Mechanotransduction in musculoskeletal tissue regeneration: effects of fluid flow, loading, and cellular-molecular pathways

How controlled motion alters the biophysical properties of musculoskeletal tissue architecture

INTRODUCTION

Movement is fundamental to the normal behaviour of the hand, not only for day-to-day activity, but also for fundamental processes like development, tissue homeostasis and repair. Controlled motion is a concept that hand therapists apply to their patients daily for functional gains, yet the scientific understanding of how this works is poorly understood.

PURPOSE OF THE ARTICLE

To review the biology of the tissues in the hand that respond to movement and provide a basic science understanding of how it can be manipulated to facilitate better functionThe review outlines the concept of controlled motion and actions across the scales of tissue architecture, highlighting the the role of movement forces in tissue development, homeostasis and repair. The biophysical behaviour of mechanosensitve tissues of the hand such as skin, tendon, bone and cartilage are discussed.

CONCLUSION

Controlled motion during early healing is a form of controlled stress and can be harnessed to generate appropriate reparative tissues. Understanding the temporal and spatial biology of tissue repair allows therapists to tailor therapies that allow optimal recovery based around progressive biophysical stimuli by movement.

Unlocking the Therapeutic Potential of Irisin: Harnessing Its Function in Degenerative Disorders and Tissue Regeneration

Physical activity is well-established as an important protective factor against degenerative conditions and a promoter of tissue growth and renewal. The discovery of Fibronectin domain-containing protein 5 (FNDC5) as the precursor of Irisin in 2012 sparked significant interest in its potential as a diagnostic biomarker and a therapeutic agent for various diseases. Clinical studies have examined the correlation between plasma Irisin levels and pathological conditions using a range of assays, but the lack of reliable measurements for endogenous Irisin has led to uncertainty about its prognostic/diagnostic potential as an exercise surrogate. Animal and tissue-engineering models have shown the protective effects of Irisin treatment in reversing functional impairment and potentially permanent damage, but dosage ambiguities remain unresolved. This review provides a comprehensive examination of the clinical and basic studies of Irisin in the context of degenerative conditions and explores its potential as a therapeutic approach in the physiological processes involved in tissue repair/regeneration.

Effect of stretch frequency on osteogenesis of periodontium during periodontal ligament distraction

OBJECTIVES

Periodontal ligament distraction (PDLD) can accelerate orthodontic tooth movement (OTM). However, the effect of stretch frequency on osseous formation during PDLD remains unclear. Here, we sought to identify the effect of PDLD frequency on the osteogenic remodelling of the periodontium.

MATERIALS AND METHODS

(i) In vitro, five human periodontal ligament stem cell (PDLSC) cultures were randomized to either static conditions or exposure to a cyclic stretch force involving 12% deformation at frequencies of 0.3, 0.5, 0.7 or 1.0 Hz for 12 h, and the osteogenic differentiation of PDLSCs was assessed using Western blotting. (ii) In vivo, 18 beagle dogs underwent orthodontic distalization of bilateral maxillary first premolars. In the test groups, PDLD was performed at a frequency of two or six times/day, while Ni-Ti coil springs were applied to mimic traditional OTM in the control group. The amount of OTM and histological staining was estimated after force loading for 5, 10 and 15 days.

RESULTS

(i) In vitro, the expression of osteogenic-specific markers (runt-related transcription factor 2 [Runx2], type I collagen [COL-I] and osteocalcin [OCN]) increased with the frequency of tensile force, to a peak at 0.7 Hz. (ii) In vivo, both PDLD groups displayed a greater rate of OTM and a higher bone metabolism than the control group. The expression of COL-I and OCN was significantly reinforced in the six times/day-PDLD group in comparison to the two times/day-PDLD group.

CONCLUSIONS

The cyclic stretch force enhances osteogenesis of the periodontium in a frequency-dependent manner.

Sustained acoustic medicine for the treatment of musculoskeletal injuries: a systematic review and meta-analysis

BACKGROUND

Musculoskeletal injuries account for 10 million work-limited days per year and often lead to both acute and/or chronic pain, and increased chances of re-injury or permanent disability. Conservative treatment options include various modalities, nonsteroidal anti-inflammatory drugs, and physical rehabilitation programs. Sustained Acoustic Medicine is an emerging prescription home-use mechanotransductive device to stimulate cellular proliferation, increase microstreaming and cavitation in situ, and to increase tissue profusion and permeability. This research aims to summarize the clinical evidence on Sustained Acoustic Medicine and measurable outcomes in the literature.

METHODS

A systematic literature review was conducted using PubMed, EBSCOhost, Academic Search Complete, Google Scholar and ClinicalTrials.gov to identify studies evaluating the effects of Sustained Acoustic Medicine on the musculoskeletal system of humans. Articles identified were selected based on inclusion criteria and scored on the Downs and Black checklist. Study design, clinical outcomes and primary findings were extracted from included studies for synthesis and meta-analysis statistics.

