1
|
Liang ZT, Guo CF, Li J, Zhang HQ. The role of endocrine hormones in the pathogenesis of adolescent idiopathic scoliosis. FASEB J 2021; 35:e21839. [PMID: 34387890 DOI: 10.1096/fj.202100759r] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 11/11/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is a common spinal deformity characterized by changes in the three-dimensional structure of the spine. It usually initiates during puberty, the peak period of human growth when the secretion of numerous hormones is changing, and it is more common in females than in males. Accumulating evidence shows that the abnormal levels of many hormones including estrogen, melatonin, growth hormone, leptin, adiponectin and ghrelin, may be related to the occurrence and development of AIS. The purpose of this review is to provide a summary and critique of the research published on each hormone over the past 20 years, and to highlight areas for future study. It is hoped that the presentation will help provide a better understanding of the role of endocrine hormones in the pathogenesis of AIS.
Collapse
Affiliation(s)
- Zhuo-Tao Liang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Chao-Feng Guo
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jiong Li
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hong-Qi Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
2
|
|
3
|
Ahuja K, Garg B, Chowdhuri B, Yadav RK, Chaturvedi PK. A Comparative Analysis of the Metabolic and Coagulative Profiles in Patients with Idiopathic Scoliosis, Congenital Scoliosis and Healthy Controls: A Case-Control Study. Asian Spine J 2018; 12:1028-1036. [PMID: 30322254 PMCID: PMC6284126 DOI: 10.31616/asj.2018.12.6.1028] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/02/2018] [Indexed: 11/23/2022] Open
Abstract
Study Design Single-center, observational, case–control study. Purpose Comparison and analysis of the metabolic and coagulative profiles in patients with idiopathic scoliosis, patients with congenital scoliosis, and healthy controls. Overview of Literature Serum melatonin deficiency has been a controversial topic in the etiopathogenesis of scoliosis. Low bone mineral density, low vitamin D3 levels, and high parathyroid hormone levels are common metabolic abnormalities associated with scoliosis that may be responsible for its pathogenesis. In addition to metabolic defects, several studies have shown coagulation defects that either persist from the preoperative period or occur during surgery and usually lead to more than the expected amount of blood loss in patients undergoing deformity correction for scoliosis. Methods The study population (n=73) was classified into those having congenital scoliosis (n=31), those with idiopathic scoliosis (n=30), and healthy controls (n=12). After detailed clinicoradiological evaluation of all the subjects, 10-mL blood samples were collected, measured, and analyzed for various metabolic and coagulation parameters. Results The mean serum melatonin levels in patients with idiopathic scoliosis were significantly lower than those in the healthy controls. Although the mean serum melatonin level in the congenital group was also low, the difference was not statistically significant. Serum alkaline phosphatase and parathyroid hormone levels were higher in the scoliosis groups, whereas the vitamin D level was lower. No differences were observed in the coagulation profiles of the different groups. Conclusions Low serum melatonin levels associated with scoliosis can be a cause or an effect of scoliosis. Moreover, low bone mineral density, high bone turn over, and negative calcium balance appear to play an important role in the progression, if not the onset, of the deformity.
Collapse
Affiliation(s)
- Kaustubh Ahuja
- Department of Orthopaedics, All India Institute Of Medical Sciences, New Delhi, India
| | - Bhavuk Garg
- Department of Orthopaedics, All India Institute Of Medical Sciences, New Delhi, India
| | - Buddhadev Chowdhuri
- Department of Orthopaedics, All India Institute Of Medical Sciences, New Delhi, India
| | - Raj Kumar Yadav
- Department of Physiology, All India Institute Of Medical Sciences, New Delhi, India
| | - Pradeep Kumar Chaturvedi
- Department of Reproductive Medicine, All India Institute Of Medical Sciences Sciences, New Delhi, India
| |
Collapse
|
4
|
Onaolapo OJ, Onaolapo AY. Melatonin, adolescence, and the brain: An insight into the period-specific influences of a multifunctional signaling molecule. Birth Defects Res 2018; 109:1659-1671. [PMID: 29251845 DOI: 10.1002/bdr2.1171] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/31/2017] [Indexed: 12/21/2022]
Abstract
Melatonin is a neurohormone that is involved in the modulation of a wide range of physiological processes, including maintenance of the circadian rhythm, mediation of photoperiodic information, regulation of the sleep-wake cycle, synchronization of cell physiology, antioxidant defense, and immune-modulation. Although there are reports of increasing use of melatonin in the management of a number of health conditions, evidence exists that is suggestive of deleterious effects of melatonin administration on brain and reproductive development in the prepubertal and pubertal periods that are within the teenage years. In this review, we examine the influences of endogenous and exogenous melatonin on the adolescent brain, with specific reference to its involvement in the evolution of brain functions, brain structure, sleep regulation, and modulation of behaviors in health or disease.
Collapse
Affiliation(s)
- O J Onaolapo
- Behavioral Neuroscience/Neuropharmacology Unit, Department of Pharmacology, Ladoke Akintola University of Technology, Osogbo, Osun State, Nigeria
| | - A Y Onaolapo
- Behavioral Neuroscience/Neurobiology Unit, Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| |
Collapse
|
5
|
Fadzan M, Bettany-Saltikov J. Etiological Theories of Adolescent Idiopathic Scoliosis: Past and Present. Open Orthop J 2017; 11:1466-1489. [PMID: 29399224 PMCID: PMC5759107 DOI: 10.2174/1874325001711011466] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/01/2017] [Accepted: 09/11/2017] [Indexed: 12/11/2022] Open
Abstract
Adolescent idiopathic scoliosis is one of the most common spinal deformities, yet its cause is unknown. Various theories look to biomechanical, neuromuscular, genetic, and environmental origins, yet our understanding of scoliosis etiology is still limited. Determining the cause of a disease is crucial to developing the most effective treatment. Associations made with scoliosis do not necessarily point to causality, and it is difficult to determine whether said associations are primary (playing a role in development) or secondary (develop as a result of scoliosis). Scoliosis is a complex condition with highly variable expression, even among family members, and likely has many causes. These causes could be similar among homogenous groups of AIS patients, or they could be individual. Here, we review the most prevalent theories of scoliosis etiology and recent trends in research.
Collapse
Affiliation(s)
- Maja Fadzan
- Scoliosis 3DC, 3 Baldwin Green Common, Suite 204, Woburn, MA 01801, USA
| | | |
Collapse
|
6
|
Latalski M, Danielewicz-Bromberek A, Fatyga M, Latalska M, Kröber M, Zwolak P. Current insights into the aetiology of adolescent idiopathic scoliosis. Arch Orthop Trauma Surg 2017; 137:1327-1333. [PMID: 28710669 PMCID: PMC5602042 DOI: 10.1007/s00402-017-2756-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Indexed: 02/02/2023]
Abstract
Scoliosis occurs in about 0.2-0.6% of the general population. In the majority of cases the cause of this entity remains mostly unidentified. The search for the causes covers almost all aspects of its possible origin. We collected and systematised the contemporary theories and concepts concerning the aetiology of adolescent idiopathic scoliosis. Genetic and hereditary factors are commonly accepted as possible causes; however, the identification of the single gene responsible for the development of this condition seems impossible, which suggests multifactorial mechanism of its formation. Dysfunctions of the nervous system are recognised risks related to the development of scoliosis, but they are classified as belonging to a separate aetiological category. Scoliosis develops at the quickest rate during the child's growth spurt, which prompted the research on the role of the growth hormone in scoliosis aetiology. Melatonin is another hormone that is studied as a possible factor involved in development of this entity. In cases of progressive scoliosis, increased activity of calmodulin-a protein that regulates the levels of calcium ions-has been observed. The scientists have characterised numerous qualitative and quantitative changes in the composition of the tissue of intervertebral discs, spinal ligaments and paraspinal muscles. Some of the theories, explaining the nature of this entity, presented in this review seem to have only a purely theoretical value; their proliferation only confirms the fact that the actual nature of this condition has not been unveiled yet, and suggests its multifactorial aetiology.
Collapse
Affiliation(s)
- Michal Latalski
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland.
| | - A Danielewicz-Bromberek
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
| | - M Fatyga
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
| | - M Latalska
- Department of Vitreoretinal Surgery, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland
| | - M Kröber
- Department of Orthopaedics, Trauma und Spine Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany
| | - P Zwolak
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
- Department of Orthopaedics, Trauma und Spine Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany
| |
Collapse
|
7
|
Yang S, Zheng C, Jiang J, Lu F, Xia X, Zhu W, Jin X, Ma X. The value of applying a melatonin antagonist (Luzindole) in improving the success rate of the bipedal rat scoliosis model. BMC Musculoskelet Disord 2017; 18:137. [PMID: 28376758 PMCID: PMC5379722 DOI: 10.1186/s12891-017-1500-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An ideal animal model has always been the key to research the pathogenesis and treatment of adolescent idiopathic scoliosis (AIS), while available methods have obvious disadvantages. The deficiency of melatonin has been proved relating to AIS. In this research, we intended to apply Luzindole, the melatonin antagonist, in bipedal rat model, for the block of combination of melatonin and its receptor, to inhibit the melatonin effect, and then to understand whether this method can effectively improve the scoliosis rate of bipedal rat model, and investigate the role of melatonin in scoliosis. To investigate the feasibility of improving the success rate of bipedal rat scoliosis model via intraperitoneal injection of melatonin antagonist (Luzindole). METHODS A total of 60 3-weeks-old Sprague-Dawley rats were included in this study, and were divided into 3 groups (A, B and C). Each group included 20 rats. Osteotomy of the bilateral proximal humerus and proximal tailbone was performed in group A and group B; intraperitoneal injection of Luzindole (0.2 mg/kg) was performed in group A and group C. X-rays were taken before the surgery, 1 month after the surgery, 3 months after the surgery, and 6 months after the surgery, to calculate the Cobb's angle of the spine (>10° was considered scoliosis). The weight of every rat was also measured at the same time. Rats were euthanized 6 months after surgery to determine the calmodulin level in thrombocytes. RESULTS The rate of scoliosis in group A (14/20) was significantly higher than those in group B (6/20) and group C (0/20) (P < 0.05). The differences in the weights of the 3 groups were non-significant; as were differences in the calmodulin level in thrombocytes. CONCLUSION The application of the melatonin antagonist of Luzindole can improve the success rate of the bipedal rat scoliosis model. Meanwhile, this study indicates that a decreased melatonin level is not the primary cause of scoliosis, but that it may increase the likelihood and severity of scoliosis.
