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Zheng S, Hu G, Zheng J, Li Y, Li J. Osthole accelerates osteoporotic fracture healing by inducing the osteogenesis-angiogenesis coupling of BMSCs via the Wnt/β-catenin pathway. Phytother Res 2024. [PMID: 38873735 DOI: 10.1002/ptr.8267] [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: 11/28/2023] [Revised: 04/12/2024] [Accepted: 05/25/2024] [Indexed: 06/15/2024]
Abstract
Osthole, a natural coumarin derivative, has been shown to have multiple pharmacological activities. However, its effect on osteoporotic fracture has not yet been examined. This research was designed to explore the unknown role and potential mechanism of osthole on osteoporotic fracture healing. We first evaluated the osteogenic and angiogenic abilities of osthole. Then angiogenesis-related assays were conducted to investigate the relationship between osteogenesis and angiogenesis, and further explore its molecular mechanism. After that, we established osteoporotic fracture model in ovariectomy-induced osteoporosis rats and treated the rats with osthole or placebo. Radiography, histomorphometry, histology, and sequential fluorescent labeling were used to evaluate the effect of osthole on osteoporotic fracture healing. In vitro research revealed that osthole promoted osteogenesis and up-regulated the expression of angiogenic-related markers. Further research found that osthole couldn't facilitate the angiogenesis of human umbilical vein endothelial cells in a direct manner, but it possessed the ability to induce the osteogenesis-angiogenesis coupling of bone marrow mesenchymal stem cells (BMSCs). Mechanistically, this was conducted through activating the Wnt/β-catenin pathway. Subsequently, using ovariectomy-induced osteoporosis tibia fracture rat model, we observed that osthole facilitated bone formation and CD31hiEMCNhi type H-positive capillary formation. Sequential fluorescent labeling confirmed that osthole could effectively accelerate bone formation in the fractured region. The data above indicated that osthole could accelerate osteoporotic fracture healing by inducing the osteogenesis-angiogenesis coupling of BMSCs via the Wnt/β-catenin pathway, which implied that osthole may be a potential drug for treating osteoporosis fracture.
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Affiliation(s)
- Sheng Zheng
- Department of Traditional Chinese Orthopedics and Traumatology, Center for Orthopedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Guanyu Hu
- Department of Traditional Chinese Orthopedics and Traumatology, Center for Orthopedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Jia Zheng
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Yikai Li
- Department of Traditional Chinese Orthopedics and Traumatology, Center for Orthopedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Junhua Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
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Hemmerlein E, Vorndran E, Schmitt AM, Feichtner F, Waselau AC, Meyer-Lindenberg A. In Vivo Investigation of 3D-Printed Calcium Magnesium Phosphate Wedges in Partial Load Defects. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2136. [PMID: 38730942 PMCID: PMC11085615 DOI: 10.3390/ma17092136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024]
Abstract
Bone substitutes are ideally biocompatible, osteoconductive, degradable and defect-specific and provide mechanical stability. Magnesium phosphate cements (MPCs) offer high initial stability and faster degradation compared to the well-researched calcium phosphate cements (CPCs). Calcium magnesium phosphate cements (CMPCs) should combine the properties of both and have so far shown promising results. The present study aimed to investigate and compare the degradation and osseointegration behavior of 3D powder-printed wedges of CMPC and MPC in vivo. The wedges were post-treated with phosphoric acid (CMPC) and diammonium hydrogen phosphate (MPC) and implanted in a partially loaded defect model in the proximal rabbit tibia. The evaluation included clinical, in vivo µ-CT and X-ray examinations, histology, energy dispersive X-ray analysis (EDX) and scanning electron microscopy (SEM) for up to 30 weeks. SEM analysis revealed a zone of unreacted material in the MPC, indicating the need to optimize the manufacturing and post-treatment process. However, all materials showed excellent biocompatibility and mechanical stability. After 24 weeks, they were almost completely degraded. The slower degradation rate of the CMPC corresponded more favorably to the bone growth rate compared to the MPC. Due to the promising results of the CMPC in this study, it should be further investigated, for example in defect models with higher load.
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Affiliation(s)
- Elke Hemmerlein
- Clinic for Small Animal Surgery and Reproduction, Ludwig Maximilians University Munich, 80539 Munich, Germany (A.-C.W.); (A.M.-L.)
| | - Elke Vorndran
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, 97070 Würzburg, Germany (A.-M.S.)
| | - Anna-Maria Schmitt
- Department for Functional Materials in Medicine and Dentistry, University of Würzburg, 97070 Würzburg, Germany (A.-M.S.)
| | - Franziska Feichtner
- Clinic for Small Animal Surgery and Reproduction, Ludwig Maximilians University Munich, 80539 Munich, Germany (A.-C.W.); (A.M.-L.)
| | - Anja-Christina Waselau
- Clinic for Small Animal Surgery and Reproduction, Ludwig Maximilians University Munich, 80539 Munich, Germany (A.-C.W.); (A.M.-L.)
| | - Andrea Meyer-Lindenberg
- Clinic for Small Animal Surgery and Reproduction, Ludwig Maximilians University Munich, 80539 Munich, Germany (A.-C.W.); (A.M.-L.)
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Sharma VJ, Adegoke JA, Afara IO, Stok K, Poon E, Gordon CL, Wood BR, Raman J. Near-infrared spectroscopy for structural bone assessment. Bone Jt Open 2023; 4:250-261. [PMID: 37051828 PMCID: PMC10079377 DOI: 10.1302/2633-1462.44.bjo-2023-0014.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
Aims Disorders of bone integrity carry a high global disease burden, frequently requiring intervention, but there is a paucity of methods capable of noninvasive real-time assessment. Here we show that miniaturized handheld near-infrared spectroscopy (NIRS) scans, operated via a smartphone, can assess structural human bone properties in under three seconds. Methods A hand-held NIR spectrometer was used to scan bone samples from 20 patients and predict: bone volume fraction (BV/TV); and trabecular (Tb) and cortical (Ct) thickness (Th), porosity (Po), and spacing (Sp). Results NIRS scans on both the inner (trabecular) surface or outer (cortical) surface accurately identified variations in bone collagen, water, mineral, and fat content, which then accurately predicted bone volume fraction (BV/TV, inner R2 = 0.91, outer R2 = 0.83), thickness (Tb.Th, inner R2 = 0.9, outer R2 = 0.79), and cortical thickness (Ct.Th, inner and outer both R2 = 0.90). NIRS scans also had 100% classification accuracy in grading the quartile of bone thickness and quality. Conclusion We believe this is a fundamental step forward in creating an instrument capable of intraoperative real-time use. Cite this article: Bone Jt Open 2023;4(4):250–261.