RESULTS

A total of three hundred and seventy-two participants (372) were included in the thirteen clinical research studies reviewed including five (5) level I, four (4) level II and four (4) level IV studies. Sixty-seven (67) participants with neck and back myofascial pain and injury, one hundred and fifty-six (156) participants with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade II/III), and one hundred forty-nine (149) participants with generalized soft-tissue injury of the elbow, shoulder, back and ankle with limited function. Primary outcomes included daily change in pain intensity, change in Western Ontario McMaster Osteoarthritis Questionnaire, change in Global Rate of Change, and functional outcome measures including dynamometry, grip strength, range-of-motion, and diathermic heating (temperature measurement).

CONCLUSION

Sustained Acoustic Medicine treatment provides tissue heating and tissue recovery, improved patient function and reduction of pain. When patients failed to respond to physical therapy, Sustained Acoustic Medicine proved to be a useful adjunct to facilitate healing and return to work. As a non-invasive and non-narcotic treatment option with an excellent safety profile, Sustained Acoustic Medicine may be considered a good therapeutic option for practitioners.

Effect of Static Compressive Force on Aldehyde Dehydrogenase Activity in Periodontal Ligament Fibroblasts

Background:

The application of static compressive forces to periodontal ligament fibroblasts (PDLFs) in vivo or in vitro has been linked to the expression of biochemical agents and local tissue modifications that could be involved in maintaining homeostasis during orthodontic movement. An approach used for identifying mesenchymal cells, or a subpopulation of progenitor cells in both tumoral and normal tissues, involves determining the activity of aldehyde dehydrogenase (ALDH). However, the role of subpopulations of PDLF-derived undifferentiated cells in maintaining homeostasis during tooth movement remains unclear.

Objective:

This study aimed at analyzing the effect of applying a static compressive force to PDLFs on the activity of ALDH in these cells.

Methods:

PDLFs were distributed into two groups: control group (CG), where fibroblasts were not submitted to compression, and experimental group (EG), where fibroblasts were submitted to a static compressive force of 4 g/mm2 for 6 hours. The compressive force was applied directly to the cells using a custom-built device. ALDH activity in the PDLFs was evaluated by a flow cytometry assay.

Results:

ALDH activity was observed in both groups, but was significantly lower in EG than in CG after the application of a static compressive force in the former.

Conclusion:

Application of a static compressive force to PDLFs decreased ALDH activity.

Serum exosomes from young rats improve the reduced osteogenic differentiation of BMSCs in aged rats with osteoporosis after fatigue loading in vivo

BACKGROUND

Osteoporosis is a major public health concern for the elderly population and is characterized by fatigue load resulting in bone microdamage. The ability of bone mesenchymal stem cells (BMSCs) to repair bone microdamage diminishes with age, and the accumulation of bone microdamage increases the risk of osteoporotic fracture. There is a lack of effective means to promote the repair of bone microdamage in aged patients with osteoporosis. Exosomes have been shown to be related to the osteogenic differentiation of BMSCs. Here, we aimed to evaluate the changes in the osteogenic differentiation capacity of BMSCs in aged osteoporotic rats after fatigue loading and the treatment potential of serum exosomes from young rats.

METHODS

The tibias of six aged osteoporotic rats were subjected to fatigue loading in vivo for 2 weeks, and the bone microdamage, microstructures, and mechanical properties were assessed. Subsequently, BMSCs were extracted to evaluate their proliferation and osteogenic differentiation abilities. In addition, the BMSCs of aged osteoporotic rats after fatigue loading were treated with serum exosomes from young rats under osteogenic induction conditions, and the expression of osteogenic-related miRNAs was quantified. The osteogenetic effects of miRNA-19b-3p in exosomes and the possible target protein PTEN was detected.

RESULTS

Obvious bone microdamage at the fatigue load stress point, the bone microstructure and biomechanical properties were not obviously changed. A decreased osteogenic differentiation ability of BMSCs was observed after fatigue loading, while serum exosomes from young rats highly expressing miRNA-19b-3p improved the decreased osteogenic differentiation ability of BMSCs. Transfection with miRNA-19b-3p mimic could promote osteoblastic differentiation of BMSCs and decreased the expression of PTEN. After transfection of miRNA-19b-3p inhibitor, the promotional effect of exosomes on bone differentiation was weakened. Treatment with transfected exosomes increased the expression of PTEN.

CONCLUSION

Serum exosomes derived from young rats can improve the decreased osteogenic differentiation ability of BMSCs in aged rats with osteoporosis after fatigue loading and can provide a new treatment strategy for the repair of bone microdamage and prevention of fractures.

Influence of hyperocclusion on the remodeling of gingival tissues

OBJECTIVE

The purpose of this study was to observe the effect of hyperocclusion on the remodeling of gingival tissues and detect the related signaling pathways.

DESIGN

Hyperocclusion models were established by tooth extraction in mice. The mice were sacrificed at 3, 7, 14, 28, or 56 days after the surgery, and the left mandibular first molars with gingival tissues were isolated and examinations were focused on the gingival tissues. Apoptotic cells were examined using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) technology. Proliferating cells, p65, inflammatory cytokines, and β-catenin were detected using immunohistochemical methods.