Collapse
Affiliation(s)
- Shuo Yang
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Chaojun Zheng
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Jianyuan Jiang
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Feizhou Lu
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China.,Department of Orthopedics, The Fifth People's Hospital, Fudan University, No.128, Ruili Road, Shanghai, 200240, China
| | - Xinlei Xia
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Wei Zhu
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Xiang Jin
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China
| | - Xiaosheng Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China.
| |
Collapse
|
8
|
Samaan MC, Missiuna P, Peterson D, Thabane L. Understanding the role of the immune system in adolescent idiopathic scoliosis: Immunometabolic CONnections to Scoliosis (ICONS) study protocol. BMJ Open 2016; 6:e011812. [PMID: 27401365 PMCID: PMC4947809 DOI: 10.1136/bmjopen-2016-011812] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Adolescent idiopathic scoliosis (AIS) affects up to 3% of children around the world. There is limited knowledge of AIS aetiopathogenesis, and this evidence is needed to develop new management strategies. Paraspinal muscle in AIS demonstrates evidence of differential fibrosis based on curve sidedness. Fibrosis is the hallmark of macrophage-driven inflammation and tissue remodelling, yet the mechanisms of fibrosis in paraspinal muscle in AIS are poorly understood. OBJECTIVES The primary objective of this study is to determine the influence of curve sidedness on paraspinal muscle inflammation. Secondary objectives include defining the mechanisms of macrophage homing to muscle, and determining muscle-macrophage crosstalk in muscle fibrosis in AIS. METHODS AND ANALYSIS This is a cross-sectional study conducted in a tertiary paediatric centre in Hamilton, Ontario, Canada. We will recruit boys and girls, 10-17 years of age, who are having surgery to correct AIS. We will exclude children who have an active infection or are on immunosuppressive therapies within 2 weeks of surgery, smokers and pregnant girls. Paraspinal muscle biopsies will be obtained at the start of surgery. Also, blood and urine samples will be collected from participants, who will fill questionnaires about their lifestyle. Anthropometric measures will also be collected including height, weight, waist and hip circumferences. ETHICS AND DISSEMINATION This study has received ethics authorisation by the institutional review board. This work will be published in peer-reviewed journals and will be presented in oral and poster formats at scientific meetings. DISCUSSION This study will explore the mechanisms of paraspinal muscle inflammation, remodelling and fibrosis in AIS. This will help identify pathways and molecules as potential therapeutic targets to treat and prevent AIS. It may also yield markers that predict scoliosis progression and response to treatment in these children.
Collapse
Affiliation(s)
- M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Paul Missiuna
- Division of Orthopedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Devin Peterson
- Division of Orthopedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, Hamilton, Ontario, Canada
- Biostatistics unit, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| |
Collapse
|
9
|
Bobyn JD, Little DG, Gray R, Schindeler A. Animal models of scoliosis. J Orthop Res 2015; 33:458-67. [PMID: 25492698 DOI: 10.1002/jor.22797] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/03/2014] [Indexed: 02/04/2023]
Abstract
Multiple techniques designed to induce scoliotic deformity have been applied across many animal species. We have undertaken a review of the literature regarding experimental models of scoliosis in animals to discuss their utility in comprehending disease aetiology and treatment. Models of scoliosis in animals can be broadly divided into quadrupedal and bipedal experiments. Quadrupedal models, in the absence of axial gravitation force, depend upon development of a mechanical asymmetry along the spine to initiate a scoliotic deformity. Bipedal models more accurately mimic human posture and consequently are subject to similar forces due to gravity, which have been long appreciated to be a contributing factor to the development of scoliosis. Many effective models of scoliosis in smaller animals have not been successfully translated to primates and humans. Though these models may not clarify the aetiology of human scoliosis, by providing a reliable and reproducible deformity in the spine they are a useful means with which to test interventions designed to correct and prevent deformity.
Collapse
Affiliation(s)
- Justin D Bobyn
- Orthopaedic Research & Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Sydney, Australia
| | | | | | | |
Collapse
|
10
|
Abstract
BACKGROUND The melatonin deficiency hypothesis as a central mechanism in the pathogenesis of adolescent idiopathic scoliosis (AIS) is certainly intriguing. However, the actual role of melatonin remains unclear. The aim of this study was to assess the potential clinical value of melatonin serum level in the pathogenesis and the prognosis of AIS progression in patients who were treated nonoperatively. METHODS Two groups of patients were enrolled. The study group consisted of patients with AIS aged below 14 years who were treated conservatively. In the second group, that is, the control group, age-matched, weight-matched, and height-matched healthy individuals were enrolled. Blood samples were collected from all patients on visit 1 and the serum levels of melatonin were evaluated with the enzyme-linked immunosorbent assay (ELISA) method. The blood sampling procedure was repeated exactly 1 year later (visit 2). RESULTS Forty-two patients formed the study group (with AIS) and 29 served as the control group. The mean serum value of melatonin on visit 1 was 19.32 pg/mL for the AIS group and 12.23 pg/mL for the control group. This difference was statistically significant (P = 0.014). One year later, 34 patients from the AIS group and 23 from the control group were reevaluated and the mean serum levels of melatonin were 52.43 and 68.44 pg/mL, respectively. No statistically significant difference was found between the 2 groups (P = 0.235). Statistical analysis of the serum melatonin levels of patients with progressing AIS (>5 degrees of the Cobb angle in 1 y) when compared with patients with stable AIS (P = 0.387) or the control group (P = 0.727) failed to show that the deficiency of melatonin may be associated with the progression of AIS. CONCLUSIONS Higher melatonin levels were observed in conservatively treated patients with AIS, whereas melatonin deficiency was not associated with AIS progression in this study. LEVEL OF EVIDENCE Level III-case-control study.
Collapse
|
11
|
Abnormal response of the proliferation and differentiation of growth plate chondrocytes to melatonin in adolescent idiopathic scoliosis. Int J Mol Sci 2014; 15:17100-14. [PMID: 25257530 PMCID: PMC4200781 DOI: 10.3390/ijms150917100] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/02/2014] [Accepted: 09/19/2014] [Indexed: 02/05/2023] Open
Abstract
Abnormalities in the melatonin signaling pathway and the involvement of melatonin receptor MT2 have been reported in patients with adolescent idiopathic scoliosis (AIS). Whether these abnormalities were involved in the systemic abnormal skeletal growth in AIS during the peripubertal period remain unknown. In this cross-sectional case-control study, growth plate chondrocytes (GPCs) were cultured from twenty AIS and ten normal control subjects. Although the MT2 receptor was identified in GPCs from both AIS and controls, its mRNA expression was significantly lower in AIS patients than the controls. GPCs were cultured in the presence of either the vehicle or various concentrations of melatonin, with or without the selective MT2 melatonin receptor antagonist 4-P-PDOT (10 µM). Then the cell viability and the mRNA expression of collagen type X (COLX) and alkaline phosphatase (ALP) were assessed by MTT and qPCR, respectively. In the control GPCs, melatonin at the concentrations of 1, 100 nM and 10 µM significantly reduced the population of viable cells, and the mRNA level of COLX and ALP compared to the vehicle. Similar changes were not observed in the presence of 4-P-PDOT. Further, neither proliferation nor differentiation of GPCs from AIS patients was affected by the melatonin treatment. These findings support the presence of a functional abnormality of the melatonin signaling pathway in AIS GPCs, which might be associated with the abnormal endochondral ossification in AIS patients.
Collapse
|
12
|
Man GCW, Wai MGC, Wang WWJ, Jun WWW, Yim APY, Yee YAP, Wong JH, Ho WJ, Ng TB, Bun NT, Lam TP, Ping LT, Lee SKM, Man LSK, Ng BKW, Wah NBK, Wang CC, Chiu WC, Qiu Y, Yong Q, Cheng CY, Yiu CJC. A review of pinealectomy-induced melatonin-deficient animal models for the study of etiopathogenesis of adolescent idiopathic scoliosis. Int J Mol Sci 2014; 15:16484-99. [PMID: 25238413 PMCID: PMC4200812 DOI: 10.3390/ijms150916484] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/08/2014] [Accepted: 09/10/2014] [Indexed: 11/16/2022] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a common orthopedic disorder of unknown etiology and pathogenesis. Melatonin and melatonin pathway dysfunction has been widely suspected to play an important role in the pathogenesis. Many different types of animal models have been developed to induce experimental scoliosis mimicking the pathoanatomical features of idiopathic scoliosis in human. The scoliosis deformity was believed to be induced by pinealectomy and mediated through the resulting melatonin-deficiency. However, the lack of upright mechanical spinal loading and inherent rotational instability of the curvature render the similarity of these models to the human counterparts questionable. Different concerns have been raised challenging the scientific validity and limitations of each model. The objectives of this review follow the logical need to re-examine and compare the relevance and appropriateness of each of the animal models that have been used for studying the etiopathogenesis of adolescent idiopathic scoliosis in human in the past 15 to 20 years.
Collapse
Affiliation(s)
| | - Man Gene Chi Wai
- Department of Obstetrics and Gynaecology, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Wang William Wei Jun
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
| | | | - Yim Annie Po Yee
- Department of Orthopaedics & Traumatology, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Wong Jack Ho
- School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Ng Tzi Bun
- School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Lam Tsz Ping
- Department of Orthopaedics & Traumatology, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Lee Simon Kwong Man
- Lee Hysan Clinical Research Laboratory, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Ng Bobby Kin Wah
- Department of Orthopaedics & Traumatology, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Wang Chi Chiu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
| | | | - Qiu Yong
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
| | | | - Cheng Jack Chun Yiu
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong, China.
| |
Collapse
|
13
|
Ultrastructure of Intervertebral Disc and Vertebra-Disc Junctions Zones as a Link in Etiopathogenesis of Idiopathic Scoliosis. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/850594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Context. There is no general accepted theory on the etiology of idiopathic scoliosis (IS). An important role of the vertebrae endplate physes (VEPh) and intervertebral discs (IVD) in spinal curve progression is acknowledged, but ultrastructural mechanisms are not well understood. Purpose. To analyze the current literature on ultrastructural characteristics of VEPh and IVD in the context of IS etiology. Study Design/Setting. A literature review. Results. There is strong evidence for multifactorial etiology of IS. Early wedging of vertebra bodies is likely due to laterally directed appositional bone growth at the concave side, caused by a combination of increased cell proliferation at the vertebrae endplate and altered mechanical properties of the outer annulus fibrosus of the adjacent IVD. Genetic defects in bending proteins necessary for IVD lamellar organization underlie altered mechanical properties. Asymmetrical ligaments, muscular stretch, and spine instability may also play roles in curve formation. Conclusions. Development of a reliable, cost effective method for identifying patients at high risk for curve progression is needed and could lead to a paradigm shift in treatment options. Unnecessary anxiety, bracing, and radiation could potentially be minimized and high risk patient could receive surgery earlier, rendering better outcomes with fewer fused segments needed to mitigate curve progression.