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Affiliation(s)
- Varun J. Sharma
- Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Brian F. Buxton Department of Cardiac and Thoracic Aortic Surgery, Austin Hospital, Melbourne, Australia
- Spectromix Laboratory, Melbourne, Australia
| | - John A. Adegoke
- Spectromix Laboratory, Melbourne, Australia
- Centre for Biospectroscopy, Monash University, Melbourne, Australia
| | - Isaac O. Afara
- Spectromix Laboratory, Melbourne, Australia
- Centre for Biospectroscopy, Monash University, Melbourne, Australia
- Biomedical Spectroscopy Laboratory, Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- School of Information Technology and Electrical Engineering Faculty of Engineering, Architecture and Information Technology, Melbourne, Australia
| | - Kathryn Stok
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia
| | - Eric Poon
- Spectromix Laboratory, Melbourne, Australia
- Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Claire L. Gordon
- Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Department of Infectious Diseases, Austin Hospital, Melbourne, Australia
| | - Bayden R. Wood
- Spectromix Laboratory, Melbourne, Australia
- Centre for Biospectroscopy, Monash University, Melbourne, Australia
| | - Jaishankar Raman
- Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Brian F. Buxton Department of Cardiac and Thoracic Aortic Surgery, Austin Hospital, Melbourne, Australia
- Spectromix Laboratory, Melbourne, Australia
- Correspondence should be sent to Jaishankar Raman. E-mail:
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Lu W, Teng Z, Chen J, Shi R, Zou T, Gao M, Li W, Peng Z, Wang L, Zhao Y, Lu S. A Pain That is Easily Overlooked: Referred Pain Caused by OVCF. J Pain Res 2023; 16:961-971. [PMID: 36960463 PMCID: PMC10030002 DOI: 10.2147/jpr.s375966] [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: 06/03/2022] [Accepted: 02/25/2023] [Indexed: 03/18/2023] Open
Abstract
Purpose The objective of this study was to analyze the clinical characteristics and the therapeutic effects of treatment at our spinal center in OVCF patients associated with referred pain. The underlying goals were to deepen the understanding of referred pain caused by OVCFs, improve the currently low early diagnosis rate of OVCFs, and improve the effectiveness of treatment. Methods The patients who had referred pain from OVCFs and met the inclusion criteria were retrospectively analyzed. All patients were treated with percutaneous kyphoplasty (PKP). Visual analog scale (VAS) scores and Oswestry Disability Index (ODI) were used to evaluate the therapeutic effect at different time points. Results There were 11 males (19.6%) and 45 females (80.4%). Their corresponding mean bone mineral density (BMD) value was -3.3 ± 0.4. The regression coefficient of BMD in the linear regression equation was -4.51 (P<0.001). According to the classification system for referred pain in OVCFs, there were 27 cases of type A (48.2%), 12 cases of type B (21.2%), 8 cases of type C (14.3%), 3 cases of type D (5.4%), and 6 cases of type E (10.7%). All patients were followed up for at least 6 months, and both VAS scores and ODI were found to be significantly better postoperatively than preoperatively (P<0.001). There was no significant difference in VAS scores and ODI between different types preoperatively or 6 months postoperatively (P > 0.05). Within each type, there were significant differences in VAS scores and ODI between the pre- and postoperative timepoints (P < 0.05). Conclusion Attention should be paid to referred pain in OVCF patients, which is not uncommon in clinical practice. Our summary of the characteristics of referred pain caused by OVCFs can improve the early diagnosis rate of OVCFs patients and provide a reference for their prognosis after PKP.
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Affiliation(s)
- Wei Lu
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Zhaowei Teng
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
| | - Jiayu Chen
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Rongmao Shi
- Department of Orthopedics, Clinical College of the 920th Hospital of Joint Logistics Support Force of Kunming Medical University, Kunming, People’s Republic of China
| | - Tiannan Zou
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Ming Gao
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Weichao Li
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Zhi Peng
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Long Wang
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Yonghui Zhao
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
| | - Sheng Lu
- Yunnan Key Laboratory of Digital Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, People’s Republic of China
- Correspondence: Sheng Lu, Department of Orthopedics, the First People’s Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, People’s Republic of China, Tel +86-0871-63633071, Fax +86-0871-63633071, Email
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Kasnakova P, Mihaylova A, Djurdjev B, Tornyova B. Randomized controlled trial of multidisciplinary rehabilitation therapy using mobile applications in cases of ankle fractures. Eur J Transl Myol 2022; 32. [PMID: 35638576 PMCID: PMC9295163 DOI: 10.4081/ejtm.2022.10471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/07/2022] [Indexed: 11/23/2022] Open
Abstract
A multidisciplinary approach to rehabilitation in patients with ankle fractures is needed to return to their daily activities. Mobile health applications can improve or optimize the rehabilitation process. The purpose of this study is to monitor the efficiency of a modified and validated rehabilitation scheme for the functional rehabilitation of the lower limbs. The subjects of the study are patients in the post-immobilization and post-operative period. The algorithm of procedures administered to the patients were performed by physiotherapists and monitored via mobile apps. The results show a reduction of the swelling and the pain, overcoming the muscular imbalance, enhanced stabilization, correct way of walking, and an improved quality of life of the patients with ankle fractures. Despite a certain trend towards residual deficit, the implementation of kinesitherapeutic means creates the necessary background on the basis of which specialized methods can be applied - joint-mobilizing techniques and passive stretching, for the purpose of the full recovery of the functions of the lower extremity. The application of mobile apps optimizes the recovery process and increases access to rehabilitation.
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Affiliation(s)
| | | | - Boris Djurdjev
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Medical University of Plovdiv.
| | - Biyanka Tornyova
- Department of Health Care Management, Faculty of Public Health, Medical University of Plovdiv.
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Schmidt M, Waselau AC, Feichtner F, Julmi S, Klose C, Maier HJ, Wriggers P, Meyer-Lindenberg A. In vivo investigation of open-pored magnesium scaffolds LAE442 with different coatings in an open wedge defect. J Appl Biomater Funct Mater 2022; 20:22808000221142679. [PMID: 36545893 DOI: 10.1177/22808000221142679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The magnesium alloy LAE442 showed promising results as a bone substitute in numerous studies in non-weight bearing bone defects. This study aimed to investigate the in vivo behavior of wedge-shaped open-pored LAE442 scaffolds modified with two different coatings (magnesium fluoride (MgF2, group 1)) or magnesium fluoride/calcium phosphate (MgF2/CaP, group 2)) in a partial weight-bearing rabbit tibia defect model. The implantation of the scaffolds was performed as an open wedge corrective osteotomy in the tibia of 40 rabbits and followed for observation periods of 6, 12, 24, and 36 weeks. Radiological and microcomputed tomographic examinations were performed in vivo. X-ray microscopic, histological, histomorphometric, and SEM/EDS analyses were performed at the end of each time period. µCT measurements and X-ray microscopy showed a slight decrease in volume and density of the scaffolds of both coatings. Histologically, endosteal and periosteal callus formation with good bridging and stabilization of the osteotomy gap and ingrowth of bone into the scaffold was seen. The MgF2 coating favored better bridging of the osteotomy gap and more bone-scaffold contacts, especially at later examination time points. Overall, the scaffolds of both coatings met the requirement to withstand the loads after an open wedge corrective osteotomy of the proximal rabbit tibia. However, in addition to the inhomogeneous degradation behavior of individual scaffolds, an accumulation of gas appeared, so the scaffold material should be revised again regarding size dimension and composition.