RESULTS

A series of apoptosis and proliferation responses were triggered in stressed gingival tissues. It was observed that the levels of p65, proinflammatory factors including interleukin-1β and tumor necrosis factor-α in extraction group were higher compared with those from mice with intact dentition, and peaked on days 14, 14 and 7 respectively. The expression of β-catenin was increased under hyperocclusion situations, peaked on day 14, and declined to the initial levels over time.

CONCLUSIONS

The results of this study suggest that hyperocclusion causes remodeling of the gingival tissues by activating a series of adaptive responses. Both nuclear factor kappa B and Wnt/β-catenin signaling pathways may be responsible for those adaptive responses though the exact mechanism is not clear.

Efficacy of shear strain gradients as an osteogenic stimulus

The question of which mechanical variables are responsible for inducing osteogenic activity is unresolved despite extensive experimental and theoretical investigation. Candidate variables include strain magnitude, loading frequency, the interaction of magnitude and frequency (strain rate), and strain gradients. An additional challenge is discerning the coordination of periosteal and endosteal expansion during growth, and whether this coordination (or lack thereof) is fully dependent or partially independent of the local mechanical environment. In this study, under the assumption that calculated stresses correspond to relative strain magnitudes, we specify alternative growth algorithms of bone cross-sectional size and geometry to explore skeletal growth under alternative scenarios of osteogenic activity that are tracking 1) an attractor stress, 2) local stress magnitude or 3) steepness of stress gradients. These developmental simulations are initiated from two initial geometries (symmetrical and asymmetrical ellipses) under a time-varying torsional load whose magnitude is proportional to body size growth in a model primate. In addition, we model endosteal expansion under three conditions hypothesized in the literature, in which endosteal expansion is 1) independent of the mechanical milieu, 2) completely dependent on the mechanical milieu, and 3) a "hybrid" model in which intrinsic biological (independent) growth is operative early but gives way to mechanically-sensitive (dependent) growth at later ages. Three variables were recorded over each growth simulation: the safety factor (ratio of yield stress to actual stress), an efficiency ratio (invested bone area per unit of stress), and proximity to an isostress condition (an optimal design criterion in which stress is invariant throughout the structure). The attractor stress algorithm produces the most "adapted" bones in terms of mechanical competence and economy of material. Localized osteogenic activity that is guided in direct proportion to stress magnitude produces competent bones but with variable adult geometries depending on conditions of endosteal expansion. Stress gradients also produce functional but relatively inefficient bones, with widely variable safety factors during growth and heterogeneous stress fields. If, in fact, the osteocyte network monitors strain gradients to generate osteogenic signals, the resulting morphology is competent but falls well short of an optimal mechanical solution.

Paramagnetic Functionalization of Biocompatible Scaffolds for Biomedical Applications: A Perspective

The burst of research papers focused on the tissue engineering and regeneration recorded in the last years is justified by the increased skills in the synthesis of nanostructures able to confer peculiar biological and mechanical features to the matrix where they are dispersed. Inorganic, organic and hybrid nanostructures are proposed in the literature depending on the characteristic that has to be tuned and on the effect that has to be induced. In the field of the inorganic nanoparticles used for decorating the bio-scaffolds, the most recent contributions about the paramagnetic and superparamagnetic nanoparticles use was evaluated in the present contribution. The intrinsic properties of the paramagnetic nanoparticles, the possibility to be triggered by the simple application of an external magnetic field, their biocompatibility and the easiness of the synthetic procedures for obtaining them proposed these nanostructures as ideal candidates for positively enhancing the tissue regeneration. Herein, we divided the discussion into two macro-topics: the use of magnetic nanoparticles in scaffolds used for hard tissue engineering for soft tissue regeneration.

Mechanical performance and implications on bone healing of different screw configurations for plate fixation of diaphyseal tibia fractures: a computational study

Diaphyseal tibia fractures may require plate fixation for proper healing to occur. Currently, there is no consensus on the number of screws required for proper fixation or the optimal placement of the screws within the plate. Mechanical stability of the construct is a leading criterion for choosing plate and screws configuration. However, number and location of screws have implications on the mechanical environment at the fracture site and, consequently, on bone healing response: The interfragmentary motion attained with a specific plate and screw construct may elicit mechano-transduction signals influencing cell-type differentiation, which in turn affects how well the fracture heals. This study investigated how different screw configurations affect mechanical performance of a tibia plate fixation construct. Three configurations of an eight-hole plate were considered with the fracture in the center of the plate: eight screws-screws at first, fourth, fifth and eighth hole and screws at first, third, sixth and eighth hole. Constructs' stiffness was compared through biomechanical tests on bone surrogates. A finite element model of tibia diaphyseal fracture was used to conduct a stress analysis on the implanted hardware. Finally, the potential for bone regeneration of each screw configuration was assessed via the computational model through the evaluation of the magnitude of mechano-transduction signals at the bone callus. The results of this study indicate that having screws at fourth and fifth holes represents a preferable configuration since it provides mechanical properties similar to those attained by the stiffest construct (eight screws), and elicits an ideal bone regenerative response.

