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Hart DA. Regulation of Bone by Mechanical Loading, Sex Hormones, and Nerves: Integration of Such Regulatory Complexity and Implications for Bone Loss during Space Flight and Post-Menopausal Osteoporosis. Biomolecules 2023; 13:1136. [PMID: 37509172 PMCID: PMC10377148 DOI: 10.3390/biom13071136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
During evolution, the development of bone was critical for many species to thrive and function in the boundary conditions of Earth. Furthermore, bone also became a storehouse for calcium that could be mobilized for reproductive purposes in mammals and other species. The critical nature of bone for both function and reproductive needs during evolution in the context of the boundary conditions of Earth has led to complex regulatory mechanisms that require integration for optimization of this tissue across the lifespan. Three important regulatory variables include mechanical loading, sex hormones, and innervation/neuroregulation. The importance of mechanical loading has been the target of much research as bone appears to subscribe to the "use it or lose it" paradigm. Furthermore, because of the importance of post-menopausal osteoporosis in the risk for fractures and loss of function, this aspect of bone regulation has also focused research on sex differences in bone regulation. The advent of space flight and exposure to microgravity has also led to renewed interest in this unique environment, which could not have been anticipated by evolution, to expose new insights into bone regulation. Finally, a body of evidence has also emerged indicating that the neuroregulation of bone is also central to maintaining function. However, there is still more that is needed to understand regarding how such variables are integrated across the lifespan to maintain function, particularly in a species that walks upright. This review will attempt to discuss these regulatory elements for bone integrity and propose how further study is needed to delineate the details to better understand how to improve treatments for those at risk for loss of bone integrity, such as in the post-menopausal state or during prolonged space flight.
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Affiliation(s)
- David A Hart
- Department of Surgery, Faculty of Kinesiology, and McCaig Institute for Bone & Joint Research, University of Calgary, Calgary, AB T2N 4N1, Canada
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Kübler IC, Kretzschmar J, Brankatschk M, Sandoval-Guzmán T. Local problems need global solutions: The metabolic needs of regenerating organisms. Wound Repair Regen 2022; 30:652-664. [PMID: 35596643 PMCID: PMC7613859 DOI: 10.1111/wrr.13029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 12/01/2022]
Abstract
The vast majority of species that belong to the plant or animal kingdom evolved with two main strategies to counter tissue damage-scar formation and regeneration. Whereas scar formation provides a fast and cost-effective repair to exit life-threatening conditions, complete tissue regeneration is time-consuming and requires vast resources to reinstall functionality of affected organs or structures. Local environments in wound healing are widely studied and findings have provided important biomedical applications. Less well understood are organismic physiological parameters and signalling circuits essential to maintain effective tissue repair. Here, we review accumulated evidence that positions the interplay of local and systemic changes in metabolism as essential variables modulating the injury response. We particularly emphasise the role of lipids and lipid-like molecules as significant components long overlooked.
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Affiliation(s)
- Ines C. Kübler
- Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany
| | - Jenny Kretzschmar
- MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Cambridge, UK
| | - Marko Brankatschk
- Department of Molecular, Cell and Developmental Biology, Technische Universität Dresden, Dresden, Germany
| | - Tatiana Sandoval-Guzmán
- Department of Internal Medicine III, Center for Healthy Aging, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of Helmholtz Centre Munich, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Lewis L, Borg S, Alison L, Hardisty H, Parry-Okeden S, Kerrin D, Chadha L, Roberts K, Shabani K, Offiah AC, Bishop NJ. Parathyroid hormone changes in infants investigated for inflicted injury; an observational retrospective single centre cohort study. CHILD ABUSE & NEGLECT 2022; 131:105775. [PMID: 35803027 DOI: 10.1016/j.chiabu.2022.105775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/09/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Biochemical and haematological testing is recommended in the United Kingdom when inflicted injury is suspected. We examined the associations of test results with radiologically-confirmed fracture(s), and between test results, in a large retrospective observational cohort. METHODS Infants up to age two years presenting with suspected inflicted injury, without clinically or radiologically apparent bone disease, and where a skeletal survey was undertaken during the period 1st August 2013 to 31st December 2020, were included. Biochemical parameters: corrected calcium (cCa); phosphate (P); alkaline phosphatase (ALP); parathyroid hormone (PTH); 25-hydroxyvitamin D (25D); and haematological parameters: haemoglobin (Hb); mean corpuscular haemoglobin (MCH); mean corpuscular haemoglobin content (MCHC); mean corpuscular volume (MCV); platelet count were collated together with the results of the radiological assessments. FINDINGS Of 332 eligible infants (190 male), 142 (84 male) had fracture(s) and/or intracranial injury. Mean PTH in the non-fracture group (n measured 50/190) was 27.3 ng/l; in those with intracranial injury alone (n measured 9/23) was 39.4 ng/l; in those with fracture alone (n measured 62/84) was 45.0 ng/l; and in those with fracture and intracranial injury (n measured 20/35) 51.8 ng/l. F-test of multiple means = 0.0369. There was no difference in 25D between the groups. INTERPRETATION PTH was raised in infants who had fracture(s), intracranial injury or both. A single raised PTH may not necessarily be an indicator of prior disturbed skeletal health in these circumstances. The relevance of vitamin D status and interpretation of data from biochemical testing should be informed by the overall presentation in suspected inflicted injury cases. A single raised PTH may be a consequence of the child's injuries rather than prior disturbed bone health.