Collapse
|
14
|
Aota Y, Terayama H, Saito T, Itoh M. Pinealectomy in a broiler chicken model impairs endochondral ossification and induces rapid cancellous bone loss. Spine J 2013; 13:1607-16. [PMID: 23791240 DOI: 10.1016/j.spinee.2013.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 09/30/2012] [Accepted: 05/04/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Adolescent idiopathic scoliosis (AIS) in humans is a lateral curvature of the spine often associated with osteopenia. It has recently been accepted that the development of AIS is closely associated with spinal overgrowth. Pinealectomy (PNX) in a chicken model consistently induces scoliosis with anatomic features similar to human AIS; however, the mechanism of PNX inducing scoliosis is poorly understood. PURPOSE This experimental study attempts to improve the understanding of the mechanisms underlying the onset of scoliosis in a PNX broiler chicken model. METHODS A histomorphometric study was performed to analyze longitudinal bone growth and cancellous bone remodeling before the development of scoliosis. Static and dynamic parameters in cancellous bone and chondro-osseous junction of the 7th thoracic vertebral body at 9 days after hatching were compared between PNX chickens (n=9) and control chickens with no surgery (n=5). RESULTS PNX resulted in a rapid and marked loss of cancellous bone volume (7.9±0.9% vs. 14.2±1.8%, mean±SD, p<.0005) and profoundly disrupted trabecular structure with increases in dynamic formative parameters, such as mineralizing surface, mineralization apposition rate, and adjusted appositional rate. In the chondro-osseous junction, activated osteoclasts phagocytized degenerating chondrocytes, leaving a minimal amount of cartilage matrix and activated osteoblasts, losing their scaffolding for bone formation, and directly covering the hypertrophic zone cells. The osteoid surface and thickness in the chondro-osseous junction were significantly increased in PNX chickens (43.1±14.2% vs. 11.6±5.7% and 4.1±0.2 μm vs. 2.9±0.4 μm). In the subjacent cartilage regions being protected from further resorption, abundant labeled cartilage remained with higher cellularity. CONCLUSIONS It is known that fast-growing birds have a unique paradigm of rapid bone elongation with minimal metaphyseal bone production. A bone-forming surface exists at the front of cartilage ossification in the growth plate; therefore, papillae of hypertrophic chondrocytes become included between the trabeculae of metaphyseal bone and the overall thickness of the growth plate increases considerably in addition to distal expansion. Our results indicate that the unique mechanism for rapid bone elongation in chicken is more pronounced after PNX. PNX also induces high turnover osteoporosis, which may also contribute to the development of scoliosis in the chicken.
Collapse
Affiliation(s)
- Yoichi Aota
- Department of Orthopaedic Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama City, Kanagawa Prefecture, Yokohama 236-0004, Japan.
| | | | | | | |
Collapse
|
15
|
Yim APY, Yeung HY, Sun G, Lee KM, Ng TB, Lam TP, Ng BKW, Qiu Y, Moreau A, Cheng JCY. Abnormal Skeletal Growth in Adolescent Idiopathic Scoliosis Is Associated with Abnormal Quantitative Expression of Melatonin Receptor, MT2. Int J Mol Sci 2013; 14:6345-58. [PMID: 23519105 PMCID: PMC3634428 DOI: 10.3390/ijms14036345] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 03/13/2013] [Accepted: 03/13/2013] [Indexed: 12/15/2022] Open
Abstract
The defect of the melatonin signaling pathway has been proposed to be one of the key etiopathogenic factors in adolescent idiopathic scoliosis (AIS). A previous report showed that melatonin receptor, MT2, was undetectable in some AIS girls. The present study aimed to investigate whether the abnormal MT2 expression in AIS is quantitative or qualitative. Cultured osteoblasts were obtained from 41 AIS girls and nine normal controls. Semi-quantification of protein expression by Western blot and mRNA expression by TaqMan real-time PCR for both MT1 and MT2 were performed. Anthropometric parameters were also compared and correlated with the protein expression and mRNA expression of the receptors. The results showed significantly lower protein and mRNA expression of MT2 in AIS girls compared with that in normal controls (p = 0.02 and p = 0.019, respectively). No differences were found in the expression of MT1. When dichotomizing the AIS girls according to their MT2 expression, the group with low expression was found to have a significantly longer arm span (p = 0.036). The results of this study showed for the first time a quantitative change of MT2 in AIS that was also correlated with abnormal arm span as part of abnormal systemic skeletal growth.
Collapse
Affiliation(s)
- Annie Po-yee Yim
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China; E-Mails: (A.P.Y.); (H.Y.); (G.S.); (T.L.); (B.K.N.)
| | - Hiu-yan Yeung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China; E-Mails: (A.P.Y.); (H.Y.); (G.S.); (T.L.); (B.K.N.)
| | - Guangquan Sun
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China; E-Mails: (A.P.Y.); (H.Y.); (G.S.); (T.L.); (B.K.N.)
| | - Kwong-man Lee
- Lee Hysan clinical research laboratory, The Chinese University of Hong Kong, Hong Kong, China; E-Mail:
| | - Tzi-bun Ng
- School of Biomedical Science, The Chinese University of Hong Kong, Hong Kong, China; E-Mail:
| | - Tsz-ping Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China; E-Mails: (A.P.Y.); (H.Y.); (G.S.); (T.L.); (B.K.N.)
| | - Bobby Kin-wah Ng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China; E-Mails: (A.P.Y.); (H.Y.); (G.S.); (T.L.); (B.K.N.)
| | - Yong Qiu
- Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210000, China; E-Mail:
- The Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong, China
| | - Alain Moreau
- Research Center, Sainte-Justine Hospital, University of Montreal, Montreal, QC H3T 1C5, Canada; E-Mail:
| | - Jack Chun-yiu Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China; E-Mails: (A.P.Y.); (H.Y.); (G.S.); (T.L.); (B.K.N.)
- The Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong, China
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +852-26-098-631; Fax: +852-26-036-889
| |
Collapse
|
16
|
Ouellet J, Odent T. Animal models for scoliosis research: state of the art, current concepts and future perspective applications. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 22 Suppl 2:S81-95. [PMID: 23099524 PMCID: PMC3616476 DOI: 10.1007/s00586-012-2396-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 05/21/2012] [Accepted: 05/28/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to provide the readers with a reliable source of animal models currently being utilized to perform state-of-the-art scoliotic research. MATERIALS AND METHODS A comprehensive search was undertaken to review all publications on animal models for the study of scoliosis within the database from 1946 to January 2011. RESULTS The animal models have been grouped under specific headings reflecting the underlying pathophysiology behind the development of the spinal deformities produced in the animals: genetics, neuroendocrine, neuromuscular, external constraints, internal constraints with or without tissue injury, vertebral growth modulation and iatrogenic congenital malformations, in an attempt to organize and classify these multiple scoliotic animal models. As it stands, there are no animal models that mimic the human spinal anatomy with all its constraints and weaknesses, which puts it at risk of developing scoliosis. What we do have are a multitude of models, which produce spinal deformities that come close to the idiopathic scoliosis deformity. CONCLUSION All these different animal models compel us to believe that the clinical phenotype of what we call idiopathic scoliosis may well be caused by a variety of different underlying pathologies.
Collapse
Affiliation(s)
- Jean Ouellet
- />McGill Scoliosis and Spinal Research Chair, Deputy Chief Shriners Hospital, Montreal, Canada
- />Division of Orthopaedic Surgery, McGill University Health Hospital, Centre, Montreal Children Hospital, 2300 Tupper Street, Montreal, QC H3H 1P3 Canada
| | - Thierry Odent
- />Department of Orthopaedic Surgery, Hopital des Enfants Malade, Necker, Paris Descartes, France
- />Université Paris Descartes - Sorbonne Paris Cité - Service d’orthopédie pédiatrique - Hôpital Universitaire Necker - Enfants-Malades, Paris, France
| |
Collapse
|
17
|
Pinchuk DY, Bekshaev SS, Bumakova SA, Dudin MG, Pinchuk OD. Bioelectric activity in the suprachiasmatic nucleus-pineal gland system in children with adolescent idiopathic scoliosis. ISRN ORTHOPEDICS 2012; 2012:987095. [PMID: 24977086 PMCID: PMC4063198 DOI: 10.5402/2012/987095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 07/25/2012] [Indexed: 11/23/2022]
Abstract
The purpose of this work is to identify a role of the pineal gland/suprachiasmatic nucleus system in adolescent idiopathic scoliosis (AIS) aetiology and pathogenesis. To analyze electroencephalograms of 292 children with AIS and in 46 healthy subjects, a processing method was used to assess three-dimensional coordinates of electric equivalent dipole sources (EEDSs) within the brain. Amounts of EEDSs in the pineal gland and suprachiasmatic nucleus (SCN) area were assessed in different age groups and during the progress of orthopaedic pathology. It was shown that children with AIS, compared with healthy children, were characterized by a higher level of electric activity (as judged by EEDS values) in the pineal gland area. It was also revealed that the number of EEDS in the pineal gland area increases significantly with increased severity of spinal deformation, while their number in the suprachiasmatic nucleus (SCN) area decreases compared with the number in healthy peers. Changes in electric activity and changes in the pineal gland and SCN area suggest that mechanisms of AIS aetiology and pathogenesis involve functional disturbances in brain areas responsible for the formation and maintenance of normal biorhythms, including osteogenesis and bone growth.
Collapse
Affiliation(s)
- Dmitry Yu Pinchuk
- Human Brain Research Centre, Finlandsky pr. 4-A, Office 901, St. Petersburg 194044, Russia ; Ogonyok Rehabilitation Center of Pediatric Orthopedics and Traumatology, St. Petersburg Highway 101, St. Petersburg 198515, Russia
| | - Sergey S Bekshaev
- Human Brain Research Centre, Finlandsky pr. 4-A, Office 901, St. Petersburg 194044, Russia ; Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, Toreza st., 44, St. Petersburg 194223, Russia
| | - Svetlana A Bumakova
- Ogonyok Rehabilitation Center of Pediatric Orthopedics and Traumatology, St. Petersburg Highway 101, St. Petersburg 198515, Russia
| | - Mikhail G Dudin
- Ogonyok Rehabilitation Center of Pediatric Orthopedics and Traumatology, St. Petersburg Highway 101, St. Petersburg 198515, Russia
| | - Olga D Pinchuk
- Human Brain Research Centre, Finlandsky pr. 4-A, Office 901, St. Petersburg 194044, Russia
| |
Collapse
|
18
|
Acaroglu E, Bobe R, Enouf J, Marcucio R, Moldovan F, Moreau A. The metabolic basis of adolescent idiopathic scoliosis: 2011 report of the "metabolic" workgroup of the Fondation Yves Cotrel. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 21:1033-42. [PMID: 22402844 PMCID: PMC3366135 DOI: 10.1007/s00586-012-2245-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 02/16/2012] [Accepted: 02/23/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this review is to elucidate the metabolic processes involved in the pathogenesis of adolescent idiopathic scoliosis (AIS) in light of research by the present authors as well as current literature. METHODS Pathogenetic mechanisms involved in AIS were modeled as (a) a form of neuromuscular scoliosis (in conjunction with an adverse mechanical environment such as bipedality), in which hormonal and other chemical factors act as regulators of skeletal muscle tone and function; (b) as a consequence of an abnormality in growth of the spinal column (in conjunction with an adverse mechanical environment such as bipedality), in which hormones and other chemical factors act as regulators of growth; and (c) as a mechanical failure of one side of the vertebral column due to a defect in trabecular formation or mineralization (in conjunction with an adverse mechanical environment such as bipedality); in which hormonal and other chemical factors act as regulators of bone formation, mineralization and/or resorption. RESULTS AND CONCLUSION Current evidence supporting these models individually or in combination is discussed.