The Effect of Isometric Exercise Plantar Flexor on Osteoblast Activity Measured by Bone Specific Alkaline Phosphatase and Callus Formation in a Patient Post Open Reduction Internal Fixation with Non-articular Tibia Fracture

BACKGROUND

Post-operative non-articular tibia fracture several problems that can occur include; pain, muscles atrophy, muscles weakness, joint stiffness, delayed union, and non-union that makes patients limited in their daily activities. Several factors that play a role in the process of fracture healing include osteoblast activity and exercise. Isometric exercises plantar flexor might effectively prevent the problem. Markers of osteoblast activity are bone-specific alkaline phosphatase (BSAP) levels and Hummer scale callus formation. Not yet known the effect isometric exercise of plantar flexor on osteoblast activity in the post open reduction internal fixation of non-articular tibia fractures, due to the lack of studies in this field.

AIM

This research was conducted to investigate the effect of isometric plantar flexor on osteoblast activity and callus formation in patients post open reduction internal fixation nonarticular tibial fractures.

HYPOTHESIS

There are differences in osteoblast activity and callus formation between groups that do isometric exercises of plantar flexor muscles with those that without isometric exercises plantar flexor.

ANALYSIS

Hypothesis test used a paired t-test with a value of α 0.05 and a confidence level of 95%.

METHODS

This clinical trial was true experimental with pre-post test control group design divided into two groups, group I obtained treatment of isometric exercises of the plantar flexor muscle, range of motion knee joint, and ankle while group II obtained the range of motion knee joints and ankle. Osteoblast activity measured with bone-specific alkaline phosphatase level and callus formation.

RESULTS

The result of the study found to increase mean bone-specific alkaline phosphatase group I; 15.6 and group II; 5.2. A paired t-test of independent samples with α of 0.05 and confidence interval 95% was obtained p-value = 0.000, there is a significant difference in increased levels of bone-specific alkaline phosphatase group I obtained isometric exercises plantar flexor with group II without isometric exercises plantar flexor in patients post open reduction internal fixation of a non-articular tibia fracture. Radiographic examination of Hummer scale callus in group I who carried out isometric exercises plantar flexor had an average value of 2.63, whereas group II without isometric exercises plantar flexor average of 3.06. Wilcoxon test with α 0.05 and 95% confidence interval obtained p-value = 0.000, there is a significant difference in callus image in both groups of patients post open reduction internal fixation non-articular tibia fracture. The linear regression calculated of callus assessment with bone-specific alkaline phosphatase obtained the value of R quadrat = 0.793, which showed that the formation of callus Hummer classification could predict the change in bone-specific alkaline phosphatase value by 79%.

CONCLUSION

The research found isometric exercise plantar flexor in patients post open reduction internal fixation non-articular tibia fracture enhances osteoblast activity and callus formation that will likely short the healing process time and prevent delayed union or non-union.

Mechanobiological modulation of in situ and in vivo osteocyte calcium oscillation by acoustic radiation force

The biological effect of ultrasound on bone regeneration has been well documented, yet the underlying mechanotransduction mechanism is largely unknown. In relation to the mechanobiological modulation of the cytoskeleton and Ca²⁺ influx by short-term focused acoustic radiation force (FARF), the current study aimed to visualize and quantify Ca²⁺ oscillations in real-time of in situ and in vivo osteocytes in response to focused low-intensity pulsed ultrasound (FLIPUS). For in situ studies, fresh mice calvaria were subjected to FLIPUS stimulation at 0.05, 0.2, 0.3, and 0.7 W. For the in vivo study, 3-month-old C57BL/6J Ai38/Dmp1-Cre mice were subjected to FLIPUS at 0.15, 1, and 1.5 W. As observed via real-time confocal imaging, in situ FLIPUS led to more than 80% of cells exhibiting Ca²⁺ oscillations at 0.3-0.7 W and led to a higher number of Ca²⁺ spikes with larger values at >0.3 W. In vivo FLIPUS at 1-1.5 W led to more than 90% of cells exhibiting Ca²⁺ oscillations. Higher FLIPUS energies led to larger Ca²⁺ spike magnitudes. In conclusion, this study provided a pilot study of both in situ and in vivo osteocytic Ca²⁺ oscillations under noninvasive FARF, which aids further exploration of the mechanosensing mechanism of the controlled bone cell motility response to the stimulus.

