osteogenic differentiation of MSCs in vitro. In vivo, only the application of DFO without MIF during the initial healing phase increased callus mineralization and vessel formation in a preclinical mouse-osteotomy-model modified to display a compromised healing. Although we did not find a synergistically effect of MIF when added to DFO, our findings provide additional support for a preventive strategy towards bone healing disorders in patients with a higher risk by accelerating fracture healing using DFO to stabilize HIF-1α.
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Affiliation(s)
- Annemarie Lang
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany; Berlin Institute of Health at Charité Universitätsmedizin Berlin, Center for Regenerative Therapies, Berlin, Germany
| | - Jonathan Stefanowski
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Moritz Pfeiffenberger
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Angelique Wolter
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Alexandra Damerau
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Shabnam Hemmati-Sadeghi
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; Berlin Institute of Health at Charité Universitätsmedizin Berlin, Center for Regenerative Therapies, Berlin, Germany; Institute of Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany
| | - Rainer Haag
- Institute of Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany
| | - Anja E Hauser
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Max Löhning
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Georg N Duda
- Berlin Institute of Health at Charité Universitätsmedizin Berlin, Center for Regenerative Therapies, Berlin, Germany; Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany; Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Julius Wolff Institute, Berlin, Germany
| | - Paula Hoff
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany; Berlin Institute of Health at Charité Universitätsmedizin Berlin, Center for Regenerative Therapies, Berlin, Germany
| | - Katharina Schmidt-Bleek
- Berlin Institute of Health at Charité Universitätsmedizin Berlin, Center for Regenerative Therapies, Berlin, Germany; Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany; Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Julius Wolff Institute, Berlin, Germany
| | - Timo Gaber
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany; Berlin Institute of Health at Charité Universitätsmedizin Berlin, Center for Regenerative Therapies, Berlin, Germany.
| | - Frank Buttgereit
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany; Berlin Institute of Health at Charité Universitätsmedizin Berlin, Center for Regenerative Therapies, Berlin, Germany
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19
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Oh J, Jo D, Park K, Kang P, Shin Y. Experimental Rat Model of Bony Defects in the Facet Joint Maintained with Bone Wax for the Study of Spinal Pain. J Pain Res 2022; 15:171-180. [PMID: 35125888 PMCID: PMC8807867 DOI: 10.2147/jpr.s344810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/11/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose Studies using experimental rat models for low back pain due to facet-joint defects are scarce. This study used a novel experimental rat model to determine whether bony defects induced by facetectomy could be maintained by bone wax, thus mimicking spondylolysis, and to analyze the effect of the facetectomy on rat behavior. Patients and Methods Twelve 10-week-old male Wistar rats weighing 300–350 g were divided into group A (n = 6) that underwent unilateral facetectomy of the right L5-6 facet joint and group B (n = 6) that additionally applied water-soluble bone wax at the facetectomy site. The difference in the left and right stride length, detected by the footprint test, and change in the left and right facet joint area were compared before and 4 weeks after the experiment. Results Even though the difference between the left and right stride lengths of groups A and B was not statistically significant, in contrast to group A, group B showed a shorter stride length on the right side (p = 0.22 and 0.46, in group A and group B, respectively). The right facet joint area, where the facetectomy was performed, was significantly smaller in group B 4 weeks after surgery, but not in group A (p = 0.50 and < 0.01, in group A and group B, respectively). Conclusion Based on the results, we concluded that the bony defects, induced by facetectomy at the L5-6 facet joint, were maintained with bone wax. This study will provide an experimental model for bony defects in the facet joint.
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Affiliation(s)
- Jinyoung Oh
- Department of Anesthesiology and Pain Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Daehyun Jo
- Jodaehyun Pain Center, Jeonju, Republic of Korea
| | - Kicheol Park
- Clinical Research Institute, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Posoon Kang
- Department of Anesthesiology and Pain Medicine, Konynang University Hospital, Daejeon, Republic of Korea
| | - Youngsup Shin
- Department of Anesthesiology and Pain Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
- Correspondence: Youngsup Shin, Department of Anesthesiology and Pain Medicine, Chungnam National University College of Medicine, 282, Munhwa-ro, Junggu, Daejon, 35015, Republic of Korea, Tel +82-42-280-7840, Fax +82-42-280-7968, Email
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20
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A pilot study of circulating levels of TGF-β1 and TGF-β2 as biomarkers of bone healing in patients with non-hypertrophic pseudoarthrosis of long bones. Bone Rep 2021; 16:101157. [PMID: 34950754 PMCID: PMC8671858 DOI: 10.1016/j.bonr.2021.101157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022] Open
Abstract
Background Pseudoarthrosis or non-union is a complication with an incidence of 5-10% of bone fractures, most frequently located in the diaphysis of long bones. The management of this complication is addressed by means of complex surgical procedures and is a concern for orthopaedic and trauma surgeons nowadays. The use of biomarkers for diagnosing patients at risk of non-union would help us to establish special measures for early corrective treatment. Methods Prospective exploratory pilot study with a cohort of 20 patients diagnosed of non-hypertrophic pseudoarthrosis of long bones who were treated surgically with either autologous bone graft or a Tissue Engineering Product composed of bone marrow-derived Mesenchymal Stromal Cells. Patients were followed for 12 months and plasma blood samples were obtained to determine circulating levels of Transforming Growth Factor Beta 1 and Beta 2 (TGF-β1 and TGF-β2, respectively) at inclusion, and at 1 week, 2 weeks, and months 1, 2, 3, 6 and 12 after surgery. Radiological bone healing was evaluated by the Tomographic Union Score (TUS). Results Basal levels of TGF-β1 and TGF-β2 were determined in the twenty patients (26,702 ± 14,537 pg/mL and 307.8 ± 83.1 pg/mL, respectively). Three of them withdrew from the study, so complete follow-up was conducted on 17 patients (9 successfully healed vs. 8 that did not heal). Statistically significant differences between the bone healing group and the non-union group were found at month 12 for both TGF-β1 (p = 0.005) and TGF-β2 (p = 0.02). Conclusions TGF-β1 and TGF-β2 are biomarkers that correlate with clinical evidence of bone regeneration and may be used to monitor patients, although early predictive value after intervention needs to be further studied in combination with other molecules.
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21
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Knox AM, McGuire AC, Natoli RM, Kacena MA, Collier CD. Methodology, selection, and integration of fracture healing assessments in mice. J Orthop Res 2021; 39:2295-2309. [PMID: 34436797 PMCID: PMC8542592 DOI: 10.1002/jor.25172] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 08/02/2021] [Accepted: 08/13/2021] [Indexed: 02/04/2023]
Abstract
Long bone fractures are one of the most common and costly medical conditions encountered after trauma. Characterization of the biology of fracture healing and development of potential medical interventions generally involves animal models of fracture healing using varying genetic or treatment groups, then analyzing relative repair success via the synthesis of diverse assessment methodologies. Murine models are some of the most widely used given their low cost, wide variety of genetic variants, and rapid breeding and maturation. This review addresses key concerns regarding fracture repair investigations in mice and may serve as a guide in conducting and interpreting such studies. Specifically, this review details the procedures, highlights relevant parameters, and discusses special considerations for the selection and integration of the major modalities used for quantifying fracture repair in such studies, including X-ray, microcomputed tomography, histomorphometric, biomechanical, gene expression and biomarker analyses.