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Affiliation(s)
- Marlene Schmidt
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Anja-Christina Waselau
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Franziska Feichtner
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Stefan Julmi
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Garbsen, Germany
| | - Christian Klose
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Garbsen, Germany
| | - Hans Jürgen Maier
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Garbsen, Germany
| | - Peter Wriggers
- Institute of Continuum Mechanics, Leibniz Universität Hannover, Garbsen, Germany
| | - Andrea Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-University Munich, Munich, Germany
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Chen J, Li S, Jiao Y, Li J, Li Y, Hao YL, Zuo Y. In Vitro Study on the Piezodynamic Therapy with a BaTiO 3-Coating Titanium Scaffold under Low-Intensity Pulsed Ultrasound Stimulation. ACS APPLIED MATERIALS & INTERFACES 2021; 13:49542-49555. [PMID: 34610736 DOI: 10.1021/acsami.1c15611] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
To solve the poor sustainability of electroactive stimulation in clinical therapy, a strategy of combining a piezoelectric BaTiO3-coated Ti6Al4V scaffold and low-intensity pulsed ultrasound (LIPUS) was unveiled and named here as piezodynamic therapy. Thus, cell behavior could be regulated phenomenally by force and electricity simultaneously. First, BaTiO3 was deposited uniformly on the surface of the three-dimensional (3D) printed porous Ti6Al4V scaffold, which endowed the scaffold with excellent force-electricity responsiveness under pulsed ultrasound exposure. The results of live/dead staining, cell scanning electron microscopy, and F-actin staining showed that cells had better viability, better pseudo-foot adhesion, and more muscular actin bundles when they underwent the piezodynamic effect of ultrasound and piezoelectric coating. This piezodynamic therapy activated more mitochondria at the initial stage that intervened in the cell cycle by promoting cells' proliferation and weakened the apoptotic damage. The quantitative real-time polymerase chain reaction data further confirmed that the costimulation of the ultrasound and the piezoelectric scaffolds could trigger adequate current to upregulated the expression of osteogenic-related genes. The continuous electric cues could be generated by the BaTiO3-coated scaffold and intermittent LIPUS stimulation; thereon, more efficient bone healing would be promoted by piezodynamic therapy in future treatment.
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Affiliation(s)
- Jie Chen
- Research Center for Nano Biomaterials, and Analytical & Testing Center, Sichuan University, Chengdu 610064, People's Republic of China
| | - Shujun Li
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, People's Republic of China
| | - Yilai Jiao
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, People's Republic of China
| | - Jidong Li
- Research Center for Nano Biomaterials, and Analytical & Testing Center, Sichuan University, Chengdu 610064, People's Republic of China
| | - Yubao Li
- Research Center for Nano Biomaterials, and Analytical & Testing Center, Sichuan University, Chengdu 610064, People's Republic of China
| | - Yu-Lin Hao
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, People's Republic of China
| | - Yi Zuo
- Research Center for Nano Biomaterials, and Analytical & Testing Center, Sichuan University, Chengdu 610064, People's Republic of China
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Seely KD, Kotelko CA, Douglas H, Bealer B, Brooks AE. The Human Gut Microbiota: A Key Mediator of Osteoporosis and Osteogenesis. Int J Mol Sci 2021; 22:9452. [PMID: 34502371 PMCID: PMC8431678 DOI: 10.3390/ijms22179452] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 12/14/2022] Open
Abstract
An expanding body of research asserts that the gut microbiota has a role in bone metabolism and the pathogenesis of osteoporosis. This review considers the human gut microbiota composition and its role in osteoclastogenesis and the bone healing process, specifically in the case of osteoporosis. Although the natural physiologic processes of bone healing and the pathogenesis of osteoporosis and bone disease are now relatively well known, recent literature suggests that a healthy microbiome is tied to bone homeostasis. Nevertheless, the mechanism underlying this connection is still somewhat enigmatic. Based on the literature, a relationship between the microbiome, osteoblasts, osteoclasts, and receptor activator of nuclear factor-kappa-Β ligand (RANKL) is contemplated and explored in this review. Studies have proposed various mechanisms of gut microbiome interaction with osteoclastogenesis and bone health, including micro-RNA, insulin-like growth factor 1, and immune system mediation. However, alterations to the gut microbiome secondary to pharmaceutical and surgical interventions cannot be discounted and are discussed in the context of clinical therapeutic consideration. The literature on probiotics and their mechanisms of action is examined in the context of bone healing. The known and hypothesized interactions of common osteoporosis drugs and the human gut microbiome are examined. Since dysbiosis in the gut microbiota can function as a biomarker of bone metabolic activity, it may also be a pharmacological and nutraceutical (i.e., pre- and probiotics) therapeutic target to promote bone homeostasis.
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Affiliation(s)
- Kevin D. Seely
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (C.A.K.); (H.D.); (B.B.); (A.E.B.)
| | - Cody A. Kotelko
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (C.A.K.); (H.D.); (B.B.); (A.E.B.)
| | - Hannah Douglas
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (C.A.K.); (H.D.); (B.B.); (A.E.B.)
| | - Brandon Bealer
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (C.A.K.); (H.D.); (B.B.); (A.E.B.)
| | - Amanda E. Brooks
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA; (C.A.K.); (H.D.); (B.B.); (A.E.B.)
- Department of Research and Scholarly Activity, Rocky Vista University, Ivins, UT 84738, USA
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Só BB, Silveira FM, Llantada GS, Jardim LC, Calcagnotto T, Martins MAT, Martins MD. Effects of osteoporosis on alveolar bone repair after tooth extraction: A systematic review of preclinical studies. Arch Oral Biol 2021; 125:105054. [PMID: 33667958 DOI: 10.1016/j.archoralbio.2021.105054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE This systematic review aimed to address whether the alveolar socket repair after a tooth extraction is impacted by an osteoporotic phenotype and propose methodological observations. DESIGN A search strategy in MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases was performed. Quality assessment was carried out through the SYRCLE Risk of Bias tool. RESULTS Out of the 1147 potentially relevant records, 25 met the inclusion criteria. Most of the studies were performed in rats, and ovariectomy (OVX) was the most frequent osteoporosis induction method. Histomorphometry, micro-computed tomography (microCT), and immunohistochemistry were the main bone repair evaluation methods. Most of the included studies (88 %) presented negative impacts of osteoporosis on the alveolar socket repair. Only three studies (12 %) showed no statistical differences among groups. Overall, most of the quality assessment categories presented a high percentage of unclear risk of bias due to insufficient information in the studies. CONCLUSIONS The results indicated that an osteoporotic phenotype seems to impair alveolar socket repair after tooth extraction. However, there is still a lack of information and standardization. Therefore, further studies should consider the proposed methodological aspects regarding animal characteristics, OVX associated with a low calcium diet, waiting 8 weeks to osteoporosis induction, maxillary molars as the best option for tooth extraction, confirming and reporting OVX and osteoporosis success, and an appropriate method of repair analysis.
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Affiliation(s)
- Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Felipe Martins Silveira
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, CEP: 13414-903, Piracicaba, SP, Brazil
| | - Gabriela Sauer Llantada
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Luisa Comerlato Jardim
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Thiago Calcagnotto
- Oral and Maxillofacial Surgery Department, FATEC Dental CEEO, Igrejinha, R. Independência, 290, CEP: 95650-000, RS, Brazil
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, CEP: 13414-903, Piracicaba, SP, Brazil.