Carbon Nanodots Doped Super-paramagnetic Iron Oxide Nanoparticles for Multimodal Bioimaging and Osteochondral Tissue Regeneration via External Magnetic Actuation

Super-paramagnetic iron oxide nanoparticles (SPIONs) have multiple theranostics applications such as T2 contrast agent in magnetic resonance imaging (MRI) and electromagnetic manipulations in biomedical devices, sensors, and regenerative medicines. However, SPIONs suffer from the limitation of free radical generation, and this has a certain limitation in its applicability in tissue imaging and regeneration applications. In the current study, we developed a simple hydrothermal method to prepare carbon quantum dots (CD) doped SPIONs (FeCD) from easily available precursors. The nanoparticles are observed to be cytocompatible, hemocompatible, and capable of scavenging free radicals in vitro. They also have been observed to be useful for bimodal imaging (fluorescence and MRI). Further, 3D printed gelatin-FeCD nanocomposite nanoparticles were prepared and used for tissue engineering using static magnetic actuation. Wharton's jelly derived mesenchymal stem cells (MSCs) were cultured on them with magnetic actuation and implanted at the subcutaneous region. The tissues obtained have shown features of both osteogenic and chondrogenic differentiation of the stem cells in vivo. In vitro, PCR studies show MSCs express gene expression of both bone and cartilage-specific markers, suggesting FeCDs under magnetic actuation can lead MSCs to go through differentiating into an endochondral ossification route.

Physical Activity and Bone Health: What Is the Role of Immune System? A Narrative Review of the Third Way

Bone tissue can be seen as a physiological hub of several stimuli of different origin (e.g., dietary, endocrine, nervous, immune, skeletal muscle traction, biomechanical load). Their integration, at the bone level, results in: (i) changes in mineral and protein composition and microarchitecture and, consequently, in shape and strength; (ii) modulation of calcium and phosphorous release into the bloodstream, (iii) expression and release of hormones and mediators able to communicate the current bone status to the rest of the body. Different stimuli are able to act on either one or, as usual, more levels. Physical activity is the key stimulus for bone metabolism acting in two ways: through the biomechanical load which resolves into a direct stimulation of the segment(s) involved and through an indirect load mediated by muscle traction onto the bone, which is the main physiological stimulus for bone formation, and the endocrine stimulation which causes homeostatic adaptation. The third way, in which physical activity is able to modify bone functions, passes through the immune system. It is known that immune function is modulated by physical activity; however, two recent insights have shed new light on this modulation. The first relies on the discovery of inflammasomes, receptors/sensors of the innate immunity that regulate caspase-1 activation and are, hence, the tissue triggers of inflammation in response to infections and/or stressors. The second relies on the ability of certain tissues, and particularly skeletal muscle and adipose tissue, to synthesize and secrete mediators (namely, myokines and adipokines) able to affect, profoundly, the immune function. Physical activity is known to act on both these mechanisms and, hence, its effects on bone are also mediated by the immune system activation. Indeed, that immune system and bone are tightly connected and inflammation is pivotal in determining the bone metabolic status is well-known. The aim of this narrative review is to give a complete view of the exercise-dependent immune system-mediated effects on bone metabolism and function.

Transcriptome analysis of osteoblasts in an ovariectomized mouse model in response to physical exercise

Objectives

Osteoporosis is a metabolic disease resulting in progressive loss of bone mass as measured by bone mineral density (BMD). Physical exercise has a positive effect on increasing or maintaining BMD in postmenopausal women. The contribution of exercise to the regulation of osteogenesis in osteoblasts remains unclear. We therefore investigated the effect of exercise on osteoblasts in ovariectomized mice.

Methods

We compared the activity of differentially expressed genes of osteoblasts in ovariectomized mice that undertook exercise (OVX+T) with those that did not (OVX), using microarray and bioinformatics.

Results

Many inflammatory pathways were significantly downregulated in the osteoblasts after exercise. Meanwhile, IBSP and SLc13A5 gene expressions were upregulated in the OVX+T group. Furthermore, in in vitro assay, IBSP and SLc13A5 mRNAs were also upregulated during the osteogenic differentiation of MC3T3-E1 and 7F2 cells.

Conclusion

These findings suggest that exercise may not only reduce the inflammatory environment in ovariectomized mice, indirectly suppressing the overactivated osteoclasts, but may also directly activate osteogenesis-related genes in osteoblasts. Exercise may thus prevent the bone loss caused by oestrogen deficiency through mediating the imbalance between the bone resorptive activity of osteoclasts and the bone formation activity of osteoblasts.

Cite this article: W-B. Hsu, W-H. Hsu, J-S. Hung, W-J. Shen, R. W-W. Hsu. Transcriptome analysis of osteoblasts in an ovariectomized mouse model in response to physical exercise. Bone Joint Res 2018;7:601–608. DOI: 10.1302/2046-3758.711.BJR-2018-0075.R2.

Tension-loaded bone marrow stromal cells potentiate the paracrine osteogenic signaling of co-cultured vascular endothelial cells

Co-culture of bone marrow stromal cells (BMSCs) and vascular endothelial cells (VECs) is a promising strategy for better osteogenesis and pre-vascularization in bone tissue engineering. Recent reports have shown that mechanical stretching further promotes osteogenesis in BMSC/VEC co-culture systems, but the underlying mechanism of this process remains unclear. In this study, noncontact co-cultures of rat primary BMSCs and VECs were employed to interrogate paracrine cell-to-cell communications in response to tension. Exposure of VECs to 6% tension for 48 h elicited neither ALP activity nor mRNA expression of OCN and OPN in BMSCs incubated in a shared culture medium. Instead, BMSCs subjected to tension induced robust VEGF release, and its conditioned medium enhanced the proliferation and tubular formation of VECs with a concurrent increase in BMP-2 and IGF-1 production. Conditioned medium from activated VECs in turn promoted expression of osteogenic genes in BMSCs, followed by an increase in matrix mineralization. The addition of VEGF-R inhibitor Tivozanib to these systems abrogated the tension-induced paracrine effects on VECs and subsequently impaired BMSC osteogenesis. These results clearly demonstrate that the response of BMSCs to tension potentiates paracrine osteogenic signaling from VECs; this positive feedback loop is initiated by VEGF release.