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Affiliation(s)
- L Lewis
- Sheffield Children's NHS Foundation Trust, Sheffield, UK; Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK
| | - S Borg
- Sheffield Children's NHS Foundation Trust, Sheffield, UK; Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - L Alison
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - H Hardisty
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - S Parry-Okeden
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - D Kerrin
- Barnsley NHS Foundation Trust, UK
| | - L Chadha
- Doncaster and Bassetlaw NHS Foundation Trust, UK
| | - K Roberts
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - K Shabani
- The Rotherham NHS Foundation Trust, UK
| | - A C Offiah
- Sheffield Children's NHS Foundation Trust, Sheffield, UK; Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - N J Bishop
- Sheffield Children's NHS Foundation Trust, Sheffield, UK; Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
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Sarı A, Dinçel YM, Çetin MÜ, İnan S. Can fracture healing be accelerated by serum transfer in head trauma cases? An experimental head trauma model in rats. Jt Dis Relat Surg 2021; 32:306-312. [PMID: 34145805 PMCID: PMC8343832 DOI: 10.52312/jdrs.2021.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/28/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives
In this study, we aimed to investigate whether the positive union effect caused by head trauma could be transferred between individuals. Materials and methods
Seventy-two male rats with an average weight of 375 g were used in this study and divided into four groups including 18 in each group. Group 1 consisted of serum donor rats that were exposed to head trauma, while Group 2 consisted of study rats with long bone fractures that were given the serum obtained from the rats in Group 1, Group 3 included control rats with isolated long bone fractures, and Group 4 included control rats with both head trauma and long bone fractures. For radiological evaluation, the ratio of the width of the callus to the width of the neighboring diaphysis was considered as the callus-to- diaphyseal ratio in the study and control groups. Histopathological and radiological evaluations was made on Days 10, 20, and 30. Results
In evaluation of the radiological data regarding the callus- to-diaphyseal ratio, Group 3 was found to have significantly lower radiological values than Group 4 on Day 10 (p=0.006). Group 2 had significantly higher values than Group 3 (p=0.02). On Day 20, Group 2 exhibited significantly higher radiological values than Group 3 (p=0.004), but lower than Group 4 (p=0.032). As for Day 30, Group 2 exhibited significantly higher radiological values than Group 3, but lower than Group 4 (p=0.001). In the evaluation of the Huo scores obtained for histopathological evaluation, there was no significant difference among the groups on Days 10, 20, and 30 (p=0.295, p=0.569, and p=0.729, respectively). Conclusion
Our study results suggest that the osteoinductive effect after head trauma can be transmitted between individuals by means of serum transfer.
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Affiliation(s)
- Abdülkadir Sarı
- Namık Kemal Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 59030 Tekirdağ, Türkiye.
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Suprascapular nerve neuropathy leads to supraspinatus tendon degeneration. J Orthop Sci 2020; 25:588-594. [PMID: 31718907 DOI: 10.1016/j.jos.2019.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/20/2019] [Accepted: 09/20/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nowadays most of attention regarding rotator cuff is payed to how to reduce the failure after rotator cuff surgical repair rather than how to prevent the rotator cuff tear before surgery. The etiologies of rotator cuff tear are still unclear. As we all know, the nerve system include brain, spinal cord, sensory organs and all the neurons allover our body coordinates the homoeostasis of our body. We hypothesis that the nerve injury proximal to suprascapular nerve can leads to rotator cuff degeneration even tear. METHODS Thirty-six SD rats were used. A defect on the suprascapular nerve was made on the right side and a sham surgery on the nerve (expose nerve only) at the left side. The insertion of supraspinatus tendon and supraspinatus muscle were harvested for testing. Twelve rats were sacrificed for biomechanical (six rats) and histological (six rats) properties were evaluated at 3, 6, and 9 weeks after surgery, respectively. RESULTS Significant inferior biomechanical properties of rotator cuff were found in nerve injured side compared to the nerve intact side at 6-9 weeks. Significant muscle atrophy was found at nerve injured side from 3 to 9 weeks. The enthesis of nerve injured side showed significant excessive cell maturity, reduced cellularity, smaller metachromasia area and more type-III collagen especially at 9 weeks after surgery. CONCLUSIONS The neuropathy proximal to suprascapular nerve can leads to rotator cuff degeneration even tear. The nerve dysfunction maybe an important etiology for rotator cuff tear.