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Miao Q, Yang S, Ding H, Liu J. Controlled degradation of chitosan-coated strontium-doped calcium sulfate hemihydrate composite cement promotes bone defect repair in osteoporosis rats. Biomed Mater 2020; 15:055039. [DOI: 10.1088/1748-605x/ab9fcf] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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11
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Asgari M, Gazor R, Abdollahifar MA, Fadaei Fathabady F, Zare F, Norouzian M, Amini A, Khosravipour A, Kiani P, Atashgah RB, Rezaei F, Ghoreishi SK, Chien S, Hamblin MR, Bayat M. Combined therapy of adipose-derived stem cells and photobiomodulation on accelerated bone healing of a critical size defect in an osteoporotic rat model. Biochem Biophys Res Commun 2020; 530:173-180. [PMID: 32828282 DOI: 10.1016/j.bbrc.2020.06.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/03/2020] [Indexed: 12/29/2022]
Abstract
We investigated the impact of human demineralized bone matrix (hDBM) plus adipose-derived stem cells (hADS) plus photobiomodulation (PBM) on a critical-sized femoral defect (CSFD) in ovariectomy induced osteoporosis in rats. There were 6 groups as follows. In group 1 (control, C), only CSFDs were created. Groups 2-6 were implanted with DBM into the CSFD (DBM-CSFD). In group 2 (S), only DBM was transplanted into the CSFD. In group 3 (S + PBM), the DBM-CSFDs were treated with PBM. In group 4, the DBM-CSFDs were treated with alendronate (S + ALN). In group 5, ADSs were seeded into DBM-CSFD (S + ADS). In group 6, ADSs were seeded into DBM-CSFD and the CSFDs were treated with PBM (S + PBM + ADS). At week eight (catabolic phase of bone repair), the S + ALN, S + PBM + ADS, S + PBM, and S + ADS groups all had significantly increased bone strength than the S group (ANOVA, p = 0.000). The S + PBM, S + PBM + ADS, and S + ADS groups had significantly increased Hounsfield unit than the S group (ANOVA, p = 0.000). ALN, ADS, and PBM significantly increased healed bone strength in an experimental model of DBM-treated CSFD in the catabolic phase of bone healing in osteoporotic rats. However, ALN alone and PBM plus ADS were superior to the other protocols.
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Affiliation(s)
- Mehrdad Asgari
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Rouhallah Gazor
- Department of Anatomy, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Mohammad-Amin Abdollahifar
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Fadaei Fathabady
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Zare
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohsen Norouzian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Abdollah Amini
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Armin Khosravipour
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Pejman Kiani
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Science, Tehran, Iran.
| | - Rahimeh B Atashgah
- Department of Pharmaceutical Biomaterials, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, 13169-43551, Iran.
| | - Fatemehsadat Rezaei
- University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY, 40536, USA.
| | | | - Sufan Chien
- Price Institute of Surgical Research, University of Louisville, Noveratech LLC, Louisville, KY, USA.
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, USA; Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, 2028, South Africa.
| | - 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, Noveratech LLC, Louisville, KY, USA.
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12
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Sun X, Li X, Qi H, Hou X, Zhao J, Yuan X, Ma X. MiR-21 nanocapsules promote early bone repair of osteoporotic fractures by stimulating the osteogenic differentiation of bone marrow mesenchymal stem cells. J Orthop Translat 2020; 24:76-87. [PMID: 32695607 PMCID: PMC7349941 DOI: 10.1016/j.jot.2020.04.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/10/2020] [Accepted: 04/16/2020] [Indexed: 02/06/2023] Open
Abstract
Objective The healing of osteoporotic fractures in the elderly patients is a difficult clinical problem. Currently, based on the internal fixation of fractures, the available drug treatments mainly focus on either inhibiting osteoclast function, such as bisphosphonate, calcitonin, oestrogen or promoting osteogenesis, such as parathyroid hormones. However, the availability of current antiosteoporotic drugs in promoting osteoporotic fracture healing is limited. The objective of the present study was to investigate the ability of the MiR-21/nanocapsule to enhance the early bone repair of osteoporotic fractures. Methods Based on the presence of matrix metalloproteinases that are overexpressed at the fracture site, we designed the matrix metalloproteinase–sensitive nanocapsules which were formed by in situ free radical polymerisation on the surface of MiR-21 with 2-(methacryloyloxy) ethyl phosphorylcholine and the bisacryloylated VPLGVRTK peptide. The MiR-21/nanocapsule [n (miR-21)] and O-carboxymethyl chitosan (CMCS) were mixed until they formed a gel-like material [CMCS/n (miR-21)] with good fluidity and injectability. Thirty elderly Sprague Dawley (SD) rats (female, 14-month-old, 380 ± 10 g) were subjected to bilateral removal of the ovaries (ovariectomised). All rats were subjected to bilateral bone defects (2 mm diameter) of the proximal tibia and randomly divided into three groups (groups A, B, and C): separately injected with CMCS/n (miR-21), CMCS/n (NC-miR), and saline. Micro-computed tomography (CT) imaging was performed to evaluate newly formed bone volume and connectivity. Nondecalcified histology and toluidine blue staining were performed to measure the effects of CMCS/n (miR-21) on bone repair. In vitro, the effect of n (miR-21) on osteogenic differentiation to bone marrow mesenchymal stem cells (BMSCs) which derived from the ovariectomised rat model was observed. Results The morphology of n (miR-21) was a regular spherical nanocapsule with a uniform small size (25–35 nm). The results confirmed that n (miR-21) could be efficiently phagocytosed by BMSCs and released in the cytoplasm to promote osteogenesis. The expression level of alkaline phosphatase and Runt-related transcription factor 2 mRNA in the n (miR-21) group was higher than that in the n (NC-miR) group. Animal experiments proved that CMCS/n (miR-21) produced better bone repair compared with the CMCS/n (NC-miR) group in the early stages of fracture healing at 4 weeks. In the late stage of fracture healing (8 weeks), micro-CT quantitative analysis showed that the new bone trabeculae in the CMCS/n (miR-21) group has decreased compared with the CMCS/n (NC-miR) group. In the CMCS/n (miR-21) group, the new cancellous bone had been absorbed, and the process of bone healing was almost completed. In contrast, the new bone in the CMCS/n (NC-miR) and the control groups was still in the healing process. Conclusion The cytological tests confirmed that n (miR-21) can promote osteogenic differentiation of BMSCs derived from the osteoporosis rat model. Furthermore, the results of animal tests demonstrated that local injection of CMCS/n (miR-21) promoted the early healing of osteoporotic bone defects. Consequently CMCS/n (miR-21) promoted the bone repair process to enter the moulding phase earlier. The translational potential of this article CMCS/n (miR-21) can be widely applied to elderly patients with osteoporotic fractures. This method can help patients with osteoporotic fractures recover earlier and avoid serious complications. It provides a potential approach for the clinical treatment of osteoporotic fractures in the elderly.
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Affiliation(s)
- Xiaolei Sun
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, 300072, China.,Department of Orthopaedics, Tianjin Hospital, Tianjin, 300211, China
| | - Xueping Li
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, 300072, China
| | - Hongzhao Qi
- Institute for Translational Medicine, Qingdao University, Qingdao, 266021, China
| | - Xin Hou
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, 300072, China
| | - Jin Zhao
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, 300072, China
| | - Xubo Yuan
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, 300072, China
| | - Xinlong Ma
- Department of Orthopaedics, Tianjin Hospital, Tianjin, 300211, China
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13
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Gorter E, Gerretsen B, Krijnen P, Appelman-Dijkstra N, Schipper I. Does osteoporosis affect the healing of subcapital humerus and distal radius fractures? J Orthop 2020; 22:237-241. [PMID: 32425424 PMCID: PMC7226641 DOI: 10.1016/j.jor.2020.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/15/2020] [Accepted: 05/02/2020] [Indexed: 01/18/2023] Open
Abstract
Introduction Animal models indicate that osteoporosis may negatively influence the fracture healing process, but clinical studies on this topic are scarce. In this study we investigated the effect of osteoporosis on fracture healing in patients with an upper extremity fracture. Methods This retrospective cohort study included all patients aged 50 years or older, with a fracture of the proximal humerus or the distal radius treated in the period June 2012 to July 2015 and a DEXA scan within a year after fracture. The incidence of delayed-union and non-union were compared between patients with or without osteoporosis (BMD T score ≤ -2.5SD). A secondary analysis was performed with a more pragmatically definition; BMD T score ≤ -2.5SD or a proximal humerus fracture with a T-score between -2.5SD and -1.0SD. Results Osteoporosis was diagnosed in 133/455 patients (29.2%). A total of 461 fractures (distal radius n = 311 and proximal humerus n = 150) were treated. Radiological delayed- or non-union was described in 11/461 cases (2.4%); all proximal humerus fractures of which 6 cases (1.3%) were clinically manifest. The incidence of delayed- or non-union in fracture treatment did not differ between patients with osteoporosis (5/137 fractures) and the patients without osteoporosis (6/324 fractures) (p = 0.27). In the second analysis a significantly higher incidence was found in patients with osteoporosis (10/214 fractures vs 1/247 fractures p = 0.003). Conclusions The results of this study suggest that osteoporosis does not significantly influence the progress of fracture healing in distal radius and proximal humerus fractures, although there seems to be a tendency towards a negative effect.