Collapse
Affiliation(s)
- Emre Acaroglu
- Ankara Spine Center, Iran caddesi 45/2, Kavaklidere, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
19
|
Lombardi G, Akoume MY, Colombini A, Moreau A, Banfi G. Biochemistry of adolescent idiopathic scoliosis. Adv Clin Chem 2011; 54:165-82. [PMID: 21874761 DOI: 10.1016/b978-0-12-387025-4.00007-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This chapter reviews the biochemical, hormonal, and hematological factors in the onset and development of adolescent idiopathic scoliosis (AIS), an orthopedic entity of unknown etiology. Briefly, AIS is defined as a lateral curvature of the spine combined with vertebral rotation that occurs in patients of 10 years of age or older until bone maturity (18-20 years of age). AIS is predominant in females. If untreated, the curvature could evolve with negative long-term prognosis including psychosocial impact, back pain, pulmonary compromise, cor pulmonale, and even death due to respiratory failure. Causes of the disease have been postulated to involve genetics, abnormal muscle, connective tissue and bone structures, and neuroendocrine disorders. Psychological pathways have also been studied. Little data, however, have been collected on bone turnover in these patients. Some studies demonstrated decreased bone mineral density which may be suggestive of increased osteoblast activity. Other studies suggested a correlation to abnormal platelet morphology. Alterations in the spinal muscle contractile function may be responsible for spinal curvature. Measurement of trace elements in serum revealed impaired zinc and selenium metabolism, probably secondary to hormonal deregulation. Subsequent endocrine studies suggested a role for leptin and growth hormone in AIS. Recently, a neuroendocrine hypothesis has been proposed. This theory involves a unique melatonin-signaling dysfunction and opens new frontiers in the elucidation of the pathologic mechanisms for onset and progression of this disease.
Collapse
|
20
|
Clinical uses of melatonin in pediatrics. Int J Pediatr 2011; 2011:892624. [PMID: 21760817 PMCID: PMC3133850 DOI: 10.1155/2011/892624] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 03/31/2011] [Accepted: 04/08/2011] [Indexed: 11/29/2022] Open
Abstract
This study analyzes the results of clinical trials of treatments with melatonin conducted in children, mostly focused on sleep disorders of different origin. Melatonin is beneficial not only in the treatment of dyssomnias, especially delayed sleep phase syndrome, but also on sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, and, in general, in all sleep disturbances associated with mental, neurologic, or other medical disorders. Sedative properties of melatonin have been used in diagnostic situations requiring sedation or as a premedicant in children undergoing anesthetic procedures. Epilepsy and febrile seizures are also susceptible to treatment with melatonin, alone or associated with conventional antiepileptic drugs. Melatonin has been also used to prevent the progression in some cases of adolescent idiopathic scoliosis. In newborns, and particularly those delivered preterm, melatonin has been used to reduce oxidative stress associated with sepsis, asphyxia, respiratory distress, or surgical stress. Finally, the administration of melatonin, melatonin analogues, or melatonin precursors to the infants through the breast-feeding, or by milk formula adapted for day and night, improves their nocturnal sleep. Side effects of melatonin treatments in children have not been reported. Although the above-described results are promising, specific studies to resolve the problem of dosage, formulations, and length of treatment are necessary.
Collapse
|
21
|
Janssen MMA, de Wilde RF, Kouwenhoven JWM, Castelein RM. Experimental animal models in scoliosis research: a review of the literature. Spine J 2011; 11:347-58. [PMID: 21474088 DOI: 10.1016/j.spinee.2011.03.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 02/01/2011] [Accepted: 03/08/2011] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Many animal species and an overwhelming variety of procedures that produce an experimental scoliosis have been reported in the literature. However, varying results have been reported on identical procedures in different animal species. Furthermore, the relevance of experimental animal models for the understanding of human idiopathic scoliosis remains questionable. PURPOSE To give an overview of the procedures that have been performed in animals in an attempt to induce experimental scoliosis and discuss the characteristics and significance of various animal models. STUDY DESIGN Extensive review of the literature on experimental animal models in scoliosis research. METHODS MEDLINE electronic database was searched, focusing on parameters concerning experimental scoliosis in animal models. The search was limited to the English, French, and German languages. RESULTS The chicken appeared to be the most frequently used experimental animal followed by the rabbit and rat. Additionally, scoliosis has been induced in primates, goats, sheep, pigs, cows, dogs, and frogs. Procedures widely varied from systemic to local procedures. CONCLUSIONS Although it has been possible to induce scoliosis-like deformities in many animals through various ways, this always required drastic surgical or systemic interventions, thus making the relation to human idiopathic scoliosis unclear. The basic drawback of all used models remains that no animal resembles the upright biomechanical spinal loading condition of man, with its inherent rotational instability of certain spinal segments. The fundamental question remains what the significance of these animal models is to the understanding of human idiopathic scoliosis.
Collapse
Affiliation(s)
- Michiel M A Janssen
- Department of Orthopaedics, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | | | | | | |
Collapse
|
22
|
Girardo M, Bettini N, Dema E, Cervellati S. The role of melatonin in the pathogenesis of adolescent idiopathic scoliosis (AIS). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 20 Suppl 1:S68-74. [PMID: 21416282 PMCID: PMC3087042 DOI: 10.1007/s00586-011-1750-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Indexed: 12/15/2022]
Abstract
The cause of adolescent idiopathic scoliosis (AIS) in humans remains obscure and probably multifactorial. At present, there is no proven method or test available to identify children or adolescent at risk of developing AIS or identify which of the affected individuals are at risk of progression. Reported associations are linked in pathogenesis rather than etiologic factors. Melatonin may play a role in the pathogenesis of scoliosis (neuroendocrine hypothesis), but at present, the data available cannot clearly show the role of melatonin in producing scoliosis in humans. The data regarding human melatonin levels are mixed at best, and the melatonin deficiency as a causative factor in the etiology of scoliosis cannot be supported. It will be an important issue of future research to investigate the role of melatonin in human biology, the clinical efficacy, and safety of melatonin under different pathological situations. Research is needed to better define the role of all factors in AIS development.
Collapse
Affiliation(s)
- M Girardo
- Department of Spine Surgery, CTO/CRF/Maria Adelaide, Turin, Italy.
| | | | | | | |
Collapse
|
23
|
Genetic variants in melatonin synthesis and signaling pathway are not associated with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2011; 36:37-40. [PMID: 21192222 DOI: 10.1097/brs.0b013e3181e8755b] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Genetic association study investigating the association of genetic markers of melatonin signaling and biosynthesis with adolescent idiopathic scoliosis (AIS). OBJECTIVE To determine whether gene polymorphisms related to the melatonin signaling or biosynthesis pathways are associated with AIS. SUMMARY OF BACKGROUND DATA Data have been published on the potential role of gene polymorphisms for melatonin receptor (MTNR) 1B in predicting AIS. Other genes in the melatonin pathways have been tested for association with AIS. METHODS The following genes involved in melatonin synthesis were evaluated herein: tryptophan 5-hyroxylase 1 (TPH1), serotonin N-acetyltransferase (SNAT), and hydroxyindoleo-methyltransferase (HIOMT). In addition, proteins involved in melatonin signaling were also included in this study: MTNR1A, MTNR1B, and protein kinase C delta (PKCd). High throughput microarray-based single nucleotide polymorphism (SNP) genotyping was performed for these seven genes using DNA samples from 589 AIS subjects and 1533 ethnically matched controls. Chi-square analyses of allele frequency between AIS cases and controls were performed and odds ratios were calculated for all SNP markers. RESULTS Three SNPs were tested for both MTNR1A and HIOMT, 4 for TPH1 and SNAT, 12 for PKCd, and 7 for MTNR1B. The minor allele frequencies were not significantly different between AIS cases and controls. No association was thus found between AIS and the investigated SNPs. CONCLUSIONS Genetic polymorphisms associated with either melatonin synthesis or its signaling pathway are unlikely to be commonly associated with AIS.
Collapse
|
24
|
Sánchez-Barceló EJ, Mediavilla MD, Tan DX, Reiter RJ. Scientific basis for the potential use of melatonin in bone diseases: osteoporosis and adolescent idiopathic scoliosis. J Osteoporos 2010; 2010:830231. [PMID: 20981336 PMCID: PMC2957228 DOI: 10.4061/2010/830231] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 03/03/2010] [Indexed: 11/20/2022] Open
Abstract
The objective of this paper was to analyze the data supporting the possible role of melatonin on bone metabolism and its repercussion in the etiology and treatment of bone pathologies such as the osteoporosis and the adolescent idiopathic scoliosis (AIS). Melatonin may prevent bone degradation and promote bone formation through mechanisms involving both melatonin receptor-mediated and receptor-independent actions. The three principal mechanisms of melatonin effects on bone function could be: (a) the promotion of the osteoblast differentiation and activity; (b) an increase in the osteoprotegerin expression by osteoblasts, thereby preventing the differentiation of osteoclasts; (c) scavenging of free radicals generated by osteoclast activity and responsible for bone resorption. A variety of in vitro and in vivo experimental studies, although with some controversial results, point toward a possible role of melatonin deficits in the etiology of osteoporosis and AIS and open a new field related to the possible therapeutic use of melatonin in these bone diseases.
Collapse
Affiliation(s)
- E. J. Sánchez-Barceló
- Department of Physiology & Pharmacology, School of Medicine, University of Cantabria, 39011 Santander, Spain,*E. J. Sánchez-Barceló:
| | - M. D. Mediavilla
- Department of Physiology & Pharmacology, School of Medicine, University of Cantabria, 39011 Santander, Spain
| | - D. X. Tan
- Department of Cellular & Structural Biology, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - R. J. Reiter
- Department of Cellular & Structural Biology, University of Texas Health Science Center, San Antonio, TX 78229, USA
| |
Collapse
|
25
|
Burwell RG, Aujla RK, Grevitt MP, Dangerfield PH, Moulton A, Randell TL, Anderson SI. Pathogenesis of adolescent idiopathic scoliosis in girls - a double neuro-osseous theory involving disharmony between two nervous systems, somatic and autonomic expressed in the spine and trunk: possible dependency on sympathetic nervous system and hormones with implications for medical therapy. SCOLIOSIS 2009; 4:24. [PMID: 19878575 PMCID: PMC2781798 DOI: 10.1186/1748-7161-4-24] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Accepted: 10/31/2009] [Indexed: 12/24/2022]
Abstract
Anthropometric data from three groups of adolescent girls - preoperative adolescent idiopathic scoliosis (AIS), screened for scoliosis and normals were analysed by comparing skeletal data between higher and lower body mass index subsets. Unexpected findings for each of skeletal maturation, asymmetries and overgrowth are not explained by prevailing theories of AIS pathogenesis. A speculative pathogenetic theory for girls is formulated after surveying evidence including: (1) the thoracospinal concept for right thoracic AIS in girls; (2) the new neuroskeletal biology relating the sympathetic nervous system to bone formation/resorption and bone growth; (3) white adipose tissue storing triglycerides and the adiposity hormone leptin which functions as satiety hormone and sentinel of energy balance to the hypothalamus for long-term adiposity; and (4) central leptin resistance in obesity and possibly in healthy females. The new theory states that AIS in girls results from developmental disharmony expressed in spine and trunk between autonomic and somatic nervous systems. The autonomic component of this double neuro-osseous theory for AIS pathogenesis in girls involves selectively increased sensitivity of the hypothalamus to circulating leptin (genetically-determined up-regulation possibly involving inhibitory or sensitizing intracellular molecules, such as SOC3, PTP-1B and SH2B1 respectively), with asymmetry as an adverse response (hormesis); this asymmetry is routed bilaterally via the sympathetic nervous system to the growing axial skeleton where it may initiate the scoliosis deformity (leptin-hypothalamic-sympathetic nervous system concept = LHS concept). In some younger preoperative AIS girls, the hypothalamic up-regulation to circulating leptin also involves the somatotropic (growth hormone/IGF) axis which exaggerates the sympathetically-induced asymmetric skeletal effects and contributes to curve progression, a concept with therapeutic implications. In the somatic nervous system, dysfunction of a postural mechanism involving the CNS body schema fails to control, or may induce, the spinal deformity of AIS in girls (escalator concept). Biomechanical factors affecting ribs and/or vertebrae and spinal cord during growth may localize AIS to the thoracic spine and contribute to sagittal spinal shape alterations. The developmental disharmony in spine and trunk is compounded by any osteopenia, biomechanical spinal growth modulation, disc degeneration and platelet calmodulin dysfunction. Methods for testing the theory are outlined. Implications are discussed for neuroendocrine dysfunctions, osteopontin, sympathoactivation, medical therapy, Rett and Prader-Willi syndromes, infantile idiopathic scoliosis, and human evolution. AIS pathogenesis in girls is predicated on two putative normal mechanisms involved in trunk growth, each acquired in evolution and unique to humans.