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Affiliation(s)
- Adam M. Knox
- Department of Orthopaedic Surgery, Indiana University School of Medicine, IN, USA
| | - Anthony C. McGuire
- Department of Orthopaedic Surgery, Indiana University School of Medicine, IN, USA
| | - Roman M. Natoli
- Department of Orthopaedic Surgery, Indiana University School of Medicine, IN, USA
| | - Melissa A. Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, IN, USA
- Richard L. Roudebush VA Medical Center, IN, USA
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22
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Menger MM, Laschke MW, Scheuer C, Bauer D, Bleimehl M, Später T, Rollmann MF, Braun BJ, Herath SC, Raza A, Menger MD, Histing T. Establishment of a reliable model to study the failure of fracture healing in aged mice. J Gerontol A Biol Sci Med Sci 2021; 77:909-917. [PMID: 34626193 DOI: 10.1093/gerona/glab304] [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: 03/25/2021] [Indexed: 11/15/2022] Open
Abstract
The failure of fracture healing represents a substantial clinical problem. Moreover, aged patients demonstrate an elevated risk for failed bone healing. However, murine models to study the failure of fracture healing are established only in young adult animals. Therefore, the aim of this study was to develop a reliable model to study failed fracture healing in aged mice. After creation of a 1.8 mm segmental defect and periosteal resection, femora of aged mice (18-20 months) and young adult control mice (3-4 months) were stabilized by pin-clip fixation. Segmental defects were analyzed by means of biomechanics, X-ray and micro-computed tomography (µCT), as well as histomorphometric, immunohistochemical and Western blot analysis. After 10 weeks all animals showed a complete lack of osseous bridging, resulting in fracture healing failure. Segmental defects in aged mice revealed a reduced bone formation and vascularization when compared to young adult mice. This was associated with a decreased expression of bone formation markers. In addition, we detected a reduced number of tartrate-resistance acid phosphatase (TRAP)-positive osteoclasts and an elevated osteoprotegerin (OPG)/receptor activator of NF-ĸB ligand (RANKL)-ratio in aged animals, indicating a reduced osteoclast activity. Moreover, aged animals showed also an enhanced inflammatory response, characterized by an increased infiltration of macrophages within the callus tissue. Taken together, we herein report for the first time a reliable model to study fracture healing failure in aged mice. In the future, the use of this model enables to study novel therapeutic strategies and molecular mechanics of failed fracture healing during aging.
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Affiliation(s)
- Maximilian M Menger
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany.,Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Claudia Scheuer
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - David Bauer
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Michelle Bleimehl
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Thomas Später
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Mika F Rollmann
- Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Benedikt J Braun
- Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Steven C Herath
- Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Ahsan Raza
- Department of Experimental and Clinical Pharmacology and Toxicology, Saarland University, 66421 Homburg/Saar, Germany
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Tina Histing
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany.,Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
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Mice Lacking the Calcitonin Receptor Do Not Display Improved Bone Healing. Cells 2021; 10:cells10092304. [PMID: 34571953 PMCID: PMC8471896 DOI: 10.3390/cells10092304] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
Despite significant advances in surgical techniques, treatment options for impaired bone healing are still limited. Inadequate bone regeneration is not only associated with pain, prolonged immobilization and often multiple revision surgeries, but also with high socioeconomic costs, underlining the importance of a detailed understanding of the bone healing process. In this regard, we previously showed that mice lacking the calcitonin receptor (CTR) display increased bone formation mediated through the increased osteoclastic secretion of sphingosine-1-phosphate (S1P), an osteoanabolic molecule promoting osteoblast function. Although strong evidence is now available for the crucial role of osteoclast-to-osteoblast coupling in normal bone hemostasis, the relevance of this paracrine crosstalk during bone regeneration is unknown. Therefore, our study was designed to test whether increased osteoclast-to-osteoblast coupling, as observed in CTR-deficient mice, may positively affect bone repair. In a standardized femoral osteotomy model, global CTR-deficient mice displayed no alteration in radiologic callus parameters. Likewise, static histomorphometry demonstrated moderate impairment of callus microstructure and normal osseous bridging of osteotomy ends. In conclusion, bone regeneration is not accelerated in CTR-deficient mice, and contrary to its osteoanabolic action in normal bone turnover, osteoclast-to-osteoblast coupling specifically involving the CTR-S1P axis, may only be of minor relevance during bone healing.
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Chow SKH, Cui C, Cheng KYK, Chim YN, Wang J, Wong CHW, Ng KW, Wong RMY, Cheung WH. Acute Inflammatory Response in Osteoporotic Fracture Healing Augmented with Mechanical Stimulation is Regulated In Vivo through the p38-MAPK Pathway. Int J Mol Sci 2021; 22:ijms22168720. [PMID: 34445423 PMCID: PMC8395718 DOI: 10.3390/ijms22168720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 01/01/2023] Open
Abstract
Low-magnitude high-frequency vibration (LMHFV) has previously been reported to modulate the acute inflammatory response of ovariectomy-induced osteoporotic fracture healing. However, the underlying mechanisms are not clear. In the present study, we investigated the effect of LMHFV on the inflammatory response and the role of the p38 MAPK mechanical signaling pathway in macrophages during the healing process. A closed femoral fracture SD rat model was used. In vivo results showed that LMHFV enhanced activation of the p38 MAPK pathway at the fracture site. The acute inflammatory response, expression of inflammatory cytokines, and callus formation were suppressed in vivo by p38 MAPK inhibition. However, LMHFV did not show direct in vitro enhancement effects on the polarization of RAW264.7 macrophage from the M1 to M2 phenotype, but instead promoted macrophage enlargement and transformation to dendritic monocytes. The present study demonstrated that p38 MAPK modulated the enhancement effects of mechanical stimulation in vivo only. LMHFV may not have exerted its enhancement effects directly on macrophage, but the exact mechanism may have taken a different pathway that requires further investigation in the various subsets of immune cells.
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Affiliation(s)
- Simon Kwoon Ho Chow
- Correspondence: (S.K.H.C.); (W.H.C.); Tel.: +852-3505-1559 (S.K.H.C.); +852-3505-2715 (W.H.C.)
| | | | | | | | | | | | | | | | - Wing Hoi Cheung
- Correspondence: (S.K.H.C.); (W.H.C.); Tel.: +852-3505-1559 (S.K.H.C.); +852-3505-2715 (W.H.C.)
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25
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Augat P, Simpson H. Enhancement of Fracture Healing. Injury 2021; 52 Suppl 2:S1-S2. [PMID: 34099104 DOI: 10.1016/j.injury.2021.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Peter Augat
- Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Germany & Paracelsus Medical University Salzburg, Austria.
| | - Hamish Simpson
- Department of Trauma and Orthopaedics, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK
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26
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Wu XQ, Wang D, Liu Y, Zhou JL. Development of a tibial experimental non-union model in rats. J Orthop Surg Res 2021; 16:261. [PMID: 33853660 PMCID: PMC8045330 DOI: 10.1186/s13018-021-02408-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Many non-union animal models have been developed to explore the problems surrounding fracture healing. However, the existing models are not perfect and cannot satisfy all non-union studies. This study aimed to make a non-union model of the tibia in rats by cauterization of the posterior of 2 mm on both sides of the fracture end after open osteotomy of the tibia and fixing the fractured tibia with a Kirschner wire 0.8 mm in diameter. METHODS For this study, 96 female adult Sprague-Dawley (SD) rats were used. The rats underwent surgery to produce a tibial open fracture and were fixed with a 0.8-mm diameter Kirschner wire. In 48 of the rats, the periosteum proximal and distal to the fracture end was cauterized. RESULTS At 2, 4, 6, and 8 weeks after surgery, radiological and histological analysis showed typical physiological healing in the control group, and the healing rate was 100% at 6 weeks. But the non-union group was characterized by resorption of the fracture ends with few callus formations and no bridging callus formation, and the healing rate was 0% at 8 weeks. CONCLUSIONS This method represents a reproducible model to create atrophic non-unions. This model provides a new option for studying the basic healing mechanisms and evaluating new therapies for bone regeneration and treatment of non-unions.