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Affiliation(s)
- E.A. Gorter
- Leiden University Medical Center, Departments of Trauma Surgery, Center for Bone Quality, Leiden, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- Corresponding author. Leiden University Medical Center, Department of Trauma Surgery, postzone K6-R, P.O. Box 9600, 2300, RC, Leiden, the Netherlands.
| | - B.M. Gerretsen
- Leiden University Medical Center, Departments of Trauma Surgery, Center for Bone Quality, Leiden, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
| | - P. Krijnen
- Leiden University Medical Center, Departments of Trauma Surgery, Center for Bone Quality, Leiden, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
| | - N.M. Appelman-Dijkstra
- Leiden University Medical Center, Departments of Internal Medicine, Center for Bone Quality, Leiden, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
| | - I.B. Schipper
- Leiden University Medical Center, Departments of Trauma Surgery, Center for Bone Quality, Leiden, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
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Miranda TS, Napimoga MH, De Franco L, Marins LM, Malta FDS, Pontes LA, Morelli FM, Duarte PM. Strontium ranelate improves alveolar bone healing in estrogen‐deficient rats. J Periodontol 2020; 91:1465-1474. [DOI: 10.1002/jper.19-0561] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/13/2019] [Accepted: 01/24/2020] [Indexed: 11/07/2022]
Affiliation(s)
| | - Marcelo Henrique Napimoga
- Faculdade São Leopoldo Mandic Instituto São Leopoldo Mandic Área de Imunologia Campinas São Paulo Brazil
| | - Leonardo De Franco
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos São Paulo Brazil
| | - Letícia Macedo Marins
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos São Paulo Brazil
| | - Fernando de Souza Malta
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos São Paulo Brazil
| | - Louise Antonialice Pontes
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos São Paulo Brazil
| | - Fernando Mendes Morelli
- Faculdade São Leopoldo Mandic Instituto São Leopoldo Mandic Área de Imunologia Campinas São Paulo Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos São Paulo Brazil
- Department of Periodontology College of Dentistry University of Florida Gainesville FL
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Yuan Y, Duan R, Wu B, Huang W, Zhang X, Qu M, Liu T, Yu X. Gene expression profiles and bioinformatics analysis of insulin-like growth factor-1 promotion of osteogenic differentiation. Mol Genet Genomic Med 2019; 7:e00921. [PMID: 31419079 PMCID: PMC7082822 DOI: 10.1002/mgg3.921] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/20/2019] [Accepted: 07/23/2019] [Indexed: 02/04/2023] Open
Abstract
Background Insulin‐like growth factor‐1 (IGF‐1) promotes osteoblast differentiation and mineralization. The objective of this study was to investigate the effects of IGF‐1 on proliferation, mineralization, alkaline phosphatase (ALP) synthesis, and gene expression of osteoblast differentiation in MC3T3‐E1 osteoblasts cells, and to explore gene expression profiling differential genes. Methods MC3T3‐E1 osteoblasts cells were cultured in medium with or without IGF‐1. The ALP assay was employed to determine the osteoblast mineralization, and Alizarin red S to stain for calcium deposits, which were the indicators of mature osteocytes. The living cell number was assessed by the Cell Counting Kit‐8 method. RNA‐seq analysis was applied to identify genes that were differentially expressed in with or without IGF‐1 as well as genes that varied between these two groups. The expression of osteogenic marker genes was determined by quantitative real‐time polymerase chain reaction (qRT‐PCR) and western blot analysis. Result The cell number of osteoblasts exposed to IGF‐1 at 200 μg/L significantly increased compared with the control group. The ALP activity in IGF‐1‐treated cells was higher than that in the control group. IGF‐1 can increase ALP synthesis in osteoblasts in vitro. RNA‐seq analysis showed that 677 triggered differentially expressed genes by IGF, of which 383 genes were downregulated and 294 genes were upregulated. Gene ontology (GO) analysis showed that IGF‐1 caused a significant change in gene expression patterns. Conclusions This result suggested that IGF‐1 could probably promote the synthesis of organic matrix and mineralize action of bone. Osteogenic‐related genes (DMP1, PHEX, SOST, BMP2, RUNX2, OPN, and OCN) were significantly upregulated both in GO analysis and in pathway analysis to perform qRT‐PCR. Western blot analysis demonstrated that the Notch pathway was highly upregulated in MC3T3‐E1 cells.
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Affiliation(s)
- Yashuai Yuan
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Ruimeng Duan
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Baolin Wu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Wei Huang
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Xiuzhi Zhang
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Mingjia Qu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Tao Liu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Xiaobing Yu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
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16
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Xie Y, Zhang L, Xiong Q, Gao Y, Ge W, Tang P. Bench-to-bedside strategies for osteoporotic fracture: From osteoimmunology to mechanosensation. Bone Res 2019; 7:25. [PMID: 31646015 PMCID: PMC6804735 DOI: 10.1038/s41413-019-0066-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 12/16/2022] Open
Abstract
Osteoporosis is characterized by a decrease in bone mass and strength, rendering people prone to osteoporotic fractures caused by low-energy forces. The primary treatment strategy for osteoporotic fractures is surgery; however, the compromised and comminuted bones in osteoporotic fracture sites are not conducive to optimum reduction and rigid fixation. In addition, these patients always exhibit accompanying aging-related disorders, including high inflammatory status, decreased mechanical loading and abnormal skeletal metabolism, which are disadvantages for fracture healing around sites that have undergone orthopedic procedures. Since the incidence of osteoporosis is expected to increase worldwide, orthopedic surgeons should pay more attention to comprehensive strategies for improving the poor prognosis of osteoporotic fractures. Herein, we highlight the molecular basis of osteoimmunology and bone mechanosensation in different healing phases of elderly osteoporotic fractures, guiding perioperative management to alleviate the unfavorable effects of insufficient mechanical loading, high inflammatory levels and pathogen infection. The well-informed pharmacologic and surgical intervention, including treatment with anti-inflammatory drugs and sufficient application of antibiotics, as well as bench-to-bedside strategies for bone augmentation and hardware selection, should be made according to a comprehensive understanding of bone biomechanical properties in addition to the remodeling status of osteoporotic bones, which is necessary for creating proper biological and mechanical environments for bone union and remodeling. Multidisciplinary collaboration will facilitate the improvement of overall osteoporotic care and reduction of secondary fracture incidence.