Effect of capsaicin-sensitive sensory neurons on bone architecture and mechanical properties in the rat hindlimb suspension model

Background/Objective

The participation of sensory neural regulation in bone metabolism has been widely studied. However, the physiological role of sensory neural regulation in the functional adaptation to weight bearing is not clear. This study was conducted to investigate the effect of capsaicin-induced sensory neuron lesions on cancellous architecture properties in a hindlimb suspension (HLS) model.

Methods

Thirty-two female rats were randomly assigned to four groups. Groups b and d underwent systemic capsaicin treatment, whereas Groups a and c were treated with vehicle. Then, Groups c and d were subjected to HLS, whereas Groups a and b were allowed hindlimbs full loading. The proximal trabecular and mid-shaft cortical bone structure were evaluated via microcomputed tomography, and the biomechanical properties of the tibial mid-shaft were assessed using the four-point bending test.

Results

The trabecular bone volume was reduced by 40% and 50% in Groups b and c, respectively, and was also reduced significantly in Group d. Trabecular thickness and trabecular separation in Group b were not significantly different from those of Group a. The cortical bone area fraction showed no significant difference among all groups. Compared with Group a, the ultimate strength in Group b decreased by 20.3%, whereas it did not change significantly in Group c.

Conclusion

The results suggest that capsaicin-sensitive sensory neurons play an important role in bone modelling. The effect of capsaicin is similar to HLS. However, HLS has no add-on effect to capsaicin in the reduction of bone density and mechanical properties.

Translational potential of this article: This study gives clues to the function of sensory neurons in bone modelling.

A Concert between Biology and Biomechanics: The Influence of the Mechanical Environment on Bone Healing

In order to achieve consistent and predictable fracture healing, a broad spectrum of growth factors are required to interact with one another in a highly organized response. Critically important, the mechanical environment around the fracture site will significantly influence the way bone heals, or if it heals at all. The role of the various biological factors, the timing, and spatial relationship of their introduction, and how the mechanical environment orchestrates this activity, are all crucial aspects to consider. This review will synthesize decades of work and the acquired knowledge that has been used to develop new treatments and technologies for the regeneration and healing of bone. Moreover, it will discuss the current state of the art in experimental and clinical studies concerning the application of these mechano-biological principles to enhance bone healing, by controlling the mechanical environment under which bone regeneration takes place. This includes everything from the basic principles of fracture healing, to the influence of mechanical forces on bone regeneration, and how this knowledge has influenced current clinical practice. Finally, it will examine the efforts now being made for the integration of this research together with the findings of complementary studies in biology, tissue engineering, and regenerative medicine. By bringing together these diverse disciplines in a cohesive manner, the potential exists to enhance fracture healing and ultimately improve clinical outcomes.

Mechanobiology of bone remodeling and fracture healing in the aged organism

Bone can adapt to changing load demands by mechanically regulated bone remodeling. Osteocytes, osteoblasts, and mesenchymal stem cells are mechanosensitive and respond to mechanical signals through the activation of specific molecular signaling pathways. The process of bone regeneration after fracture is similarly and highly regulated by the biomechanical environment at the fracture site. Depending on the tissue strains, mesenchymal cells differentiate into fibroblasts, chondrocytes, or osteoblasts, determining the course and the success of healing. In the aged organism, mechanotransduction in both intact and fractured bones may be altered due to changed hormone levels and expression of growth factors and other signaling molecules. It is proposed that altered mechanotransduction may contribute to disturbed healing in aged patients. This review explains the basic principles of mechanotransduction in the bone and the fracture callus and summarizes the current knowledge on aging-induced changes in mechanobiology. Furthermore, the methods for external biomechanical stimulation of intact and fractured bones are discussed with respect to a possible application in the elderly patient.

Mechanosensitive Molecular Networks Involved in Transducing Resistance Exercise-Signals into Muscle Protein Accretion