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Affiliation(s)
- Xue-Qiang Wu
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
- Department of Handsurgery, Tangshan Second Hospital, Tangshan, 063000, China
| | - Dong Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yang Liu
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Jun-Lin Zhou
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
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Hu H, Wang D, Li L, Yin H, He G, Zhang Y. Role of microRNA-335 carried by bone marrow mesenchymal stem cells-derived extracellular vesicles in bone fracture recovery. Cell Death Dis 2021; 12:156. [PMID: 33542183 PMCID: PMC7862274 DOI: 10.1038/s41419-021-03430-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 01/30/2023]
Abstract
Mesenchymal stem cells (MSCs) have the potential to reduce healing time and treat nonunion in fracture patients. In this study, bone marrow MSCs-derived extracellular vesicles (B-EVs) were firstly extracted and identified. CD9-/- and normal mice were enrolled for the establishment of fracture models and then injected with B-EVs. Osteoblast differentiation and fracture recovery were estimated. The levels of osteoblast-related genes were detected, and differentially expressed microRNAs (miRs) in B-EVs-treated normal fracture mice were screened and verified. The downstream mechanisms of miR were predicted and assessed. The loss-of functions of miR-335 in B-EV and gain-of-functions of VapB were performed in animal and cell experiments to evaluate their roles in bone fracture. Collectively, B-EVs promoted bone fracture recovery and osteoblast differentiation by releasing miR-335. miR-335 downregulation in B-EVs impaired B-EV functions in fracture recovery and osteoblast differentiation. miR-335 could target VapB, and VapB overexpression reversed the effects of B-EVs on osteoblast differentiation. B-EV treatment activated the Wnt/β-catenin pathway in fracture mice and osteoblasts-like cells. Taken together, the study suggested that B-EVs carry miR-335 to promote bone fracture recovery via VapB and the Wnt/β-catenin pathway. This study may offer insights into bone fracture treatment.
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Affiliation(s)
- Haifeng Hu
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dong Wang
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lihong Li
- Department of Clinical Laboratory, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Haiyang Yin
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Guoyu He
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yonghong Zhang
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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28
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Oliveira ÉR, Nie L, Podstawczyk D, Allahbakhsh A, Ratnayake J, Brasil DL, Shavandi A. Advances in Growth Factor Delivery for Bone Tissue Engineering. Int J Mol Sci 2021; 22:E903. [PMID: 33477502 PMCID: PMC7831065 DOI: 10.3390/ijms22020903] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/17/2022] Open
Abstract
Shortcomings related to the treatment of bone diseases and consequent tissue regeneration such as transplants have been addressed to some extent by tissue engineering and regenerative medicine. Tissue engineering has promoted structures that can simulate the extracellular matrix and are capable of guiding natural bone repair using signaling molecules to promote osteoinduction and angiogenesis essential in the formation of new bone tissues. Although recent studies on developing novel growth factor delivery systems for bone repair have attracted great attention, taking into account the complexity of the extracellular matrix, scaffolding and growth factors should not be explored independently. Consequently, systems that combine both concepts have great potential to promote the effectiveness of bone regeneration methods. In this review, recent developments in bone regeneration that simultaneously consider scaffolding and growth factors are covered in detail. The main emphasis in this overview is on delivery strategies that employ polymer-based scaffolds for spatiotemporal-controlled delivery of both single and multiple growth factors in bone-regeneration approaches. From clinical applications to creating alternative structural materials, bone tissue engineering has been advancing constantly, and it is relevant to regularly update related topics.
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Affiliation(s)
- Érica Resende Oliveira
- Food Engineering Department, School of Agronomy, Universidade Federal de Goiás, Campus Samambaia, Goiânia CEP 74690-900, Goiás, Brazil;
| | - Lei Nie
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
| | - Daria Podstawczyk
- Department of Process Engineering and Technology of Polymer and Carbon Materials, Faculty of Chemistry, Wroclaw University of Science and Technology, 4/6 Norwida Street, 50-373 Wroclaw, Poland;
| | - Ahmad Allahbakhsh
- Department of Materials and Polymer Engineering, Faculty of Engineering, Hakim Sabzevari University, Sabzevar 9617976487, Iran;
| | - Jithendra Ratnayake
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin 9016, New Zealand;
| | - Dandara Lima Brasil
- Food Science Department, Universidade Federal de Lavras, Lavras CEP 37200-900, Minas Gerais, Brazil;
| | - Amin Shavandi
- BioMatter Unit—École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue F.D. Roosevelt, 50—CP 165/61, 1050 Brussels, Belgium
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Wang Y, Ling L, Tian F, Won Kim SH, Ho S, Bikle DD. Ablation of Ephrin B2 in Col2 Expressing Cells Delays Fracture Repair. Endocrinology 2020; 161:5912608. [PMID: 32987403 PMCID: PMC7609132 DOI: 10.1210/endocr/bqaa179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 09/23/2020] [Indexed: 01/15/2023]
Abstract
Ephrin B2 is critical for endochondral bone development. In this study, we investigated its role in fracture repair by deleting ephrin B2 in type II collagen (Col.2) expressing cells. We used a nonstable tibia fracture model to evaluate fracture repair at 3 sites: intramembranous bone formation, endochondral bone formation, and intramedullary bone formation. We observed that during fracture repair, deletion of ephrin B2 impaired periosteal stem cell activation, inhibited their proliferation, decreased their survival, and blocked their differentiation into osteoblasts and chondrocytes. In addition, deletion of ephrin B2 decreased vascular endothelial growth factor production as well as vascular invasion into the fracture site. These changes led to reduced cartilage to bone conversion in the callus with decreased new bone formation, resulting in impaired fracture repair. Our data indicate that ephrin B2 in Col2-expressing cells is a critical regulator of fracture repair, pointing to a new and potentially targetable mechanism to enhance fracture repair.
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Affiliation(s)
- Yongmei Wang
- Endocrine Unit, University of California, San Francisco and Veterans Affairs Health Care System, San Francisco, California, USA
- Correspondence: Yongmei Wang, MD, PhD, Endocrine Unit (111N), VAMC, 1700 Owens Street, San Francisco, CA 94158. E-mail:
| | - Lin Ling
- Endocrine Unit, University of California, San Francisco and Veterans Affairs Health Care System, San Francisco, California, USA
| | - Faming Tian
- Endocrine Unit, University of California, San Francisco and Veterans Affairs Health Care System, San Francisco, California, USA
| | - Sun Hee Won Kim
- Endocrine Unit, University of California, San Francisco and Veterans Affairs Health Care System, San Francisco, California, USA
| | - Sunita Ho
- Bioengineering & Biomaterials Micro-CT and Imaging Facility, University of California, San Francisco, San Francisco, California, USA
| | - Daniel D Bikle
- Endocrine Unit, University of California, San Francisco and Veterans Affairs Health Care System, San Francisco, California, USA
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Pinheiro NM, Cardoso FAG, Mendonça AC, Zanier-Gomes PH, Corrêa RRM, Carneiro ACDM, Crema VO. Effect of radiofrequency on patellar ligament repair of Wistar rats. J Bodyw Mov Ther 2020; 24:164-167. [DOI: 10.1016/j.jbmt.2020.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/16/2020] [Accepted: 07/19/2020] [Indexed: 11/30/2022]
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Wang R, Shi M, Xu F, Qiu Y, Zhang P, Shen K, Zhao Q, Yu J, Zhang Y. Graphdiyne-modified TiO 2 nanofibers with osteoinductive and enhanced photocatalytic antibacterial activities to prevent implant infection. Nat Commun 2020; 11:4465. [PMID: 32901012 PMCID: PMC7479592 DOI: 10.1038/s41467-020-18267-1] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 08/07/2020] [Indexed: 02/03/2023] Open
Abstract
Titanium implants have been widely used in bone tissue engineering for decades. However, orthopedic implant-associated infections increase the risk of implant failure and even lead to amputation in severe cases. Although TiO2 has photocatalytic activity to produce reactive oxygen species (ROS), the recombination of generated electrons and holes limits its antibacterial ability. Here, we describe a graphdiyne (GDY) composite TiO2 nanofiber that combats implant infections through enhanced photocatalysis and prolonged antibacterial ability. In addition, GDY-modified TiO2 nanofibers exert superior biocompatibility and osteoinductive abilities for cell adhesion and differentiation, thus contributing to the bone tissue regeneration process in drug-resistant bacteria-induced implant infection.