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Affiliation(s)
- Yong Xie
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Licheng Zhang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Qi Xiong
- Department of Oncology, Chinese PLA General Hospital, Beijing, China
| | - Yanpan Gao
- State Key Laboratory of Medical Molecular Biology and Department of Immunology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Ge
- State Key Laboratory of Medical Molecular Biology and Department of Immunology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Peifu Tang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
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[Influence of hormone or hormone replacement therapy on bone healing]. Unfallchirurg 2019; 122:512-517. [PMID: 31172230 DOI: 10.1007/s00113-019-0677-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Since the observations of Fuller Albright in 1940, it is well documented that estrogen deficiency is one of the major causes of osteoporosis. Osteoporosis increases not only the risk of fracture and consecutively the number of fractures but can also induce a disorder of fracture healing. This raises the question whether estrogen deficiency negatively influences bone healing in addition to fragility. The currently available literature on this topic provides indications that estrogen deficiency negatively influences fracture healing in the various stages of healing. Furthermore, there is evidence that the administration of estrogen antagonizes these negative effects. Future clinical investigations are needed to find out whether the experimental data can be transferred to the patients.
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Hoffmeyer P, Miozzari H, Holzer N. Non-hip/non-vertebral fractures - How to treat best? Best Pract Res Clin Rheumatol 2019; 33:236-263. [PMID: 31547981 DOI: 10.1016/j.berh.2019.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Fractures of the extremities in the elderly constitute more than two-thirds of all fragility fractures befalling frail, osteoporotic and sarcopenic patients. Although treatment controversies abound, consensus exists. Upper extremity fractures hinder activities of daily living and are debilitating. Open fractures or displaced fractures will need surgical intervention. Wrist fractures treated operatively allow early use of the hand. Most pelvic fractures are treated conservatively. In the lower extremities, fractures of the long bones, tibia and femur need surgical intervention. Non-displaced fractures around the foot may be treated with immobilisation and avoidance of full weight-bearing. As a rule, fractures take four months for consolidation. Individually tailored solutions are needed for frail patients with comorbidities. Maintaining joint mobility and muscle strength preserves mobility and autonomy. Caring for extremities trauma is team work, involving family and health care providers. Prevention efforts are mandatory.
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Affiliation(s)
- Pierre Hoffmeyer
- Swiss Foundation for Innovation and Training in Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1205, Switzerland.
| | - Hermes Miozzari
- Department of Orthopaedics, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1205, Switzerland.
| | - Nicolas Holzer
- Department of Orthopaedics, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1205, Switzerland.
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Leiblein M, Henrich D, Fervers F, Kontradowitz K, Marzi I, Seebach C. Do antiosteoporotic drugs improve bone regeneration in vivo? Eur J Trauma Emerg Surg 2019; 46:287-299. [DOI: 10.1007/s00068-019-01144-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/22/2019] [Indexed: 12/26/2022]
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Abstract
PURPOSE OF REVIEW Substantial advances have been made in understanding the biological basis of fracture healing. Yet, it is unclear whether the presence of osteoporosis or prior or current osteoporosis therapy influences the healing process or is associated with impaired healing. This review discusses the normal process of fracture healing and the role of osteoporosis and patient-specific factors in relation to fracture repair. RECENT FINDINGS The definitive association of osteoporosis to impaired fracture healing remains inconclusive because of limited evidence addressing this point. eStudies testing anabolic agents in preclinical models of ovariectomized animals with induced fractures have produced mostly positive findings showing enhanced fracture repair. Prospective human clinical trials, although few in number and limited in design and to testing only one anabolic agent, have similarly yielded modestly favorable results. Interest is high for exploring currently available osteoporosis therapies for efficacy in fracture repair. Definitive data supporting their efficacy are essential in achieving approval for this indication.
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Affiliation(s)
- Cheng Cheng
- Endocrine Research Unit, Department of Medicine, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, Room 369, San Francisco, CA, 94158, USA
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, USA
| | - Dolores Shoback
- Endocrine Research Unit, Department of Medicine, San Francisco Veterans Affairs Medical Center, 1700 Owens Street, Room 369, San Francisco, CA, 94158, USA.
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, USA.
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Tian L, Tang N, Ngai T, Wu C, Ruan Y, Huang L, Qin L. Hybrid fracture fixation systems developed for orthopaedic applications: A general review. J Orthop Translat 2018; 16:1-13. [PMID: 30723676 PMCID: PMC6350075 DOI: 10.1016/j.jot.2018.06.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/11/2018] [Accepted: 06/29/2018] [Indexed: 12/28/2022] Open
Abstract
Orthopaedic implants are applied daily in our orthopaedic clinics for treatment of musculoskeletal injuries, especially for bone fracture fixation. To realise the multiple functions of orthopaedic implants, hybrid system that contains several different materials or parts have also been designed for application, such as prosthesis for total hip arthroplasty. Fixation of osteoporotic fracture is challenging as the current metal implants made of stainless steel or titanium that are rather rigid and bioinert, which are not favourable for enhancing fracture healing and subsequent remodelling. Magnesium (Mg) and its alloys are reported to possess good biocompatibility, biodegradability and osteopromotive effects during its in vivo degradation and now tested as a new generation of degradable metallic biomaterials. Several recent clinical studies reported the Mg-based screws for bone fixation, although the history of testing Mg as fixation implant was documented more than 100 years ago. Truthfully, Mg has its limitations as fixation implant, especially when applied at load-bearing sites because of rather rapid degradation. Currently developed Mg-based implants have only been designed for application at less or non-loading-bearing skeletal site(s). Therefore, after years research and development, the authors propose an innovative hybrid fixation system with parts composed of Mg and titanium or stainless steel to maximise the biological benefits of Mg; titanium or stainless steel in this hybrid system can provide enough mechanical support for fractures at load-bearing site(s) while Mg promotes the fracture healing through novel mechanisms during its degradation, especially in patients with osteoporosis and other metabolic disorders that are unfavourable conditions for fracture healing. This hybrid fixation strategy is designed to effectively enhance the osteoporotic fracture healing and may potentially also reduce the refracture rate. The translational potential of this article: This article systemically reviewed the combination utility of different metallic implants in orthopaedic applications. It will do great contribution to the further development of internal orthopaedic implants for fracture fixation. Meanwhile, it also introduced a titanium-magnesium hybrid fixation system as an alternative fixation strategy, especially for osteoporotic patients.