Collapse
Affiliation(s)
- R Geoffrey Burwell
- Centre for Spinal Studies and Surgery, Nottingham University Hospitals Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - Ranjit K Aujla
- Centre for Spinal Studies and Surgery, Nottingham University Hospitals Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - Michael P Grevitt
- Centre for Spinal Studies and Surgery, Nottingham University Hospitals Trust, Queen's Medical Centre Campus, Nottingham, UK
| | | | - Alan Moulton
- Department of Orthopaedic Surgery, King's Mill Hospital, Mansfield, UK
| | - Tabitha L Randell
- Department of Child Health, Nottingham University Hospitals Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - Susan I Anderson
- School of Biomedical Sciences, University of Nottingham, Nottingham, UK
| |
Collapse
|
26
|
Comparison of the melatonin and calmodulin in paravertebral muscle and platelets of patients with or without adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2009; 34:E659-63. [PMID: 19680092 DOI: 10.1097/brs.0b013e3181a3c7a2] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Controlled clinical study. OBJECTIVE.: To compare muscle and platelet calmodulin and melatonin concentrations of scoliotic and nonscoliotic populations. SUMMARY OF BACKGROUND DATA Melatonin and calmodulin are potential key molecules in scoliosis etiology. Calmodulin is not only a second messenger of melatonin but also has been shown to have effects on muscle contractility. There is a possibility that it may be of importance in the regulation of spinal alignment. Platelets have been defined as mini muscles calmodulin and melatonin levels of which may be the projections of muscle values. METHODS Twenty patients undergoing posterior surgery for adolescent idiopathic scoliosis (AIS) and 9 thoracic-lumbar trauma patients undergoing posterior surgery constituted the population. Autologous bloods were collected and processed to obtain platelets. Paravertebral muscle tissue samples from both sides were obtained at T12-L1 level intraoperatively. Muscle and platelet samples were analyzed for the levels of melatonin by radio immuno assay and for calmodulin by enzyme-linked immunosorbent analysis. Groups, concave (left side for the control group) and convex side (right side for the control group), muscles and platelet median protein concentrations, and optic densitometry (OD) ratio values were compared. RESULTS AIS group consisted of 2 male and 18 female patients. Mean age was 16.1 +/- 3.78 (11-29). Control group consisted of 5 male and 4 female patients. Mean age was 35 +/- 13.47 (16-55). Platelet Calmodulin OD/Supernatant's OD ratios and both convex and concave sides' muscle Calmodulin OD/Supernatants' OD ratios were not different between groups. On the other hand, convex side muscle calmodulin to total muscle calmodulin ratios were higher in AIS group compared with concave (P = 0.048); likewise, concave side calmodulin to total calmodulin ratios were lower in AIS group compared with control (P = 0.035). Convex side calmodulin to concave side calmodulin ratios were significantly different among groups (P = 0.048). Neither platelet melatonin to total protein ratios, nor convex or concave side muscle melatonin to total protein ratios, nor convex to concave side melatonin ratios were significantly different between groups. Convex or concave side calmodulin or melatonin values were not correlated with platelet values. CONCLUSION AIS group had an asymmetric distribution of calmodulin in paraspinal muscle, higher at the convex side and lower at the concave. Neither platelet melatonin nor platelet calmodulin was found to be representative of the muscle protein values.
Collapse
|
27
|
[Molecular and genetic aspects of idiopathic scoliosis. Blood test for idiopathic scoliosis]. DER ORTHOPADE 2009; 38:114-6, 118-21. [PMID: 19212754 DOI: 10.1007/s00132-008-1362-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Spinal deformities, and particularly scoliosis, are the most frequent forms of orthopedic deformities in children and adolescents. About 1-6% of the population has scoliosis. This disorder leads to severe spinal deformities and predominantly affects adolescent girls.Although the multifactorial origin of adolescent idiopathic scoliosis (AIS) is broadly recognized, the genetic causes of AIS are still largely unknown. Our previous studies suggested a generalized dysfunction of melatonin transduction (the hormone that is primarily produced in the brain and epiphysis). In the meantime we have demonstrated that such a defect of signal transduction is caused by chemical alterations, which inactivate the function of the inhibitory G protein-coupled melatonin receptors. This discovery has led to the development of the first blood test to detect children without symptoms who are at risk of developing scoliosis. Since a single function (cellular reaction to melatonin) is determined, the unique advantage of this test is that it can be performed without knowledge of mutations in defective genes that could provoke the onset of AIS.
Collapse
|
28
|
Smania N, Picelli A, Romano M, Negrini S. Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis. Disabil Rehabil 2009; 30:763-71. [DOI: 10.1080/17483100801921311] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
29
|
Fagan AB, Kennaway DJ, Oakley AP. Pinealectomy in the chicken: a good model of scoliosis? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2009; 18:1154-9. [PMID: 19340465 DOI: 10.1007/s00586-009-0927-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Revised: 01/18/2009] [Accepted: 02/23/2009] [Indexed: 11/25/2022]
Abstract
The phenomenon of spinal deformity in the pinealectomized chicken has led researchers to postulate a disturbance of melatonin activity as a potential cause of adolescent idiopathic scoliosis (AIS). More recently, structural differences between curves seen in this model and those seen in scoliosis have been highlighted suggesting the deformities observed are not as similar as first thought. We examined melatonin levels, and the radiological and histological characteristics of scoliosis after pinealectomy in chickens. They underwent pinealectomy (P) at 2 days of age, sham surgery (S) or served as controls (C). Mean melatonin levels were 32.9 pmol/L (P), 175 pmol/L (S) and 227.3 pmol/L (C). Scoliosis developed in 75% of chickens after pinealectomy and 38% after a sham procedure. Nineteen percent of unoperated controls also developed scoliosis. A lower melatonin level was associated with the development of scoliosis (p < or = 0.001), but exceptions were seen with levels up to 265 pmol/L observed in one case. Most of the curves occurring spontaneously and after sham surgery and almost half after pinealectomy were short angular curves: distinct from those resembling idiopathic scoliosis. These occur over one or two segments and are characterized by marked apical wedging, frequently associated with subluxation or dislocation. The intervertebral joint in the chicken is more like a synovial joint histologically than an intervertebral disc. This study highlights important differences between the chicken and the human, and between their respective spinal deformities. Caution is advised when drawing conclusions regarding the pathogenesis of AIS from this model.
Collapse
Affiliation(s)
- Andrew B Fagan
- Discipline of Orthopaedics and Trauma, The University of Adelaide, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia.
| | | | | |
Collapse
|
30
|
Machida M, Dubousset J, Yamada T, Kimura J. Serum melatonin levels in adolescent idiopathic scoliosis prediction and prevention for curve progression--a prospective study. J Pineal Res 2009; 46:344-8. [PMID: 19317797 DOI: 10.1111/j.1600-079x.2009.00669.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The correlation of serum melatonin levels and curve progression in adolescent idiopathic scoliosis, and the effects of melatonin therapy in scoliotic patients with reduced levels of endogenous melatonin were studied in 40 adolescent patients with moderate to severe idiopathic scoliosis. Of the scoliotic subjects, 28 had stable scoliosis and 12 had progressive scoliosis. Normal melatonin levels were derived from 25 age-matched control patients. Serum melatonin levels were monitored yearly in scoloiotic patients for a period ranging from 3 to 6 yr, revealing a diurnal pattern with low values during the day and high at night. Scoliotic patients with normal levels were not treated or were treated with a brace, and all but two patients with low endogenous melatonin were treated with oral supplements of the indole. Of the 22 patients with a normal melatonin level, 16 had stable scoliosis and six had progressive scoliosis. Of the 16 patients treated for a low melatonin level, 12 had stable scoliosis and four had a progressive course. The two untreated cases had a progressive course. Of the 12 patients who had progressive scoliosis, nine had >35 degrees of curve at initial examination. These findings suggest that melatonin deficiency plays a role in the prognosis of idiopathic scoliosis. Therefore, melatonin supplements may prevent the progression of scoliosis, especially in mild cases with less than a 35 degrees curve.
Collapse
Affiliation(s)
- Masafumi Machida
- National Institute of Musculo-Skeletal Disorders, Murayama Medical Center, Tokyo, Japan.
| | | | | | | |
Collapse
|
31
|
Abstract
STUDY DESIGN Review of the literature on the pathogenesis of adolescent idiopathic scoliosis (AIS). OBJECTIVE To discuss the different theories that have appeared on this subject. SUMMARY OF BACKGROUND DATA The pathogenesis of AIS, a condition exclusive to humans, has been the subject of many studies. Over the years, practically every structure of the body has been mentioned in the pathogenesis of AIS; however, the cause of this spinal deformity remains little understood. The pathogenesis of this condition is termed multifactorial. METHODS PubMed and Google Scholar electronic databases were searched focused on parameters concerning the pathogenesis of adolescent idiopathic scoliosis. The search was limited to the English language. RESULTS No single causative factor for the development of idiopathic scoliosis has been identified, it is thus termed multifactorial. AIS is a complex genetic disorder. The fully erect posture, which is unique to humans, seems to be a prerequisite for the development of AIS. CONCLUSION Although any or all of the mentioned factors in this review may play a certain role in the initiation and progression of AIS at a certain stage, the presented material suggests that in the observed deformation, genetics, and the unique mechanics of the fully upright human spine play a decisive role.