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Affiliation(s)
- Rui Wang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China
- Medical Research Institute, School of Medicine, Wuhan University, 430071, Wuhan, PR China
| | - Miusi Shi
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China
| | - Feiyan Xu
- Foshan Xianhu Laboratory of the Advanced Energy Science and Technology Guangdong Laboratory, Xianhu Hydrogen Valley, 528200, Foshan, PR China
- State Key Laboratory of Advanced Technology for Material Synthesis and Processing, Wuhan University of Technology, Luoshi Road 122#, 430070, Wuhan, PR China
| | - Yun Qiu
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China
| | - Peng Zhang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China
| | - Kailun Shen
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China
| | - Qin Zhao
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China
| | - Jiaguo Yu
- Foshan Xianhu Laboratory of the Advanced Energy Science and Technology Guangdong Laboratory, Xianhu Hydrogen Valley, 528200, Foshan, PR China.
- State Key Laboratory of Advanced Technology for Material Synthesis and Processing, Wuhan University of Technology, Luoshi Road 122#, 430070, Wuhan, PR China.
| | - Yufeng Zhang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, PR China.
- Medical Research Institute, School of Medicine, Wuhan University, 430071, Wuhan, PR China.
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MalekiGorji M, Golestaneh A, Razavi SM. The effect of two phosphodiesterase inhibitors on bone healing in mandibular fractures (animal study in rats). J Korean Assoc Oral Maxillofac Surg 2020; 46:258-265. [PMID: 32855373 PMCID: PMC7469969 DOI: 10.5125/jkaoms.2020.46.4.258] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/09/2019] [Accepted: 12/17/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Despite advances in maxillofacial surgery, impaired bone healing remains a concern for surgical teams. Many studies have evaluated the effects of sildenafil and pentoxifylline on bone healing. However, their effects on healing of bone fractures have not been well investigated. This study aimed to assess the effects of the phosphodiesterase inhibitors sildenafil and pentoxifylline on healing of mandibular fractures in rats. MATERIALS AND METHODS A total of 60 rats were randomly divided into six groups of 10. Mandibular fracture was induced in all rats. After the surgical procedure, group C1 received saline, group S1 received 10 mg/kg sildenafil and group P1 received 50 mg/kg pentoxifylline. The rats were sacrificed after 1 week. Groups C4, S4, and P4 received pharmaceutical therapy as in groups C1, S1, and P1 but were sacrificed after 4 weeks. The samples then underwent histological analysis. RESULTS The mean rate of bone healing of mandibular fractures in groups S1 and P1 was significantly higher than in group C1 at 1 week (P<0.001). The mean rate of bone healing of mandibular fractures in group P1 was higher than in group S1 at 1 week (P=0.04). The mean rate of bone healing of mandibular fractures in groups S4 (P=0.001) and P4 (P=0.004) was significantly higher than in group C4 at 4 weeks, but no significant difference was noted in the rate of healing between groups P4 and S4 (P=0.53). CONCLUSION Sildenafil and pentoxifylline can be used as adjuncts to enhance bone healing in rats.
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Affiliation(s)
- Mohsen MalekiGorji
- Department of Oral and Maxillofacial Surgery, Dental School, Islamic Azad University, Isfahan (Khorasgan) Branch, Iran
| | - Arash Golestaneh
- Department of Oral and Maxillofacial Surgery, Dental School, Islamic Azad University, Isfahan (Khorasgan) Branch, Iran
| | - Seyyed Mohammad Razavi
- Torabinejad Dental Research Center and Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Xue Y, Li Z, Wang Y, Zhu X, Hu R, Xu W. Role of the HIF‑1α/SDF‑1/CXCR4 signaling axis in accelerated fracture healing after craniocerebral injury. Mol Med Rep 2020; 22:2767-2774. [PMID: 32945380 PMCID: PMC7453606 DOI: 10.3892/mmr.2020.11361] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/22/2020] [Indexed: 12/21/2022] Open
Abstract
The hypoxic state of the brain tissue surrounding craniocerebral injury induces an increase in the secretion of HIF-1α during the healing process. HIF-1α can promote mesenchymal stem cell (MSC) migration to ischemic and hypoxic sites by regulating the expression levels of molecules such as stromal cell-derived factor-1 (SDF-1) in the microenvironment. Stem cells express the SDF-1 receptor C-X-C chemokine receptor type 4 (CXCR4) and serve a key role in tissue repair, as well as a number of physiological and pathological processes. The present study aimed to determine the role of HIF-1α/SDF-1/CXCR4 signaling in the process of accelerated fracture healing during craniocerebral injury. Cultured MSCs underwent HIF-1α knockdown to elucidate its effect on the proliferative ability of MSCs, and the effect of SDF-1 in MSCs was investigated. It was also determined whether HIF-1α could promote osteogenesis via SDF-1/CXCR4 signaling and recruit MSCs. The results indicated that HIF-1α knockdown suppressed MSC proliferation in vitro, and SDF-1 promoted cell migration via binding to CXCR4. Furthermore, HIF-1α knockdown inhibited MSC migration via SDF-1/CXCR4 signaling. Considering the wide distribution and diversity of roles of SDF-1 and CXCR4, the present results may form a basis for the development of novel strategies for the treatment of craniocerebral injury.
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Affiliation(s)
- Yonghua Xue
- Department of Neurosurgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Zhikun Li
- Department of Orthopedic Surgery, Tongren Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai 200331, P.R. China
| | - Yi Wang
- Department of Orthopedic Surgery, Tongren Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai 200331, P.R. China
| | - Xiaodong Zhu
- Department of Orthopedic Surgery, Tongren Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai 200331, P.R. China
| | - Ruixi Hu
- Department of Orthopedic Surgery, Tongren Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai 200331, P.R. China
| | - Wei Xu
- Department of Orthopedic Surgery, Tongren Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai 200331, P.R. China
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KADİROĞLU ET, KARAYÜREK F, AKBALIK ME. Evaluation of the effects of bone morphogenetic protein-2 on the healing of bone calvarial defects in ovariectomized rats. TURKISH JOURNAL OF VETERINARY AND ANIMAL SCIENCES 2020. [DOI: 10.3906/vet-1911-24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Predicting Functional Outcomes Following Fracture Nonunion Repair-Development and Validation of a Risk Profiling Tool. J Orthop Trauma 2020; 34:e214-e220. [PMID: 32433198 DOI: 10.1097/bot.0000000000001718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To develop a tool that can be used preoperatively to identify patients at risk of poor functional outcome following operative repair of fracture nonunion. DESIGN Retrospective analysis of prospectively collected data. SETTING Academic medical center. PATIENTS/PARTICIPANTS Three hundred twenty-eight patients who underwent operative repair of a fracture nonunion were prospectively followed for a minimum of 12 months post-operatively. INTERVENTION After randomization, 223 (68%) patients comprised an experimental cohort and 105 (32%) patients comprised a separate validation cohort. Within the experimental cohort, forward stepwise multivariate logistic regression was applied to 17 independent variables to generate a predictive model identifying patients at risk of having a poor functional outcome [Predicting Risk of Function in Trauma-Nonunion (PRoFiT-NU) Score]. MAIN OUTCOME MEASUREMENTS Functional outcomes were assessed using the Short Musculoskeletal Function Assessment (SMFA). Poor outcome was defined as an SMFA function index greater than 10 points above the mean at 12 months post-operatively. RESULTS Significant predictors of poor outcome were lower extremity nonunion [odds ratio (OR) = 3.082; P = 0.021], tobacco use (OR = 2.994; P = 0.009), worker's compensation insurance (OR = 3.986; P = 0.005), radiographic bone loss (OR = 2.397; P = 0.040), and preoperative SMFA function index (OR = 1.027; P = 0.001). The PRoFiT-NU model was significant and a good predictor of poor functional outcome (χ(5) = 51.98, P < 0.0005; area under the receiver operating curve = 0.79). Within the separate validation cohort, 16% of patients had a poor outcome at a PRoFiT-NU score below 25% (low risk), 39% of patients had a poor outcome at a PRoFiT-NU score between 25% and 50% (intermediate risk), and 63% of patients had a poor outcome at a PRoFiT-NU score above 50% (high risk). CONCLUSIONS The PRoFiT-NU score is an accurate predictor of poor functional outcome following fracture nonunion repair. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence description of levels of evidence.