Loss of skeletal muscle myofibrillar protein with disease and/or inactivity can severely deteriorate muscle strength and function. Strategies to counteract wasting of muscle myofibrillar protein are therefore desirable and invite for considerations on the potential superiority of specific modes of resistance exercise and/or the adequacy of low load resistance exercise regimens as well as underlying mechanisms. In this regard, delineation of the potentially mechanosensitive molecular mechanisms underlying muscle protein synthesis (MPS), may contribute to an understanding on how differentiated resistance exercise can transduce a mechanical signal into stimulation of muscle accretion. Recent findings suggest specific upstream exercise-induced mechano-sensitive myocellular signaling pathways to converge on mammalian target of rapamycin complex 1 (mTORC1), to influence MPS. This may e.g. implicate mechanical activation of signaling through a diacylglycerol kinase (DGKζ)-phosphatidic acid (PA) axis or implicate integrin deformation to signal through a Focal adhesion kinase (FAK)-Tuberous Sclerosis Complex 2 (TSC2)-Ras homolog enriched in brain (Rheb) axis. Moreover, since initiation of translation is reliant on mRNA, it is also relevant to consider potentially mechanosensitive signaling pathways involved in muscle myofibrillar gene transcription and whether some of these pathways converge with those affecting mTORC1 activation for MPS. In this regard, recent findings suggest how mechanical stress may implicate integrin deformation and/or actin dynamics to signal through a Ras homolog gene family member A protein (RhoA)-striated muscle activator of Rho signaling (STARS) axis or implicate deformation of Notch to affect Bone Morphogenetic Protein (BMP) signaling through a small mother of decapentaplegic (Smad) axis.

Mechanical stress regulates osteogenic differentiation and RANKL/OPG ratio in periodontal ligament stem cells by the Wnt/β-catenin pathway

BACKGROUND

The balance between osteoblastic and osteoclastic activity is critical in orthodontic tooth movement (OTM). Mesenchymal stem cells (MSCs) play an important role in maintaining bone homeostasis, and periodontal ligament stem cells (PDLSCs) are tissue-specific MSCs in the periodontal ligament. However, whether PDLSCs are required for periodontal tissue remodeling during OTM is not fully understood.

METHODS

Here, we used PDGFRα and Nestin to trace PDLSCs during OTM in rats. We treat human PDLSCs with 100kpa static pressure for 1h or 12h in vitro, and examined the phenotypic changes and expression of RANKL and OPG in these cells.

RESULTS

In vivo, we found that positive signals of PDGFRα and Nestin in the PDL gradually increased and then decreased on the pressure side to which pressure was applied. In vitro, the osteogenic differentiation of PDLSCs was significantly increased after force treatment for 1h relative to 12h. In contrast, the expression ratio of RANKL/OPG was reduced at 1h and significantly increased at 12h. Furthermore, we found that the Wnt/β-catenin pathway was dynamically activated in the PDL and in PDLSCs after mechanical stimulation. Importantly, the canonical Wnt pathway inhibitor DKK1 blocked the osteogenesis effect and rescued the ratio of RANKL/OPG in PDLSCs under force treatment for 1h.

CONCLUSIONS

Our findings reveal that PDLSCs participate in OTM and that the Wnt/β-catenin pathway maintains bone homeostasis during tooth movement by regulating the balance between osteoblastic and osteoclastic activity.

GENERAL SIGNIFICANCE

We describe a novel potential mechanism related to tooth movement.

Mechanotransduction: Relevance to Physical Therapist Practice-Understanding Our Ability to Affect Genetic Expression Through Mechanical Forces

Mechanotransduction, the mechanism by which mechanical perturbation influences genetic expression and cellular behavior, is an area of molecular biology undergoing rapid exploration and discovery. Cells are sensitive to forces such as shear, tension, and compression, and they respond accordingly through cellular proliferation, migration, tissue repair, altered metabolism, and even stem cell differentiation and maturation. The study of how cells sense and respond to mechanical stimulation is under robust expansion, with new scientific methods and technologies at our disposal. The application of these technologies to physical therapist practice may hold answers to some of our age-old questions while creating new avenues for our profession to optimize movement for societal health. Embracing this science as foundational to our profession will allow us to be valuable scientific collaborators with distinctive knowledge of the effects of loading. These partnerships will be key to augmenting the clinical utility of emerging therapies such as regenerative medicine, tissue engineering, and gene therapy. Collaboration with other scientific disciplines in these endeavors, along with the inclusion and application of these discoveries in our academic programs, will enhance the understanding of the impact of our practice on biologic and genetic processes. A basic understanding of mechanotransduction and its relevance to physical therapist practice is warranted to begin the conversation.

Megakaryocytic Maturation in Response to Shear Flow Is Mediated by the Activator Protein 1 (AP-1) Transcription Factor via Mitogen-activated Protein Kinase (MAPK) Mechanotransduction

Megakaryocytes (MKs) are exposed to shear flow as they migrate from the bone marrow hematopoietic compartment into circulation to release pro/preplatelets into circulating blood. Shear forces promote DNA synthesis, polyploidization, and maturation in MKs, and platelet biogenesis. To investigate mechanisms underlying these MK responses to shear, we carried out transcriptional analysis on immature and mature stem cell-derived MKs exposed to physiological shear. In immature (day (d)9) MKs, shear exposure up-regulated genes related to growth and MK maturation, whereas in mature (d12) MKs, it up-regulated genes involved in apoptosis and intracellular transport. Following shear-flow exposure, six activator protein 1 (AP-1) transcripts (ATF4,JUNB,JUN,FOSB,FOS, andJUND) were up-regulated at d9 and two AP-1 proteins (JunD and c-Fos) were up-regulated both at d9 and d12. We show that mitogen-activated protein kinase (MAPK) signaling is linked to both the shear stress response and AP-1 up-regulation. c-Jun N-terminal kinase (JNK) phosphorylation increased significantly following shear stimulation, whereas JNK inhibition reduced shear-induced JunD expression. Although p38 phosphorylation did not increase following shear flow, its inhibition reduced shear-induced JunD and c-Fos expression. JNK inhibition reduced fibrinogen binding and P-selectin expression of d12 platelet-like particles (PLPs), whereas p38 inhibition reduced fibrinogen binding of d12 PLPs. AP-1 expression correlated with increased MK DNA synthesis and polyploidization, which might explain the observed impact of shear on MKs. To summarize, we show that MK exposure to shear forces results in JNK activation, AP-1 up-regulation, and downstream transcriptional changes that promote maturation of immature MKs and platelet biogenesis in mature MKs.