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Affiliation(s)
- Li Tian
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Ning Tang
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - To Ngai
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Chi Wu
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Yechun Ruan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, PR China
| | - Le Huang
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Ling Qin
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, PR China.,Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, PR China
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Tian L, Sheng Y, Huang L, Chow DHK, Chau WH, Tang N, Ngai T, Wu C, Lu J, Qin L. An innovative Mg/Ti hybrid fixation system developed for fracture fixation and healing enhancement at load-bearing skeletal site. Biomaterials 2018; 180:173-183. [PMID: 30041069 DOI: 10.1016/j.biomaterials.2018.07.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/05/2018] [Accepted: 07/10/2018] [Indexed: 12/12/2022]
Abstract
Magnesium (Mg) is a potential biomaterial suitable for developing biodegradable orthopaedic implants, especially as internal fixators for fracture fixation at non-load bearing skeletal sites. However, Mg alone cannot provide sufficient mechanical support for stable fracture fixation at load bearing sites due to its rapid degradation in the early stage after implantation. In consideration of the strengths and weaknesses of Mg, we developed an innovative magnesium/titanium (Mg/Ti) hybrid fixation system for long bone fracture fixation and investigated the fixation efficacy. The finite element analysis (FEA) results indicated that the Mg/Ti hybrid fixation system provided sufficient mechanical support for fracture fixation at load-bearing skeletal site. As a proof-of-concept, we performed a "Z-shaped" open osteotomy at the mid-shaft of rabbit tibia. For comparison, the animals were divided into two groups: Mg/Ti group (fixated with Mg screws and Ti fixators) and Ti control group (fixated with Ti screws and Ti fixators). The radiographic, four-point bending mechanical test, histological and histomorphometric analysis were postoperatively performed in a temporal manner up to 12 weeks. Both X-ray and micro-CT images of the Mg/Ti group showed a larger callus (14.7% at 3rd week and 24.8% at 6th week, n = 5-7, p < 0.05) in the regions of interest (ROIs) over time, especially at the opposite cortex of the fixation plate. At the 12th week post-operation, the biomechanical test result indicated that the rabbit tibia in the Mg/Ti group healed better and the overall mechanical strength was approximately 3-fold higher (n = 8, p < 0.05) than that at 6th week. Furthermore, the FEA revealed that the Mg/Ti group had a higher mechanical strength (19.5% at week 6 and 31.5% at week 12) at the specified ROI and resulted in an earlier and faster endochondral ossification (68.0% at week 3 and 71.4% at week 6) with a higher expression of osteocalcin (54.0%) and collagen I (34.2%) than the Ti control group (n = 4, p < 0.05). Further evaluation suggested that a higher expression of calcitonin gene-related peptide (CGRP), a known osteogenic neuron peptide, in the fracture callus of the Mg/Ti group might be a major underlying mechanism of enhanced fracture healing attributed to the release of Mg ions during the degradation of Mg screws.
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Affiliation(s)
- Li Tian
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Yifeng Sheng
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Le Huang
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Dick Ho-Kiu Chow
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Wing Ho Chau
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Ning Tang
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - To Ngai
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Chi Wu
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Jian Lu
- Department of Mechanical and Biomedical Engineering, City University of Hong Kong, Hong Kong Special Administrative Region
| | - Ling Qin
- Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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Yoda N, Zheng K, Chen J, Liao Z, Koyama S, Peck C, Swain M, Sasaki K, Li Q. Biomechanical analysis of bone remodeling following mandibular reconstruction using fibula free flap. Med Eng Phys 2018; 56:1-8. [DOI: 10.1016/j.medengphy.2018.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/24/2018] [Accepted: 03/13/2018] [Indexed: 02/06/2023]
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Zhang K, Zhang J, Chen K, Hu X, Wang Y, Yang X, Zhang X, Fan Y. In vitro and in vivo assessment of nanostructured porous biphasic calcium phosphate ceramics for promoting osteogenesis in an osteoporotic environment. RSC Adv 2018; 8:14646-14653. [PMID: 35540770 PMCID: PMC9079917 DOI: 10.1039/c8ra00768c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/02/2018] [Indexed: 11/21/2022] Open
Abstract
Treatment of bone defects in osteoporotic patients with bone substitutes is difficult, due to insufficient osseointegration. The development of appropriate biomaterials to solve the problem requires the assessment of the material performance in an osteoporotic environment, which is rarely investigated. Herein, nanostructured biphasic calcium phosphate (nBCP) ceramics were prepared via the incorporation of hydroxyapatite nanoparticles (HANPs) into porous biphasic CaP (BCP) substrates, leading to an increase of over 500% in the specific surface area. Primary osteoblasts harvested from osteoporotic rats were cultured on the nBCP ceramics, and it was found that the osteoblast functions, including proliferation, alkaline phosphatase activity, osteocalcin secretion and expression of osteogenic genes, were significantly enhanced compared with osteoblasts grown on non-nanostructured BCP ceramics. To further assess the osteoinduction ability, the ceramics were implanted in the femur of osteoporotic rats. Compared to the rats implanted with non-nanostructured BCP ceramics, a higher amount of mechanically matured bone was newly formed in the rats with nBCP ceramics after 6 weeks of implantation. Such enhanced osteoinduction ability of the nBCP ceramics may be due to the incorporated HANPs, as well as the nanostructured topography induced by the HANPs. These results indicate good in vitro and in vivo osteoinductivity of the nBCP ceramics in an osteoporotic environment and offer potential benefits for treating bone defects in osteoporotic patients.
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Affiliation(s)
- Kun Zhang
- National Engineering Research Center for Biomaterials, Sichuan University 29 Wangjiang Road Chengdu 610064 China
| | - Jieyu Zhang
- National Engineering Research Center for Biomaterials, Sichuan University 29 Wangjiang Road Chengdu 610064 China
| | - Kelei Chen
- Zenmindes Biotech Co. Ltd B2, CAS, No 9 4th Section of South Renmin Road Chengdu China +86-28-85410246 +86-28-85417654
| | - Xuefeng Hu
- National Engineering Research Center for Biomaterials, Sichuan University 29 Wangjiang Road Chengdu 610064 China
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University 29 Wangjiang Road Chengdu 610064 China
| | - Xiao Yang
- National Engineering Research Center for Biomaterials, Sichuan University 29 Wangjiang Road Chengdu 610064 China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University 29 Wangjiang Road Chengdu 610064 China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University 29 Wangjiang Road Chengdu 610064 China
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Abstract
OBJECTIVES Our aim was to investigate whether patients presenting with fragility fractures of the proximal femur are receiving osteoporosis treatment and to assess the number of other fragility fractures they have sustained prior to admission. METHODS All patients presenting to our institution with fragility fractures of the proximal femur within an 18-month period (January 2012-August 2013) were included. Patient demographics; fracture classification (AO/OTA); American Society of Anesthesiologists (ASA) grade; Abbreviated Mental Test Score (AMTS) on admission; type of operation; time to operation; peri-operative complications; length of hospital stay (LOS); walking status; osteoporotic medication; Dual-energy X-ray absorptiometry (DEXA) results; additional fragility fractures; and mortality were collected and analysed. RESULTS A total of 1004 patients (278 male) met the inclusion criteria and were included into the study. The mean age was 82.01 years and mean LOS was 19.54days. Fifty-four per cent of the patients were admitted from their own homes whereas 43% were capable to walk indoors without any aids before their injury. Mean time to surgery was 2.06days (Median: 1.31, range: 0-26days). Three hundred and six patients (30.5%) had at least another fragility fracture before the index episode (mean 1.40 fractures; SD: 0.71 fractures; range: 1-6 fractures). Only 16.4% were under complete osteoporosis treatment on admission, defined as receiving calcium with vitamin D and a bisphosphonate or an alternative agent. When we compared patients without a history of a previous fragility fracture (Group A) and patients with at least another previous fragility fracture (Group B), we found that patients in Group B had a significantly lower AMTS score, lower bone mineral density (BMD) as evident on the DEXA scan, an inferior mobility before admission and a higher incidence of extracapsular fractures (p<0.05). On discharge, patients in Group B had a higher chance of receiving complete bone protection compared to group A (27.9% versus 41.7%; p<0.01). Following discharge, 11.2% of the patients sustained an additional fragility fracture. The mean time from the index episode to the additional fracture was 0.65 years, whilst these injuries were more frequent in Group B (RR=1.638; p<0.05). CONCLUSION Patients presenting with a hip fracture are generally under-treated for osteoporosis. Post-operative assessment by a designated geriatrician and use of a standardised protocol is of paramount importance for reducing the risk of additional fragility fractures. Additionally, screening of the elderly population for identifying the patients who suffer from osteoporosis can potentially reduce the risk of sustaining a further fragility fracture.