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Rothe R, Schulze S, Neuber C, Hauser S, Rammelt S, Pietzsch J. Adjuvant drug-assisted bone healing: Part II - Modulation of angiogenesis. Clin Hemorheol Microcirc 2020; 73:409-438. [PMID: 31177206 DOI: 10.3233/ch-199103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The treatment of critical-size bone defects following complicated fractures, infections or tumor resections is a major challenge. The same applies to fractures in patients with impaired bone healing due to systemic inflammatory and metabolic diseases. Despite considerable progress in development and establishment of new surgical techniques, design of bone graft substitutes and imaging techniques, these scenarios still represent unresolved clinical problems. However, the development of new active substances offers novel potential solutions for these issues. This work discusses therapeutic approaches that influence angiogenesis or hypoxic situations in healing bone and surrounding tissue. In particular, literature on sphingosine-1-phosphate receptor modulators and nitric oxide (NO•) donors, including bi-functional (hybrid) compounds like NO•-releasing cyclooxygenase-2 inhibitors, was critically reviewed with regard to their local and systemic mode of action.
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Affiliation(s)
- Rebecca Rothe
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sabine Schulze
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christin Neuber
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Sandra Hauser
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Stefan Rammelt
- University Center of Orthopaedics and Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany.,Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Center for Regenerative Therapies Dresden (CRTD), Tatzberg 4, Dresden, Germany
| | - Jens Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, Dresden, Germany
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Clark D, Brazina S, Yang F, Hu D, Hsieh CL, Niemi EC, Miclau T, Nakamura MC, Marcucio R. Age-related changes to macrophages are detrimental to fracture healing in mice. Aging Cell 2020; 19:e13112. [PMID: 32096907 PMCID: PMC7059136 DOI: 10.1111/acel.13112] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/05/2019] [Accepted: 01/17/2020] [Indexed: 12/12/2022] Open
Abstract
The elderly population suffers from higher rates of complications during fracture healing that result in increased morbidity and mortality. Inflammatory dysregulation is associated with increased age and is a contributing factor to the myriad of age-related diseases. Therefore, we investigated age-related changes to an important cellular regulator of inflammation, the macrophage, and the impact on fracture healing outcomes. We demonstrated that old mice (24 months) have delayed fracture healing with significantly less bone and more cartilage compared to young mice (3 months). The quantity of infiltrating macrophages into the fracture callus was similar in old and young mice. However, RNA-seq analysis demonstrated distinct differences in the transcriptomes of macrophages derived from the fracture callus of old and young mice, with an up-regulation of M1/pro-inflammatory genes in macrophages from old mice as well as dysregulation of other immune-related genes. Preventing infiltration of the fracture site by macrophages in old mice improved healing outcomes, with significantly more bone in the calluses of treated mice compared to age-matched controls. After preventing infiltration by macrophages, the macrophages remaining within the fracture callus were collected and examined via RNA-seq analysis, and their transcriptome resembled macrophages from young calluses. Taken together, infiltrating macrophages from old mice demonstrate detrimental age-related changes, and depleting infiltrating macrophages can improve fracture healing in old mice.
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Affiliation(s)
- Daniel Clark
- Department of Orthopaedic SurgerySchool of MedicineOrthopaedic Trauma InstituteZuckerberg San Francisco General HospitalUniversity of California San FranciscoSan FranciscoCAUSA
- Division of PeriodontologyDepartment of Orofacial SciencesSchool of DentistryUniversity of California San FranciscoSan FranciscoCAUSA
| | - Sloane Brazina
- Department of Orthopaedic SurgerySchool of MedicineOrthopaedic Trauma InstituteZuckerberg San Francisco General HospitalUniversity of California San FranciscoSan FranciscoCAUSA
| | - Frank Yang
- Department of Orthopaedic SurgerySchool of MedicineOrthopaedic Trauma InstituteZuckerberg San Francisco General HospitalUniversity of California San FranciscoSan FranciscoCAUSA
| | - Diane Hu
- Department of Orthopaedic SurgerySchool of MedicineOrthopaedic Trauma InstituteZuckerberg San Francisco General HospitalUniversity of California San FranciscoSan FranciscoCAUSA
| | - Christine L. Hsieh
- Division of RheumatologyDepartment of MedicineSan Francisco VA Health Care SystemSan FranciscoCAUSA
| | - Erene C. Niemi
- Division of RheumatologyDepartment of MedicineSan Francisco VA Health Care SystemSan FranciscoCAUSA
| | - Theodore Miclau
- Department of Orthopaedic SurgerySchool of MedicineOrthopaedic Trauma InstituteZuckerberg San Francisco General HospitalUniversity of California San FranciscoSan FranciscoCAUSA
| | - Mary C. Nakamura
- Division of RheumatologyDepartment of MedicineSan Francisco VA Health Care SystemSan FranciscoCAUSA
| | - Ralph Marcucio
- Department of Orthopaedic SurgerySchool of MedicineOrthopaedic Trauma InstituteZuckerberg San Francisco General HospitalUniversity of California San FranciscoSan FranciscoCAUSA
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Chen M, Luo D, Zhan J, Hou Y, Chen S, Li X, Lin D. Fasudil enhanced differentiation of BMSCs in vivo and vitro, involvement of P38 signaling pathway. Chem Biol Interact 2020; 317:108944. [PMID: 31935364 DOI: 10.1016/j.cbi.2020.108944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/13/2019] [Accepted: 01/08/2020] [Indexed: 11/16/2022]
Abstract
Bone mesenchymal stem cells (BMSCs) are a well-known donor graft source due to their potential for self-renewal and differentiation into multi-lineage cell types, including osteoblasts that are critical for fracture healing. Fasudil (FAS), a Rho kinase inhibitor, has been proven to induce the differentiation of bone marrow stem cells (BMSCs) into neuron-like cells. However, its role in the osteogenesis of BMSCs remain uncertain. Herein, we for the first time studied the effects of FAS on osteogenic differentiation in a mouse fracture model and further explored the involved mechanisms in mouse BMSCs. The results showed that FAS stimulated bone formation in the fracture mouse model. Additionally, at 30 μM, FAS significantly promotes alkaline phosphatase activity, mineralization, and the expression of osteogenic markers COL-1, RUNX2 and OCN in murine BMSCs. Blocking of P38 by SB202190 significantly reversed the effects of FAS, in vitro, suggesting that P38, but not ERK or JNK activation is required for FAS-induced osteogenesis. Collectively, our results indicate that FAS may be a promising agent for promoting fracture healing.