Quick benefits of interval training versus continuous training on bone: a dual-energy X-ray absorptiometry comparative study

To delay age-related bone loss, physical activity is recommended during growth. However, it is unknown whether interval training is more efficient than continuous training to increase bone mass both quickly and to a greater extent. The aim of this study was to compare the effects of a 10-week interval training regime with a 14-week continuous training regime on bone mineral density (BMD). Forty-four male Wistar rats (8 weeks old) were separated into four groups: control for 10 weeks (C10), control for 14 weeks (C14), moderate interval training for 10 weeks (IT) and moderate continuous training for 14 weeks (CT). Rats were exercised 1 h/day, 5 day/week. Body composition and BMD of the whole body and femur respectively were assessed by dual-energy X-ray absorptiometry at baseline and after training to determine raw gain and weight-normalized BMD gain. Both trained groups had lower weight and fat mass gain when compared to controls. Both trained groups gained more BMD compared to controls when normalized to body weight. Using a 30% shorter training period, the IT group showed more than 20% higher whole body and femur BMD gains compared to the CT. Our data suggest that moderate IT was able to produce faster bone adaptations than moderate CT.

Does running strengthen bone?

Bone is a living tissue needing mechanical stress to maintain strength. Traditional endurance exercises offer only modest effects on bone. Walking and running produce low impact but lead to bone fatigue. This article is specifically addressed to therapists and explains the mechanisms involved for the effects of exercise on bone. Intermittent exercise limits bone fatigue, and downhill exercises increase ground impact forces and involve eccentric muscle contractions, which are particularly osteogenic.

Comprehensive Review of Adipose Stem Cells and Their Implication in Distraction Osteogenesis and Bone Regeneration

Bone is one of the most dynamic tissues in the human body that can heal following injury without leaving a scar. However, in instances of extensive bone loss, this intrinsic capacity of bone to heal may not be sufficient and external intervention becomes necessary. Several techniques are available to address this problem, including autogenous bone grafts and allografts. However, all these techniques have their own limitations. An alternative method is the technique of distraction osteogenesis, where gradual and controlled distraction of two bony segments after osteotomy leads to induction of new bone formation. Although distraction osteogenesis usually gives satisfactory results, its major limitation is the prolonged duration of time required before the external fixator is removed, which may lead to numerous complications. Numerous methods to accelerate bone formation in the context of distraction osteogenesis have been reported. A viable alternative to autogenous bone grafts for a source of osteogenic cells is mesenchymal stem cells from bone marrow. However, there are certain problems with bone marrow aspirate. Hence, scientists have investigated other sources for mesenchymal stem cells, specifically adipose tissue, which has been shown to be an excellent source of mesenchymal stem cells. In this paper, the potential use of adipose stem cells to stimulate bone formation is discussed.

Dynamic fluid flow induced mechanobiological modulation of in situ osteocyte calcium oscillations

Distribution of intramedullary pressure (ImP) induced bone fluid flow has been suggested to influence the magnitude of mechanotransductory signals within bone. As osteocytes have been suggested as major mechanosensors in bone network, it is still unclear how osteocytes embedded within a mineralized bone matrix respond to the external mechanical stimuli derived from direct coupling of dynamic fluid flow stimulation (DFFS). While in vitro osteocytes show unique Ca(2+) oscillations to fluid shear, the objective of this study was to use a confocal imaging technique to visualize and quantify Ca(2+) responses in osteocytes in situ under DFFS into the marrow cavity of an intact ex vivo mouse femur. This study provided significant technical development for evaluating mechanotransduction mechanism in bone cell response by separation of mechanical strain and fluid flow factors using ImP stimulation, giving the ability for true real-time imaging and monitoring of bone cell activities during the stimulation. Loading frequency dependent Ca(2+) oscillations in osteocytes indicated the optimized loading at 10Hz, where such induced response was significantly diminished via blockage of the Wnt/β-catenin signaling pathway. The results provided a pilot finding of the potential crosstalk or interaction between Wnt/β-catenin signaling and Ca(2+) influx signaling of in situ osteocytes in response to mechanical signals. Findings from the present study make a valuable tool to investigate how in situ osteocytes respond and transduce mechanical signals, e.g. DFFS, as a central mechanosensor.