Collapse
|
32
|
Association study of tryptophan hydroxylase 1 and arylalkylamine N-acetyltransferase polymorphisms with adolescent idiopathic scoliosis in Han Chinese. Spine (Phila Pa 1976) 2008; 33:2199-203. [PMID: 18794762 DOI: 10.1097/brs.0b013e31817c03f9] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A genetic association study of tryptophan hydroxylase 1 gene (TPH1) and arylalkylamine N-acetyltransferase gene(AANAT) with adolescent idiopathic scoliosis (AIS) in Han Chinese. OBJECTIVE To access whether TPH1 and AANAT polymorphisms are associated with the predisposition, gender, and/or severity of AIS. SUMMARY OF BACKGROUND DATA Studies have shown that AIS is a multifactorial inheritance disease, but the etiology is still unknown. In addition, several lines of evidence show that melatonin deficiency is closely associated with AIS, although there are still doubts and debates. Some polymorphisms in TPH1 and AANAT, the genes of 2 critical enzymes involved in melatonin biosynthesis, may contribute to variability of melatonin production in pineal glands. METHODS We genotyped 16 reported single nuclear polymorphisms (SNPs) present in TPH1 and AANAT in 103 AIS patients and 108 controls with matched sex and age. The data of 6 SNPs with minor allele frequence (MAF) above 5% were analyzed by the allelic and genotypic association analysis, the genotype-phenotype (gender and Cobb angle) association analysis, and the haplotype analysis. RESULTS The single SNP analysis showed that rs10488682, located in the promoter region of TPH1, was related with the occurrence of AIS (P < 0.05). No SNP was found to be correlated with gender or Cobb angle. Two makers (rs8176799 and rs2108977) in TPH1 were found to be in strong LD [ D' = 1.0 (95% CI, 0.9-1.0), gamma = 0.501, LOD = 18.93] in the controls. Both global haplotype analysis and individual haplotype analysis showed that there was no haplotype significantly associated with AIS in this LD block. CONCLUSION TPH1 polymorphisms were associated with AIS but not with gender and Cobb angle in AIS patients. AANAT polymorphisms were not associated with AIS. These results suggested that TPH1 was an AIS predisposition gene, and there was a close relationship between the dyssynthesis of melatonin and AIS.
Collapse
|
33
|
Grivas TB, Vasiliadis E, Savvidou OD, Triantafyllopoulos G. What a school screening program could contribute in clinical research of idiopathic scoliosis aetiology. Disabil Rehabil 2008; 30:752-62. [PMID: 18432433 DOI: 10.1080/09638280802041086] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Scoliosis school screening (SSS) programs have clinically benefited many children through early detection and treatment, as it is clearly stated in the Consensus Paper which has been published by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). It is also through these SSS programs that almost all of our current knowledge on the natural history and curve progression of IS has been made known. The present study summarizes the contribution of SSS in research of IS aetiology. METHOD We reviewed all the reports in relation to research of IS aetiology, which were published in peer-review journals and were originated from the Thriasio SSS program. RESULTS Analysis comprises of reports for (i) IS prevalence, (ii) aetiological studies originated from school screening referrals which implicate numerous environmental and biological factors in IS pathogenesis, (iii) suggestions for a more efficient screening, (iv) IS natural history, and (v) the evolving aim of SSS based on the reported research. CONCLUSIONS SSS should be adopted by policy makers, because its scope goes beyond the identification of IS at an early stage, contributing significantly into the research for IS aetiology.
Collapse
|
34
|
Day GA, McPhee IB, Tuffley J, Tomlinson F, Chaseling R, Kellie S, Torode I, Sherwood M, Cutbush K, Geddes AJ, Brankoff B. Idiopathic scoliosis and pineal lesions in Australian children. J Orthop Surg (Hong Kong) 2007; 15:327-33. [PMID: 18162681 DOI: 10.1177/230949900701500318] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To determine whether treatment of pineal lesions in children is associated with development of idiopathic scoliosis. METHODS 38 boys and 10 girls with pineal lesions were identified. Their mean age at presentation was 10 years. The pineal pathology varied from cysts and epidermoid to teratoma, germinoma, pineocytoma, and glioblastoma. Treatment ranged from biopsy/extirpation to radiotherapy. RESULTS 12 patients died. No scoliosis was found in any females or any of the deceased. Two boys had scoliosis: one had a 12-degree right upper thoracic curve with 32-degree kyphosis and the other had a 60-degree right thoracolumbar idiopathic curve, requiring a 2-stage arthrodesis. CONCLUSION Pineal ablation is not related to the development of idiopathic scoliosis in humans.
Collapse
Affiliation(s)
- G A Day
- University of Queensland, Australia.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Cheung KMC, Wang T, Qiu GX, Luk KDK. Recent advances in the aetiology of adolescent idiopathic scoliosis. INTERNATIONAL ORTHOPAEDICS 2007; 32:729-34. [PMID: 17572891 PMCID: PMC2898941 DOI: 10.1007/s00264-007-0393-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Revised: 05/06/2007] [Accepted: 05/07/2007] [Indexed: 12/24/2022]
Abstract
The aetiology of adolescent idiopathic scoliosis (AIS) is still unknown despite many years of research effort. Theories on AIS's aetiology have included mechanical, hormonal, metabolic, neuromuscular, growth, and genetic abnormalities. Amongst these, some factors may be epiphenomena rather than the cause itself. Other factors may even contribute to curve progression, rather than curve initiation. Current views maintain that AIS is a multifactorial disease with genetic predisposing factors [Lowe et al. in J Bone Joint Surg [Am] 82:1157-1168, 2000]. With improvements in diagnostic methods, imaging and genomics, there has been considerable recent work on aetiology. This review aims to bring readers up-to-date with the latest developments in scoliosis research.
Collapse
Affiliation(s)
- Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | | | | | | |
Collapse
|
36
|
Grivas TB, Savvidou OD. Melatonin the "light of night" in human biology and adolescent idiopathic scoliosis. SCOLIOSIS 2007; 2:6. [PMID: 17408483 PMCID: PMC1855314 DOI: 10.1186/1748-7161-2-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2007] [Accepted: 04/04/2007] [Indexed: 12/15/2022]
Abstract
Melatonin "the light of night" is secreted from the pineal gland principally at night. The hormone is involved in sleep regulation, as well as in a number of other cyclical bodily activities and circadian rhythm in humans. Melatonin is exclusively involved in signalling the 'time of day' and 'time of year' (hence considered to help both clock and calendar functions) to all tissues and is thus considered to be the body's chronological pacemaker or 'Zeitgeber'. The last decades melatonin has been used as a therapeutic chemical in a large spectrum of diseases, mainly in sleep disturbances and tumours and may play a role in the biologic regulation of mood, affective disorders, cardiovascular system, reproduction and aging. There are few papers regarding melatonin and its role in adolescent idiopathic scoliosis (AIS). Melatonin may play a role in the pathogenesis of scoliosis (neuroendocrine hypothesis) but at present, the data available cannot clearly support this hypothesis. Uncertainties and doubts still surround the role of melatonin in human physiology and pathophysiology and future research is needed.
Collapse
Affiliation(s)
- Theodoros B Grivas
- Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Avenue, Magula, 19600 Greece
| | - Olga D Savvidou
- Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Avenue, Magula, 19600 Greece
| |
Collapse
|
37
|
Gorman KF, Breden F. Teleosts as models for human vertebral stability and deformity. Comp Biochem Physiol C Toxicol Pharmacol 2007; 145:28-38. [PMID: 17240199 DOI: 10.1016/j.cbpc.2006.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2006] [Revised: 10/12/2006] [Accepted: 10/12/2006] [Indexed: 11/17/2022]
Abstract
Vertebral development is a dynamic and complicated process, and defects can be caused by a variety of influences. Spinal curvature with no known cause (idiopathic scoliosis) affects 2-3% of the human population. In order to understand the etiology and pathogenesis of complex human skeletal defects such as idiopathic scoliosis, multiple models must be used to study all of the factors affecting vertebral stability and deformity. Although fish and humans have many of the same types of offenses to vertebral integrity, they have been overlooked as a resource for study. The most common morphological deformity reported for fish are those that occur during the development of the spinal system, and as with humans, curvature is a common morphological consequence. Here we review spinal curvature in teleosts and suggest that they are an unexploited resource for understanding the basic elements of vertebral stability, deformity, development and genetics. Fish can be a value to vertebral research because they are tractable, have a diversity of non-induced vertebral deformities, and substantial genomic resources. Current animal models lack non-induced deformities and the experimental tractability necessary for genetic studies. The fact that fish are free of an appendicular skeleton should allow for analysis of basic spinal integrity without the biomechanical constraints observed in quadrupedal and bipedal models. To illustrate the point we review human idiopathic scoliosis and the potential contribution teleosts can make for the identification of causes, risk factors, and treatment options.
Collapse
Affiliation(s)
- Kristen F Gorman
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada.
| | | |
Collapse
|
38
|
Suh KT, Lee SS, Kim SJ, Kim YK, Lee JS. Pineal gland metabolism in patients with adolescent idiopathic scoliosis. ACTA ACUST UNITED AC 2007; 89:66-71. [PMID: 17259419 DOI: 10.1302/0301-620x.89b1.18058] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The scoliosis observed in chickens after pinealectomy resembles that seen in humans with an adolescent idiopathic scoliosis, suggesting that melatonin deficiency may be responsible. However, to date there have been no studies of pineal gland glucose metabolism in patients with adolescent idiopathic scoliosis that might support this hypothesis. We examined the excretion of urinary 6-sulfatoxyl-melatonin as well as the glucose metabolism of the pineal gland in 14 patients with an adolescent idiopathic scoliosis and compared them with those of 13 gender-matched healthy controls using F-18 fluorodeoxyglucose brain positron emission tomography. There was no significant difference in the level of urinary 6-sulfatoxyl-melatonin or pineal gland metabolism between the study and the control group. We conclude that permanent melatonin deficiency is not a causative factor in the aetiology of adolescent idiopathic scoliosis.
Collapse
Affiliation(s)
- K T Suh
- Department of Orthopaedic Surgery, Pusan National University, School of Medicine, Pusan, Korea
| | | | | | | | | |
Collapse
|
39
|
Abstract
The understanding of idiopathic scoliosis continues to evolve. At some time in the foreseeable future the term will be oxymoronic. It may eventuate, based on a series of laboratory and genetic tests, that there will be three groups: One in which the curve will never be of significance and regular follow-up is unnecessary. A second group with predictable response to a brace. A third group in which spine fusion is an inevitability. This latter group should be allowed to enjoy childhood and early adolescence unfettered by treatment until such time as surgery is necessary. Until then, efforts must be directed toward early detection, comprehensive evaluation, and best efforts at preventing progression of the curve. To this end, a referral to an orthopedic surgeon for suspected scoliosis never is disparaged.