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Affiliation(s)
- Meihui Chen
- Research Laboratory of Spine Degenerative Disease, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China; Laboratory of Osteology and Traumatology of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Dan Luo
- Research Laboratory of Spine Degenerative Disease, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China; Laboratory of Osteology and Traumatology of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Jiheng Zhan
- Laboratory of Osteology and Traumatology of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China; Second College of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Yu Hou
- Research Laboratory of Spine Degenerative Disease, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China; Laboratory of Osteology and Traumatology of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Shudong Chen
- Research Laboratory of Spine Degenerative Disease, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China; Laboratory of Osteology and Traumatology of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Xing Li
- Research Laboratory of Spine Degenerative Disease, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China; Laboratory of Osteology and Traumatology of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
| | - Dingkun Lin
- Research Laboratory of Spine Degenerative Disease, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China; Laboratory of Osteology and Traumatology of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
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Bartold M, Gronthos S, Haynes D, Ivanovski S. Mesenchymal stem cells and biologic factors leading to bone formation. J Clin Periodontol 2019; 46 Suppl 21:12-32. [PMID: 30624807 DOI: 10.1111/jcpe.13053] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/23/2018] [Accepted: 10/26/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Physiological bone formation and bone regeneration occurring during bone repair can be considered distinct but similar processes. Mesenchymal stem cells (MSC) and associated biologic factors are crucial to both bone formation and bone regeneration. AIM To perform a narrative review of the current literature regarding the role of MSC and biologic factors in bone formation with the aim of discussing the clinical relevance of in vitro and in vivo animal studies. METHODS The literature was searched for studies on MSC and biologic factors associated with the formation of bone in the mandible and maxilla. The search specifically targeted studies on key aspects of how stem cells and biologic factors are important in bone formation and how this might be relevant to bone regeneration. The results are summarized in a narrative review format. RESULTS Different types of MSC and many biologic factors are associated with bone formation in the maxilla and mandible. CONCLUSION Bone formation and regeneration involve very complex and highly regulated cellular and molecular processes. By studying these processes, new clinical opportunities will arise for therapeutic bone regenerative treatments.
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Affiliation(s)
- Mark Bartold
- School of Dentistry, University of Adelaide, Adelaide, SA, Australia
| | - Stan Gronthos
- Mesenchymal Stem Cell Laboratory, Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - David Haynes
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Saso Ivanovski
- School of Dentistry, University of Queensland, Brisbane, Qld, Australia
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40
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MalekiGorji M, Golestaneh A. Histological Evaluation of the Effect of Sildenafil and Pentoxifylline on Mandibular Fracture Healing in Rats. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2019. [DOI: 10.29252/jrdms.4.3.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Lu J, Wang QY, Sheng JG. Exosomes in the Repair of Bone Defects: Next-Generation Therapeutic Tools for the Treatment of Nonunion. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1983131. [PMID: 31467871 PMCID: PMC6699293 DOI: 10.1155/2019/1983131] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/22/2019] [Indexed: 12/11/2022]
Abstract
Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate and difficulties in achieving successful treatment. Bone defects are the main complications of nonunion. The conventional biological treatments for nonunion with bone defects involve the use of autologous bone grafts or bone graft substitutes and cell-based therapy. Traditional nonunion treatments have always been associated with safety issues and various other complications. Bone grafts have limited autologous cancellous bone and there is a risk of infection. Additionally, problems with bone graft substitutes, including rejection and stimulation of bone formation, have been noted, and the health of the stem cell niche is a major consideration in cell-based therapy. In recent years, researchers have found that exosomes can be used to deliver functional RNA and mediate cell-to-cell communication, suggesting that exosomes may repair bone defects by regulating cells and cytokines involved in bone metabolism. In this review, we highlight the possible relationships between risk factors for nonunion and exosomes. Additionally, we discuss the roles of exosomes in bone metabolism and bone regeneration.
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Affiliation(s)
- Jian Lu
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
- The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, China
| | - Qi-Yang Wang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Jia-Gen Sheng
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
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Meinberg EG, Clark D, Miclau KR, Marcucio R, Miclau T. Fracture repair in the elderly: Clinical and experimental considerations. Injury 2019; 50 Suppl 1:S62-S65. [PMID: 31130210 PMCID: PMC7021229 DOI: 10.1016/j.injury.2019.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/01/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023]
Abstract
Fractures in the elderly represent a significant and rising socioeconomic problem. Although aging has been associated with delays in healing, there is little direct clinical data isolating the effects of aging on bone healing from the associated comorbidities that are frequently present in elderly populations. Basic research has demonstrated that all of the components of fracture repair-cells, extracellular matrix, blood supply, and molecules and their receptors-are negatively impacted by the aging process, which likely explains poorer clinical outcomes. Improved understanding of age-related fracture healing should aid in the development of novel treatment strategies, technologies, and therapies to improve bone repair in elderly patients.
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Affiliation(s)
- E G Meinberg
- UCSF/ZSFG Orthopaedic Trauma Institute, UCSF Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - D Clark
- UCSF/ZSFG Orthopaedic Trauma Institute, UCSF Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - K R Miclau
- UCSF/ZSFG Orthopaedic Trauma Institute, UCSF Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - R Marcucio
- UCSF/ZSFG Orthopaedic Trauma Institute, UCSF Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - T Miclau
- UCSF/ZSFG Orthopaedic Trauma Institute, UCSF Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
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Wang Y, Chen L, Kang M, Ling L, Tian F, Won-Kim SH, Ho S, Bikle DD. The Fracture Callus Is Formed by Progenitors of Different Skeletal Origins in a Site-Specific Manner. JBMR Plus 2019; 3:e10193. [PMID: 31667451 PMCID: PMC6808225 DOI: 10.1002/jbm4.10193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/05/2019] [Accepted: 03/10/2019] [Indexed: 01/05/2023] Open
Abstract
We evaluated repair following a mid‐diaphyseal fracture of the tibia in 3‐month‐old mice. We observed differences in the repair process at three different sites of the callus. Site 1: bone developing from the outer layer of the periosteum of the cortex; site 2: bone developing within the bridge/central region of the fracture; and site 3: bone developing within the marrow of the ends of broken bones. We characterized these sites by correlating datasets from X‐ray CT and histology. Correlated data demonstrated the involvement of different cells and different rates of mineralization. The origin of the progenitors and mechanism of progenitor differentiation involved at these sites was then evaluated using lineage tracing of cells expressing Prx1 and Col.2. The Prx1 progeny contributed to intramembranous bone formation (IBF) at site 1 and endochondral bone formation (EndoBF) at site 2 but not to intramedullary bone formation (IMBF) at site 3. IBF at site 1 was confirmed without a chondrocyte intermediate unlike EndoBF at site 2. Additionally, the presence of Col.2 progeny contributed to EndoBF in site 2 and IMBF in site 3 but not to IBF in site 1. However, the Col.2 progeny in IMBF in site 3 appeared to come from Col.2‐expressing osteocytes originating in the cortices of the ends of the fractured bone. In conclusion we have identified three sites of bone fracture repair that differ in their origin of cells and their mechanisms of bone formation. © 2019 The Authors JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Yongmei Wang