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Zhao R, Xie P, Zhang K, Tang Z, Chen X, Zhu X, Fan Y, Yang X, Zhang X. Selective effect of hydroxyapatite nanoparticles on osteoporotic and healthy bone formation correlates with intracellular calcium homeostasis regulation. Acta Biomater 2017; 59:338-350. [PMID: 28698163 DOI: 10.1016/j.actbio.2017.07.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/20/2017] [Accepted: 07/05/2017] [Indexed: 01/21/2023]
Abstract
Adequate bone substitutes osseointegration has been difficult to achieve in osteoporosis. Hydroxyapatite of the osteoporotic bone, secreted by pathologic osteoblasts, had a smaller crystal size and lower crystallinity than that of the normal. To date, little is known regarding the interaction of synthetic hydroxyapatite nanoparticles (HANPs) with osteoblasts born in bone rarefaction. The present study investigated the biological effects of HANPs on osteoblastic cells derived from osteoporotic rat bone (OVX-OB), in comparison with the healthy ones (SHM-OB). A selective effect of different concentrations of HANPs on the two cell lines was observed that the osteoporotic osteoblasts had a higher tolerance. Reductions in cell proliferation, ALP activity, collagen secretion and osteoblastic gene expressions were found in the SHM-OB when administered with HANPs concentration higher than 25µg/ml. In contrast, those of the OVX-OB suffered no depression but benefited from 25 to 250µg/ml HANPs in a dose-dependent manner. We demonstrated that the different effects of HANPs on osteoblasts were associated with the intracellular calcium influx into the endoplasmic reticulum. The in vivo bone defect model further confirmed that, with a critical HANPs concentration administration, the osteoporotic rats had more and mechanically matured new bone formation than the non-treated ones, whilst the sham rats healed no better than the natural healing control. Collectively, the observed epigenetic regulation of osteoblastic cell function by HANPs has significant implication on defining design parameters for a potential therapeutic use of nanomaterials. STATEMENT OF SIGNIFICANCE In this study, we investigated the biological effects of hydroxyapatite nanoparticles (HANPs) on osteoporotic rat bone and the derived osteoblast. Our findings revealed a previously unrecognized phenomenon that the osteoporotic individuals could benefit from higher concentrations of HANPs, as compared with the healthy individuals. The in vivo bone defect model confirmed that, with a critical HANPs concentration administration, the osteoporotic rats had more mechanically matured new bone formation than the non-treated ones, whilst the sham rats healed no better than the natural healing control. The selective effect of HANPs might be associated with the intracellular calcium influx into the endoplasmic reticulum. Collectively, the observed epigenetic regulation by HANPs has significant implication on defining design parameters for a potential therapeutic use of nanomaterials in a pathological condition.
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Affiliation(s)
- Rui Zhao
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China
| | - Pengfei Xie
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China
| | - Kun Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China
| | - Zhurong Tang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China
| | - Xuening Chen
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China
| | - Xiangdong Zhu
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China
| | - Xiao Yang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China.
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, 29 Wangjiang Road, Chengdu 610064, China.
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Li WL, Yu X, Huang ZP, Pang QJ. Effect of parathyroid hormone on healing in osteoporotic fractures via a phospholipase C-independent pathway. J Int Med Res 2017; 45:1200-1207. [PMID: 28534698 PMCID: PMC5536420 DOI: 10.1177/0300060517707075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objective This study was performed to investigate the effect of parathyroid hormone (PTH) on healing in osteoporotic fractures via a phospholipase C (PLC)-independent pathway and explore the mechanism of PTH-mediated bone formation. Methods Ninety-six 12-week-old C57BL/6J female mice underwent bilateral ovariectomy. One month later, the lower third of the femur was fractured and the mice were treated using saline, PTH(1-28), PTH(1-34), zoledronic acid (ZA), PTH(1-28)+ZA, and PTH(1-34)+ZA. The mice were killed at weeks 2 and 4 in each group. Biomechanical testing and micro-computed tomography were performed. Results The formation and strength of the callus increased in all but the saline group. The mice treated with PTH(1-34) showed a significantly higher ultimate bending force, bending rigidity, bone mineral density, percent bone volume, and trabecular thickness than those treated with PTH(1-28). The PTH(1-34)+ZA group demonstrated the greatest improvements in the ultimate bending force, bending rigidity, bone mineral density, and relative bone volume. Conclusions PTH can promote fracture healing and callus hardness in ovariectomized mice by increasing callus formation and reconstructing trabecular bone via a PLC-independent pathway. PTH combined with ZA has a cumulative effect on the healing of fractures in ovariectomized mice.
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Affiliation(s)
- Wei-Long Li
- 1 Ningbo University School of Medicine, Ningbo, China
| | - Xiao Yu
- 2 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
| | - Zhi-Ping Huang
- 3 Department of Spinal Surgery, Nanfang Hospital, Southern University, Guangzhou, China
| | - Qing-Jiang Pang
- 2 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
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Guo Y, Tang CY, Man XF, Tang HN, Tang J, Zhou CL, Tan SW, Wang M, Feng YZ, Zhou HD. Insulin-like growth factor-1 promotes osteogenic differentiation and collagen I alpha 2 synthesis via induction of mRNA-binding protein LARP6 expression. Dev Growth Differ 2017; 59:94-103. [PMID: 28211947 DOI: 10.1111/dgd.12342] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 01/21/2017] [Accepted: 01/22/2017] [Indexed: 11/30/2022]
Abstract
This study explored the mechanism underlying the stimulation of collagen synthesis and osteoblastic differentiation by insulin-like growth factor 1 (IGF1) in primary mouse osteoblasts. Primary mouse calvarial osteoblasts were cultured and treated with various doses of IGF1 before transfection with siRNA targeting the collagen type I alpha 2 (Col1a2) or La ribonucleoprotein domain family member 6 (Larp6) genes. Alkaline phosphatase (ALP) activity, osteocalcin staining, alizarin red quantification and the expression level of runt-related transcription factor 2 (RUNX2) were performed to assess the differentiation of pre-osteoblasts. Based on Western blot analysis, IGF1 up-regulated COL1A2 protein expression in the primary osteoblasts in a dose- and time-dependent manner. In addition, Col1a2 interference inhibited the differentiation and mineralization of osteoblasts. IGF1 also stimulated the differentiation of mouse primary osteoblasts and increased LARP6 expression during osteogenic differentiation. RNA-Immunoprecipitation (IP) indicated that LARP6 could bind to Col1a2 mRNA after IGF1 stimulation. However, transfection of Larp6-specific siRNA significantly reduced collagen and ALP secretion, mineralization and inhibited the expression of osteocalcin and RUNX2, indicating that Larp6 interference inhibited the differentiation ability of primary mouse calvarial osteoblasts, and these effects could not be reversed by IGF1. Thus, IGF1 could promote COL1A2 expression and osteoblast differentiation in primary mouse calvarial pre-osteoblasts by increasing LARP6 expression via a posttranscriptional mechanism.
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Affiliation(s)
- Yue Guo
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Chen-Yi Tang
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Xiao-Fei Man
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Hao-Neng Tang
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Jun Tang
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Ci-La Zhou
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Shu-Wen Tan
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Min Wang
- Department of Metabolism & Endocrinology, Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Yun-Zhi Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
| | - Hou-De Zhou
- Department of Metabolism & Endocrinology, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, ChangSha, Hunan, China
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