Collapse
Affiliation(s)
- Gerard L Glancy
- Department of Orthopaedics, The Children's Hospital, 1056 East 19th Avenue, Denver, CO 80218, USA.
| |
Collapse
|
40
|
Poon AMS, Cheung KMC, Lu DS, Leong JCY. Changes in melatonin receptors in relation to the development of scoliosis in pinealectomized chickens. Spine (Phila Pa 1976) 2006; 31:2043-7. [PMID: 16915086 DOI: 10.1097/01.brs.0000231796.49827.39] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN The 2[125I]iodomelatonin binding assay was used to investigate the involvement of melatonin receptors in the development of scoliosis in pinealectomized chickens. OBJECTIVE To compare the binding properties of melatonin receptors in the thoracic spinal cord between pinealectomized chickens that had scoliosis develop and those that did not. SUMMARY OF BACKGROUND DATA Surgical pinealectomy in young chickens induced scoliosis with a reported incidence of 50% to 100%. The factors regulating the development of scoliosis in this animal model are unclear. Melatonin receptors have been shown in the spinal cord of chickens, but their functions are still unknown. This study addresses the question as to whether spinal cord melatonin receptors are related to the pathogenesis of scoliosis in pinealectomized chickens. METHOD Control and pinealectomized chickens were kept under controlled lighting conditions and monitored for scoliosis development. At 9-11 weeks after pinealectomy, thoracic spinal cords were removed for 2[125I]iodomelatonin binding assay, and blood was collected for serum melatonin assay at either the middle of the light period or middle of the dark period. RESULTS Pinealectomy in young chickens produced: (1) loss of diurnal variations in serum melatonin levels, (2) 50% incidence of scoliosis, and (3) attenuation in the diurnal variations in the receptor affinity to melatonin. No differences were detected in the serum melatonin levels or binding of spinal cord melatonin receptors between the pinealectomized chickens that had scoliosis develop and those that did not. CONCLUSION Changes are detected in melatonin receptor binding after pinealectomy. However, these changes cannot account for the reason why scoliosis develops in some chickens after pinealectomy, while it does not in others. Neither low melatonin serum level nor changes in spinal cord melatonin binding can be a sole etiologic factor in the pathogenesis of scoliosis in pinealectomized chickens.
Collapse
Affiliation(s)
- Angela M S Poon
- Department of Physiology, Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | | | | | | |
Collapse
|
41
|
Grivas TB, Vasiliadis E, Mouzakis V, Mihas C, Koufopoulos G. Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes. SCOLIOSIS 2006; 1:9. [PMID: 16759371 PMCID: PMC1501058 DOI: 10.1186/1748-7161-1-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Accepted: 05/23/2006] [Indexed: 11/10/2022]
Abstract
BACKGROUND Age at menarche is considered a reliable prognostic factor for idiopathic scoliosis and varies in different geographic latitudes. Adolescent idiopathic scoliosis prevalence has also been reported to be different in various latitudes and demonstrates higher values in northern countries. A study on epidemiological reports from the literature was conducted to investigate a possible association between prevalence of adolescent idiopathic scoliosis and age at menarche among normal girls in various geographic latitudes. An attempt is also made to implicate a possible role of melatonin in the above association. MATERIAL-METHODS 20 peer-reviewed published papers reporting adolescent idiopathic scoliosis prevalence and 33 peer-reviewed papers reporting age at menarche in normal girls from most geographic areas of the northern hemisphere were retrieved from the literature. The geographic latitude of each centre where a particular study was originated was documented. The statistical analysis included regression of the adolescent idiopathic scoliosis prevalence and age at menarche by latitude. RESULTS The regression of prevalence of adolescent idiopathic scoliosis and age at menarche by latitude is statistically significant (p < 0.001) and are following a parallel declining course of their regression curves, especially in latitudes northern than 25 degrees. CONCLUSION Late age at menarche is parallel with higher prevalence of adolescent idiopathic scoliosis. Pubarche appears later in girls that live in northern latitudes and thus prolongs the period of spine vulnerability while other pre-existing or aetiological factors are contributing to the development of adolescent idiopathic scoliosis. A possible role of geography in the pathogenesis of idiopathic scoliosis is discussed, as it appears that latitude which differentiates the sunlight influences melatonin secretion and modifies age at menarche, which is associated to the prevalence of idiopathic scoliosis.
Collapse
Affiliation(s)
- Theodoros B Grivas
- Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Av. 19600, Magoula, Attica, Greece
| | - Elias Vasiliadis
- Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Av. 19600, Magoula, Attica, Greece
| | - Vasilios Mouzakis
- Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Av. 19600, Magoula, Attica, Greece
| | - Constantinos Mihas
- Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Av. 19600, Magoula, Attica, Greece
| | - Georgios Koufopoulos
- Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Av. 19600, Magoula, Attica, Greece
| |
Collapse
|
42
|
Cheung KMC, Wang T, Poon AMS, Carl A, Tranmer B, Hu Y, Luk KDK, Leong JCY. The effect of pinealectomy on scoliosis development in young nonhuman primates. Spine (Phila Pa 1976) 2005; 30:2009-13. [PMID: 16166887 DOI: 10.1097/01.brs.0000179087.38730.5d] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective study on pinealectomy in primates. OBJECTIVE To evaluate whether pinealectomy in a bipedal nonhuman primate model will result in the development of scoliosis. SUMMARY OF BACKGROUND DATA Pinealectomy in newborn chickens consistently resulted in scoliosis development. Published data suggest that the surgical removal of the pineal, loss of melatonin secretion, and a bipedal posture are important elements in the development of scoliosis in lower animal models. METHOD There were 18 rhesus monkeys between 8 and 11 months old that underwent pineal excision. All monkeys were kept in a regulated 12-hour light-dark cycle. Monthly radiographs assessed scoliosis development. Completeness of pineal excision was assessed by measurement of a major metabolite of melatonin in the urine, 6-sulfatoxymelatonin, using an enzyme-linked immunosorbent assay assessed. RESULTS Mean follow-up was 28 months (range 10-41). Seven monkeys died prematurely, and 11 survived to date; the data from those that died could still be used, although follow-up was shortened. At the latest follow-up or death, scoliosis did not develop in any of the monkeys. Urinary 6-sulfatoxymelatonin measurements revealed 3 patterns. Group 1 consisted of 10 monkeys, which showed definite evidence of complete pineal excision. Group 2 consisted of an uncertain group of 2 monkeys in which the nighttime melatonin level is slightly high. Group 3 consisted of 6 monkeys that had incomplete pineal excision or ectopic melatonin production. CONCLUSIONS To our knowledge, this is the first report of pinealectomy in nonhuman primates. Of the 18 monkeys, 10 had a loss of melatonin secretion, for a mean of 29 months after surgery. Because none of the monkeys had scoliosis develop, this study strongly suggests that the possible etiologic factors producing idiopathic scoliosis in lower animals are different from primates, and findings in lower animals cannot necessarily be extrapolated to human beings.
Collapse
Affiliation(s)
- Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Moreau A, Wang DS, Forget S, Azeddine B, Angeloni D, Fraschini F, Labelle H, Poitras B, Rivard CH, Grimard G. Melatonin signaling dysfunction in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2004; 29:1772-81. [PMID: 15303021 DOI: 10.1097/01.brs.0000134567.52303.1a] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN In vitro assays were performed with bone-forming cells isolated from 41 patients with adolescent idiopathic scoliosis and 17 control patients exhibiting another type of scoliosis or none. OBJECTIVE To determine whether a dysfunction of the melatonin-signaling pathway in tissues targeted by this hormone is involved in adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA Pinealectomy in chicken has led to the formation of a scoliotic deformity, thereby suggesting that a melatonin deficiency may be at the source of adolescent idiopathic scoliosis. However, the relevance of melatonin in the etiopathogenesis of that condition is controversial because most studies have reported no significant change in circulating levels of melatonin in patients with adolescent idiopathic scoliosis. METHODS Primary osteoblast cultures prepared from bone specimens obtained intraoperatively during spine surgeries were used to test the ability of melatonin and Gpp(NH)p, a GTP analogue, to block cAMP accumulation induced by forskolin. In parallel, melatonin receptor and Gi protein functions were evaluated by immunohistochemistry and by coimmunoprecipitation experiments. RESULTS The cAMP assays demonstrated that melatonin signaling was impaired in osteoblasts isolated from adolescent idiopathic scoliosis patients to different degrees allowing their classification in 3 distinct groups based on their responsiveness to melatonin or Gpp(NH)p. CONCLUSION Melatonin signaling is clearly impaired in osteoblasts of all patients with adolescent idiopathic scoliosis tested. Classification of patients with adolescent idiopathic scoliosis in 3 groups based on functional in vitro assays suggests the presence of distinct mutations interfering with the melatonin signal transduction. Posttranslational modifications affecting Gi protein function, such as serine residues phosphorylation, should be considered as one possible mechanism in the etiopathogenesis of AIS.
Collapse
Affiliation(s)
- Alain Moreau
- Research Center, Sainte-Justine Hospital, Bone Molecular Genetics and Musculoskeletal Malformations Laboratory, Montreal, Quebec, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Corry A, Russell W, McPhillips M, Pritchard J. Re: Imashuku et al. Pineal dysfunction (low melatonin production) as a cause of sudden death in a long-term survivor of Langerhans cell histiocytosis? Med Pediatr Oncol 2003;41:151-153. Pediatr Blood Cancer 2004; 43:93-4; author reply 95. [PMID: 15170900 DOI: 10.1002/pbc.20049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
45
|
Turgut M, Yenisey C, Uysal A, Bozkurt M, Yurtseven ME. The effects of pineal gland transplantation on the production of spinal deformity and serum melatonin level following pinealectomy in the chicken. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2003; 12:487-94. [PMID: 12687443 PMCID: PMC3468002 DOI: 10.1007/s00586-003-0528-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2002] [Revised: 09/14/2002] [Accepted: 12/21/2002] [Indexed: 11/27/2022]
Abstract
Pinealectomy frequently produces spinal deformity in some animal models, but the precise biological mechanism of this phenomenon remains obscure. The current study investigated the effects of an autograft pineal body on the development of spinal deformity and serum melatonin (MLT) concentration after pinealectomy in the chicken. Thirty-six chickens (2 days of age) were divided into three equal groups. While the removal of the pineal gland was performed in groups B and C, a pineal body autograft was surgically implanted into the body wall musculature only in the pineal transplantation group (group C). Chickens in which no surgical intervention was performed served as intact controls (group A). Posteroanterior radiographs of the spines of the chickens were taken at the age of 8 weeks. These were used to determine Cobb angles and to measure the rib-vertebra angles (RVA) on the concave and convex sides of the curves, from which data the difference between the convex and concave RVA (the RVAD) was calculated. At the end of the study, serum MLT levels were determined using the enzyme-linked immunosorbent assay method, and histopathological examination of specimens from all the groups was performed. The results were compared using one-way analysis of variance followed by Duncan's test for pairwise comparisons or by the Kruskal-Wallis test followed by the Mann-Whitney U tests for comparisons between two groups. In this study, the serum MLT levels in groups B and C were significantly lower than those in group A ( P<0.05). However, scoliosis developed in only 7 of 12 (58%) in group B and 6 of 12 (50%) in group C. The average Cobb angle and RVAD in groups B and C were significantly larger than those found in group A ( P=0.000 and P=0.001, respectively). Interestingly, there were no significant differences in either serum MLT levels or development of scoliosis between groups B and C. From the results of the current study, it is evident that the intramuscular pineal gland transplantation following pinealectomy in young Hybro Broiler chickens has no significant effect on the development of spinal deformity and serum MLT level. In the light of this result, the role of MLT in the development of spinal deformity in chickens after pinealectomy remains controversial, and further investigations are warranted.