- Endocrine Unit, University of California San Francisco and Veterans Affairs Medical Center San Francisco CA USA
| | - Ling Chen
- Bioengineering & Biomaterials Micro-CT and Imaging Facility University of California, San Francisco San Francisco CA USA
| | - Misun Kang
- Bioengineering & Biomaterials Micro-CT and Imaging Facility University of California, San Francisco San Francisco CA USA
| | - Lin Ling
- Endocrine Unit, University of California San Francisco and Veterans Affairs Medical Center San Francisco CA USA
| | - Faming Tian
- Endocrine Unit, University of California San Francisco and Veterans Affairs Medical Center San Francisco CA USA
| | - Sun Hee Won-Kim
- Endocrine Unit, University of California San Francisco and Veterans Affairs Medical Center San Francisco CA USA
| | - Sunita Ho
- Bioengineering & Biomaterials Micro-CT and Imaging Facility University of California, San Francisco San Francisco CA USA
| | - Daniel D Bikle
- Endocrine Unit, University of California San Francisco and Veterans Affairs Medical Center San Francisco CA USA
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Burn and thoracic trauma alters fracture healing, systemic inflammation, and leukocyte kinetics in a rat model of polytrauma. J Orthop Surg Res 2019; 14:58. [PMID: 30782193 PMCID: PMC6381742 DOI: 10.1186/s13018-019-1082-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/31/2019] [Indexed: 01/31/2023] Open
Abstract
Background Singular traumatic insults, such as bone fracture, typically initiate an appropriate immune response necessary to restore the host to pre-insult homeostasis with limited damage to self. However, multiple concurrent insults, such as a combination of fracture, blunt force trauma, and burns (polytrauma), are clinically perceived to result in abnormal immune response leading to inadequate healing and resolution. To investigate this phenomenon, we created a model rat model of polytrauma. Methods To investigate relationship between polytrauma and delayed healing, we created a novel model of polytrauma in a rat which encompassed a 3-mm osteotomy, blunt chest trauma, and full-thickness scald burn. Healing outcomes were determined at 5 weeks where the degree of bone formation at the osteotomy site of polytrauma animals was compared to osteotomy only animals (OST). Results We observed significant differences in the bone volume fraction between polytrauma and OST animals indicating that polytrauma negatively effects wound healing. Polytrauma animals also displayed a significant decrease in their ability to return to pre-injury weight compared to osteotomy animals. Polytrauma animals also exhibited significantly altered gene expression in osteogenic pathways as well as the innate and adaptive immune response. Perturbed inflammation was observed in the polytrauma group compared to the osteotomy group as evidenced by significantly altered white blood cell (WBC) profiles and significantly elevated plasma high-mobility group box 1 protein (HMGB1) at 6 and 24 h post-trauma. Conversely, polytrauma animals exhibited significantly lower concentrations of plasma TNF-alpha (TNF-α) and interleukin 6 (IL-6) at 72 h post-injury compared to OST. Conclusions Following polytrauma with burn injury, the local and systemic immune response is divergent from the immune response following a less severe singular injury (osteotomy). This altered immune response that follows was associated with a reduced capacity for wound healing. Electronic supplementary material The online version of this article (10.1186/s13018-019-1082-4) contains supplementary material, which is available to authorized users.
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Zhang T, Han W, Zhao K, Yang W, Lu X, Jia Y, Qin A, Qian Y. Psoralen accelerates bone fracture healing by activating both osteoclasts and osteoblasts. FASEB J 2019; 33:5399-5410. [PMID: 30702934 DOI: 10.1096/fj.201801797r] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Bone fracture healing is a complex, dynamic process that involves various cell types, with osteoclasts and osteoblasts playing indispensable roles. In this study, we found that psoralen, the main active ingredient in Psoralea corylifolia L. fruit extract, enhanced bone fracture healing through activation of osteoclast and osteoblast activity via the ERK signaling pathway. In detail, psoralen promoted receptor activator of nuclear factor-κB ligand-induced osteoclastogenesis, mRNA expression of osteoclast-specific genes, and osteoclastic bone resorption in primary bone marrow-derived macrophages. Meanwhile, psoralen induced osteogenic differentiation by promoting the mRNA expression of the osteoblast differentiation markers alkaline phosphatase, runt-related transcription factor 2, osterix, and osteocalcin. At the molecular level, psoralen preferentially activated ERK1/2 but not JNK or p38 MAPKs. Further experiments revealed that psoralen-induced osteoclast and osteoblast differentiation was abrogated by a specific inhibitor of phosphorylated ERK. In addition, psoralen accelerated bone fracture healing in a rat tibial fracture model, and the numbers of osteoclasts and osteoblasts were increased in psoralen-treated fracture callus. Taken together, our findings indicate that psoralen accelerates bone fracture healing through activation of osteoclasts and osteoblasts via ERK signaling and has potential as a novel drug in the orthopedic clinic for the treatment of bone fractures.-Zhang, T., Han, W., Zhao, K., Yang, W., Lu, X., Jia, Y., Qin, A., Qian, Y. Psoralen accelerates bone fracture healing by activating both osteoclasts and osteoblasts.
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Affiliation(s)
- Tan Zhang
- Department of Orthopaedics, Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, China
| | - Weiqi Han
- Department of Orthopaedics, Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, China
| | - Kangxian Zhao
- Department of Orthopaedics, Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, China
| | - Wanlei Yang
- Department of Orthopaedics, Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, China
| | - Xuanyuan Lu
- Department of Orthopaedics, Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, China
| | - Yewei Jia
- Department of Orthopaedics, Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, China
| | - An Qin
- Department of Orthopedics, Shanghai Key Laboratory of Orthopedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Qian
- Department of Orthopaedics, Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, China
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Gonzaga MG, Santos Kotake BG, Figueiredo FAT, Feldman S, Ervolino E, Santos MCG, Issa JPM. Effectiveness of rhBMP‐2 association to autogenous, allogeneic, and heterologous bone grafts. Microsc Res Tech 2019; 82:689-695. [DOI: 10.1002/jemt.23215] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/03/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Miliane Gonçalves Gonzaga
- Ribeirão Preto Medical School, Department of Biomechanics, Medicine and Rehabilitation of LocomotorUniversity of São Paulo São Paulo Brazil
| | - Bruna Gabriela Santos Kotake
- Ribeirão Preto Medical School, Department of Biomechanics, Medicine and Rehabilitation of LocomotorUniversity of São Paulo São Paulo Brazil
| | | | - Sara Feldman
- School of Medicine, LABOATEM ‐ Osteoarticular Biology, Tissue Engineering and Emerging Therapies LaboratoryNational Rosario University Santa Fe Argentina
| | - Edilson Ervolino
- Faculty of Dentistry, Department of Basic SciencesSão Paulo State University São Paulo Brazil
| | - Maria Cecília Gorita Santos
- School of Dentistry of Ribeirão Preto, Department of Pediatric DentistryUniversity of São Paulo São Paulo Brazil
| | - João Paulo Mardegan Issa
- School of Dentistry of Ribeirão Preto, Department of Pediatric DentistryUniversity of São Paulo São Paulo Brazil
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Belluati A, Pari C, Busatto C, Pantalone A, Salini V. Intercalary allograft reconstruction in a patient with large tibial defect: Case report. Injury 2018; 49 Suppl 4:S39-S42. [PMID: 30518509 DOI: 10.1016/j.injury.2018.09.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/29/2018] [Indexed: 02/02/2023]
Abstract
A fit 26 year-old-man presented to our Department with an open fracture of the left tibial shaft (AO 42-C3). The fracture was initially treated with an External Fixator, which was replaced by an intramedullary Grosse Kempf nail after 4 months. In the following year he developed an atrophic non-union and we witnessed the increasing bone resorption at the fracture site which led to the nail breakage. An accurate CT pre-operative planning was made and a revision surgery was successfully performed: the broken nail was removed and intercalary allograft reconstruction was made, using a compressible intramedullary nail. Whereas in literature it is well described how intercalary allografts can be used to fill the massive diaphyseal defects after tumor resections, we assumed it could also be an adequate technique to treat a large bone defect at a non-union site.
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Affiliation(s)
- Alberto Belluati
- Orthopaedic and Traumatology Department, Hospital Santa Maria delle Croci, Ravenna, Italy.
| | - Carlotta Pari
- Orthopaedic and Traumatology Department, Hospital Santa Maria delle Croci, Ravenna, Italy
| | - Carlo Busatto
- Orthopaedic and Traumatology Department, Hospital Santa Maria delle Croci, Ravenna, Italy
| | - Andrea Pantalone
- Orthopaedic and Traumatology Division, Department of Medicine and Science of Aging, University of Study "G. d'Annunzio" Chieti-Pescara, Italy
| | - Vincenzo Salini
- Orthopaedic and Traumatology Division, Department of Medicine and Science of Aging, University of Study "G. d'Annunzio" Chieti-Pescara, Italy
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Xi LC, Li HY, Yin D. Long Non-coding RNA-2271 Promotes Osteogenic Differentiation in Human Bone Marrow Stem Cells. Open Life Sci 2018; 13:404-412. [PMID: 33817109 PMCID: PMC7874714 DOI: 10.1515/biol-2018-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/18/2018] [Indexed: 11/26/2022] Open
Abstract
Background Human bone marrow mesenchymal stem cells (BMSCs) are of great significance for bone regeneration and bone formation. Long non-coding RNAs (lncRNAs) may be involved in modulating cell differentiation. This study aimed to investigate the role of lncR-2271 in promoting osteogenic differentiation in human BMSCs. Methods Human BMSCs were infected using lncR-2271 overexpression (group A) with lentiviral system or transfected with lncR-2271 siRNA (group B). Cells transfected with scrambled plasmids were used as a negative control (group C). Osteogenesis markers were evaluated using alkaline phosphatase (ALP) activity, RUNX2 and osterix (OSX) at protein levels and calcification by Alizarin Red staining. Results BMSCs from group A showed significantly higher ALP activity compared to BMSCs in group B and control group (group C) at both days 7 and 14 following osteogenic induction; ALP activity was significantly lower in the group B compared to the group C. RUNX2 and OSX protein expressions were significantly higher in group A and significantly lower in group B, compared to those in group C, respectively. At day 21, calcification in human BMSCs in group A was significantly higher compared to groups B and C as shown by Alizarin Red staining; calcification was significantly lower in group B compared to group C. Conclusion Our data suggested lncR-2271 played a role in promoting osteogenic differentiation in human BMSCs. This study is the first to illustrate the important role of lncR-2271 in bone formation.
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Affiliation(s)
- Li-Cheng Xi
- Department of Orthopedics, The People's Hospital of Guangxi Zhuang Autonomous Region, No 6, Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Hong-Yu Li
- Department of Orthopedics, The People's Hospital of Guangxi Zhuang Autonomous Region, No 6, Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Dong Yin
- Department of Orthopedics, The People's Hospital of Guangxi Zhuang Autonomous Region, No 6, Taoyuan Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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Liu YZ, Akhter MP, Gao X, Wang XY, Wang XB, Zhao G, Wei X, Wu HJ, Chen H, Wang D, Cui L. Glucocorticoid-induced delayed fracture healing and impaired bone biomechanical properties in mice. Clin Interv Aging 2018; 13:1465-1474. [PMID: 30197508 PMCID: PMC6112798 DOI: 10.2147/cia.s167431] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The objective of the study was to investigate the effects of glucocorticoid (GC) on the fracture healing process in a closed femur fracture mice model. Materials and methods Forty 12-week-old female CD-1 mice were randomly allocated into four groups: healthy control and mice with prednisone exposure (oral gavage), 6 mg/kg/day (GC-L), 9 mg/kg/day (GC-M) and 12 mg/kg/day (GC-H). Three weeks after the initiation of prednisone dosing, closed femur fractures were created on prednisone-exposed mice and the healthy control. Prednisone administration was continued for 9 weeks post-fracture, and X-ray imaging was performed weekly to monitor the fracture healing process until the mice were euthanized. Necropsy was performed after 9 weeks and the fractured femurs were isolated and processed at necropsy for micro-CT and biomechanical property analysis. Another 20 mice (control and GC-H, 10 mice/group) were used for histology and micro-CT analysis at early time point (2-week post fracture) with continued prednisone exposure. Results The results showed that oral administration of prednisone for 3 months in this strain of mice could inhibit endochondral ossification and delay the healing process, especially hard callus formation (woven bone) and bone remodeling during healing. It also could significantly decrease bone biomechanical properties. Conclusion Long-term GC administration leads to significantly delayed fracture healing and impaired bone biomechanical properties. This mouse model may be used to systematically study the cellular and molecular mechanisms underlying fracture healing with GC treatment background and may also be used to study the influence of different therapeutic interventions for bone fracture healing.
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Affiliation(s)
- Yan-Zhi Liu
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, People's Republic of China, .,Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA,
| | - Mohammed P Akhter
- Osteoporosis Research Center, Department of Medicine, Creighton University, Omaha, NE, USA
| | - Xiang Gao
- Stem Cell Research and Cellular Therapy Center, Department of Orthopaedics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Xiao-Yan Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA,
| | - Xiao-Bei Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA,
| | - Gang Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA,
| | - Xin Wei
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA,
| | - Hao-Jun Wu
- Stem Cell Research and Cellular Therapy Center, Department of Orthopaedics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Hang Chen
- Stem Cell Research and Cellular Therapy Center, Department of Orthopaedics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Dong Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA,
| | - Liao Cui
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, People's Republic of China,
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De Witte TM, Fratila-Apachitei LE, Zadpoor AA, Peppas NA. Bone tissue engineering via growth factor delivery: from scaffolds to complex matrices. Regen Biomater 2018; 5:197-211. [PMID: 30094059 PMCID: PMC6077800 DOI: 10.1093/rb/rby013] [Citation(s) in RCA: 283] [Impact Index Per Article: 47.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 02/06/2023] Open
Abstract
In recent years, bone tissue engineering has emerged as a promising solution to the limitations of current gold standard treatment options for bone related-disorders such as bone grafts. Bone tissue engineering provides a scaffold design that mimics the extracellular matrix, providing an architecture that guides the natural bone regeneration process. During this period, a new generation of bone tissue engineering scaffolds has been designed and characterized that explores the incorporation of signaling molecules in order to enhance cell recruitment and ingress into the scaffold, as well as osteogenic differentiation and angiogenesis, each of which is crucial to successful bone regeneration. Here, we outline and critically analyze key characteristics of successful bone tissue engineering scaffolds. We also explore candidate materials used to fabricate these scaffolds. Different growth factors involved in the highly coordinated process of bone repair are discussed, and the key requirements of a growth factor delivery system are described. Finally, we concentrate on an analysis of scaffold-based growth factor delivery strategies found in the recent literature. In particular, the incorporation of two-phase systems consisting of growth factor-loaded nanoparticles embedded into scaffolds shows great promise, both by providing sustained release over a therapeutically relevant timeframe and the potential to sequentially deliver multiple growth factors.
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Affiliation(s)
- Tinke-Marie De Witte
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
- Additive Manufacturing Laboratory, Department of Biomechanical Engineering, Delft University of Technology (TU Delft), CD Delft, The Netherlands
| | - Lidy E Fratila-Apachitei
- Additive Manufacturing Laboratory, Department of Biomechanical Engineering, Delft University of Technology (TU Delft), CD Delft, The Netherlands
| | - Amir A Zadpoor
- Additive Manufacturing Laboratory, Department of Biomechanical Engineering, Delft University of Technology (TU Delft), CD Delft, The Netherlands
| | - Nicholas A Peppas
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
- McKetta Department of Chemical Engineering, The University of Texas at Austin, Austin, TX, USA
- Institute for Biomaterials, Drug Delivery and Regenerative Medicine, The University of Texas at Austin, Austin, TX, USA
- Department of Pediatrics, and Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
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