Collapse
Affiliation(s)
- Mehmet Turgut
- Department of Neurosurgery, Adnan Menderes University School of Medicine, Aydin, Turkey.
| | | | | | | | | |
Collapse
|
46
|
Cheung KMC, Lu DS, Poon AMS, Wang T, Luk KDK, Leong JCY. Effect of melatonin suppression on scoliosis development in chickens by either constant light or surgical pinealectomy. Spine (Phila Pa 1976) 2003; 28:1941-4. [PMID: 12973138 DOI: 10.1097/01.brs.0000083140.80750.93] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN This study was designed to compare the effect of suppression of melatonin secretion by bright light in chickens with that of surgical pinealectomy. OBJECTIVE To determine whether suppression of melatonin secretion without surgery in chickens can result in scoliosis development. SUMMARY OF BACKGROUND DATA Pinealectomy in chickens consistently produces scoliosis with anatomic characteristics similar to those of human idiopathic scoliosis. Conversely, cutting of the pineal stalk without removal of the pineal gland will also result in scoliosis. This study addresses the question of whether constant bright light can induce scoliosis formation, because it is well known that 24-hour bright lighting conditions can suppress the secretion of melatonin to an equivalent level as pinealectomy. MATERIALS AND METHOD Seventy-seven newborn Nihon chickens were separated into three groups. A control group (n = 21) with no surgery performed; a pinealectomy group (n = 15) that served as surgical controls; and a constant light group (n = 41). The first two groups were kept together in a strict 12-hour light-dark cycle, whereas the third group was separately kept with constant lighting conditions (>100 lux). All the chickens were radiographed at two weekly intervals, and blood was taken during the middle of the light and dark cycles for serum melatonin assay using ELISA. RESULTS Fifty-four percent of the pinealectomized chickens had scoliosis develop by 6 weeks. None of the constant-light chickens or controls had scoliosis develop for up to 11 weeks. Measurements of serum melatonin levels of the constant light group confirm that secretion is suppressed. CONCLUSION This study suggests that for scoliosis to develop in chickens, the surgical operation itself is important and challenges the role of melatonin as an isolated etiological factor in the development of scoliosis.
Collapse
Affiliation(s)
- Kenneth M C Cheung
- Department of Orthopaedic Surgery, The University of Hong Kong, Hong Kong, China.
| | | | | | | | | | | |
Collapse
|
47
|
Morcuende JA, Minhas R, Dolan L, Stevens J, Beck J, Wang K, Weinstein SL, Sheffield V. Allelic variants of human melatonin 1A receptor in patients with familial adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2003; 28:2025-8; discussion 2029. [PMID: 12973153 DOI: 10.1097/01.brs.0000083235.74593.49] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A genetic study of patients with familial adolescent idiopathic scoliosis. OBJECTIVES The purpose of this study was to evaluate the evidence for linkage on chromosome 4q and determine whether mutations in the gene coding for melatonin receptor are present. SUMMARY OF BACKGROUND DATA Adolescent idiopathic scoliosis is the most common spine deformity arising during childhood, but its cause remains unknown. The fact that adolescent idiopathic scoliosis is often seen in several members of the same family strongly suggests a genetic factor. Recent work by Wise et al provides evidence for linkage of adolescent idiopathic scoliosis at several different chromosome sites, including 4q. In addition, there is some evidence that adolescent idiopathic scoliosis may be related to a disturbance in melatonin metabolism, and the human melatonin-1A receptor is known to be located on chromosome 4q. METHODS Probands having clinically relevant idiopathic scoliosis (Cobb angle >30 degrees) and their relatives were identified. Radiographic confirmation was required for a positive diagnosis. Linkage analysis was performed with 15 microsatellite markers of chromosome 4q spaced at approximately 10-cM resolution and 5 microsatellite markers surrounding the site for human melatonin receptor. The gene for human melatonin receptor was screened for mutations in the coding region using genomic DNA samples by single-strand conformational polymorphism analysis. Amplimers showing a band shift were reamplified and sequenced bidirectionally. RESULTS There was no evidence for linkage at chromosome 4q in this study population. Twenty-nine individuals demonstrated aberrant single-strand conformation polymorphism band patterns, and sequence evaluation demonstrated six genetic polymorphisms for the gene for human melatonin receptor. These genetic variations were found in both affected and nonaffected individuals, and there was no correlation between gene variants and the phenotype for adolescent idiopathic scoliosis. CONCLUSIONS The results of this study demonstrated no evidence of linkage to chromosome 4q and no mutations in the coding region of the gene for human melatonin receptor. The identification of variants in the human melatonin receptor could provide a useful tool for testing the gene in the predisposition to various other melatonin-related disorders and for clarifying the role of melatonin in adolescent idiopathic scoliosis.
Collapse
Affiliation(s)
- Jose A Morcuende
- Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa, USA.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Sobajima S, Kin A, Baba I, Kanbara K, Semoto Y, Abe M. Implication for melatonin and its receptor in the spinal deformities of hereditary Lordoscoliotic Rabbits. Spine (Phila Pa 1976) 2003; 28:554-8. [PMID: 12642761 DOI: 10.1097/01.brs.0000049962.42646.53] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN The association between melatonin system and the spontaneous development of the spinal deformities in the Hereditary Lordoscoliotic Rabbit, the natural animal model for idiopathic scoliosis, was studied. OBJECTIVES To examine the implication for melatonin and its receptor in the spinal deformities of the natural animal model, the Hereditary Lordoscoliotic Rabbit. SUMMARY OF BACKGROUND DATA We previously reported radiologic and histologic studies investigating the etiology of spinal deformities in a breed of Japanese White Rabbit, the Hereditary Lordoscoliotic Rabbit. These animals develop thoracic lordoscoliosis during growth and as such can be used as a model for human idiopathic scoliosis. Although previous studies in chickens have established that pinealectomy produces scoliosis, the cause of the condition is yet to be fully elucidated. METHODS Serum melatonin levels in Hereditary Lordoscoliotic Rabbits were measured by radioimmunoassay and compared with those of Japanese White Rabbits (controls). The expression of melatonin receptor in the rabbit was detected by homology cloning to access the number of the melatonin receptor mRNA in the rabbit spinal cord by quantitative reverse-transcribed polymerase chain reaction. RESULTS Serum melatonin levels in Hereditary Lordoscoliotic Rabbits were significant higher than those of controls in each period until 20 weeks. We detected the expression of melatonin receptor mRNA in rabbit spinal cord. However, no significant quantitative differences were found in the level of expression of melatonin mRNA in the spinal cord between Hereditary Lordoscoliotic Rabbits and controls. CONCLUSIONS In relation to the present study, we suggest that causes of spinal deformities in the Hereditary Lordoscoliotic Rabbit may be the result of the contribution of melatonin receptors as well as that of altered serum melatonin levels in the Hereditary Lordoscoliotic Rabbit. Further studies will be required to investigate the expression of melatonin receptor in other tissues of the Hereditary Lordoscoliotic Rabbit as well as to delineate the role of melatonin in the pathogenesis of idiopathic scoliosis.
Collapse
Affiliation(s)
- Satoshi Sobajima
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
| | | | | | | | | | | |
Collapse
|
49
|
Lowe T, Lawellin D, Smith D, Price C, Haher T, Merola A, O'Brien M. Platelet calmodulin levels in adolescent idiopathic scoliosis: do the levels correlate with curve progression and severity? Spine (Phila Pa 1976) 2002; 27:768-75. [PMID: 11923672 DOI: 10.1097/00007632-200204010-00016] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN This ongoing longitudinal study evaluates simultaneous radiographic and platelet calmodulin determinations for patients with idiopathic scoliosis who are skeletally immature. OBJECTIVES To determine whether platelet calmodulin levels correlate with curve progression and severity. SUMMARY OF BACKGROUND DATA A previous study based on a single calmodulin determination and a single radiograph identified higher calmodulin levels in progressive curves and in higher magnitude curves. A longitudinal study was needed to demonstrate the relation of calmodulin to curve changes for individual patients over time during the growth period. METHODS In this study, 55 patients with idiopathic scoliosis of varying types and severity were followed longitudinally with serial radiographs and platelet calmodulin determinations. A Risser sign was recorded for each radiograph at each visit. RESULTS Calmodulin levels increased in all the patients with progressive curves (13/13), remained stable in 73% of the patients with nonprogressive curves (11/15), and were higher generally in curves greater than 30 degrees and double structural curves. Calmodulin levels usually decreased in patients undergoing brace treatment (14/17) or spine fusion (9/10). CONCLUSIONS It appears that platelet calmodulin levels correlate closely with curve progression and stabilization by bracing or spine fusion. Correlation with nonprogressive curves was not as consistent, with 27% noncorrelation. Longer follow-up evaluation and enrollment of additional patients will be necessary to determine whether calmodulin may serve as a biochemical marker of curve progression and to help identify stable and progressive curves.
Collapse
Affiliation(s)
- Thomas Lowe
- Woodridge Orthopaedic and Spine Center, P.C., Wheat Ridge, Colorado, USA
| | | | | | | | | | | | | |
Collapse
|
50
|
Inoh H, Kawakami N, Matsuyama Y, Aoki T, Kanemura T, Natsume N, Iwata H. Correlation between the age of pinealectomy and the development of scoliosis in chickens. Spine (Phila Pa 1976) 2001; 26:1014-21. [PMID: 11337619 DOI: 10.1097/00007632-200105010-00006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Pinealectomy induces experimental scoliosis in chickens. This study analyzed the correlation between the age at which pinealectomy was performed and the development of scoliosis in chickens. OBJECTIVE To investigate the differences in the rate or magnitude of scoliosis and the type of curvature in chickens pinealectomized at different times after hatching. SUMMARY OF BACKGROUND DATA Scoliosis develops in almost all chickens pinealectomized within 3 days after hatching, but there are no data on whether the condition will develop in chickens pinealectomized earlier or later after hatching. METHODS In this study, 106 female white leghorn chickens were divided into six groups: four pinealectomy groups (pinealectomy was performed 2, 4, 11, or 18 days after hatching in Groups P-2, P-4, P-11, and P-18, respectively), a control group (Group C), and a sham operation group (Group S). Ventrodorsal radiographs of the spine were taken at 4-week intervals until the age of 12 weeks. At 12 weeks, a 1-mL sample of blood was taken from the heart at the middle of the dark cycle, and the serum melatonin concentration was measured by radioimmunoassay. RESULTS At the age of 12 weeks, scoliosis was present in 63.6% of the chickens in Group P-2, 72.7% in Group P-4, 81% in Group P-11, and 70% in Group P-18, and the Cobb angles in the scoliotic chickens averaged 32.6, 29.8, 23.8, and 22.3 degrees in the respective groups. There were no significant differences in the rate or magnitude of scoliosis and the type of curvature among the pinealectomy groups at the age of 12 weeks. At the age of 12 weeks, the serum melatonin levels at the middle of the dark cycle in the pinealectomized chickens were significantly lower than those of chickens in Groups C and S. However, there were no differences in the serum melatonin levels between scoliotic and nonscoliotic pinealectomized chickens. CONCLUSIONS Findings from this study show that scoliosis develops in 60% to 80% of chickens pinealectomized within 18 days after hatching, and that scoliotic development is not influenced by the age at which pinealectomy is performed. However, this study suggests that melatonin plays a complicated role in spinal development, inasmuch as the serum melatonin levels after pinealectomy approximated zero. Yet scoliosis did not develop in all pinealectomized chickens.
Collapse
Affiliation(s)
- H Inoh
- Department of Orthopaedic Surgery, Nagoya Daiichi Red Cross Hospital, Nagoya, Japan.
| | | | | | | | | | | | | |
Collapse
|