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Hofman M, Andruszkow H, Heyer FL, Kobbe P, Hildebrand F, Poeze M. Risk factors of non-union in intramedullary stabilized diaphyseal long bone fractures: identifying the role of fracture stabilization strategies and concomitant injuries. Eur J Trauma Emerg Surg 2020; 47:1903-1910. [PMID: 32140749 PMCID: PMC8629802 DOI: 10.1007/s00068-020-01335-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/18/2020] [Indexed: 12/01/2022]
Abstract
Purpose Concomitant chest injury is known to negatively affect bone metabolism and fracture healing, whereas traumatic brain injury (TBI) appears to have positive effects on bone metabolism. Osteogenesis can also be influenced by the timing of fracture stabilization. We aimed to identify how chest injuries, TBI and fracture stabilization strategy influences the incidence of non-union. Methods Patients with long bone fractures of the lower extremities who had been treated between 2004 and 2014 were retrospectively analysed. Non-union was defined as fracture healing not occurring in the expected time period and in which neither progression of healing nor successful union is expected without intervention. Diverse clinical and radiological parameters were statistically analysed using the Statistical Package for the Social Sciences (SPSS). Results The total number of operations before consolidation was an independent predictor (odds ratio [OR] = 6.416, p < 0.001) for the development of non-union in patients with long bone fractures. More specifically, patients treated according to the damage control orthopaedics (DCO) principle had a significantly higher risk of developing a non-union than patients treated according to the early total care (ETC) principle (OR = 7.878, p = 0.005). Concomitant chest injury and TBI could not be identified as influencing factors for non-union development. Conclusion Our results indicate that the number of operations performed in patients with long bone fractures should be kept as low as possible and that the indication for and the timing of DCO treatment should be meticulously noted to minimize the risk of non-union development.
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Affiliation(s)
- Martijn Hofman
- Department of Orthopedic Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Hagen Andruszkow
- Department of Orthopedic Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Frans L. Heyer
- Division of Traumasurgery,, Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Philipp Kobbe
- Department of Orthopedic Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopedic Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Martijn Poeze
- Division of Traumasurgery,, Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
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Sahin A, Turkmen S, Guzel N, Mentese A, Turedi S, Karahan SC, Yulug E, Demir S, Aynaci O, Deger O, Gunduz A. A Comparison of the Effects of Grayanotoxin-Containing Honey (Mad Honey), Normal Honey, and Propolis on Fracture Healing. Med Princ Pract 2018; 27:99-106. [PMID: 29428933 PMCID: PMC5968227 DOI: 10.1159/000487552] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 02/11/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Delayed healing and non-union of fractures have a significant effect upon patient morbidity. Studies have therefore largely concentrated on accelerating fracture healing. This study was intended to compare the effect of "mad honey" and propolis on fracture healing using radiological and histopathological analysis. SUBJECTS AND METHODS Femur fracture was surgically performed on 48 rats, followed by fixation. Animals were then divided into 8 groups: 2 control groups (15- and 30-day) and 6 treatment groups (15- and 30-day normal honey, 15- and 30-day "mad honey," and 15- and 30-day propolis). Rats were sacrificed at the end of these periods, and radiological and histological examinations were performed. RESULTS Radiological healing in the propolis group after 15-day therapy was statistically better than in the control (p = 0.004) and normal honey (p = 0.006) groups. After 30-day therapy, healing in the propolis group (p = 0.005) and grayanotoxin-containing "mad honey" group (p = 0.007) were significantly better than in the control group. Histologically, there was a statistically significant difference between the 15-day propolis group and the other groups (control, honey, mad honey: p = 0.003, p = 0.003, and p = 0.002, respectively). We also found a statistically significant difference when the 30-day propolis group (p = 0.005) and "mad honey" group (p = 0.007) were compared to the control group. CONCLUSIONS This study shows that grayanotoxin-containing "mad honey" and propolis can accelerate fracture healing.
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Affiliation(s)
- Aynur Sahin
- Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
- *Aynur Sahin, Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, TR-61080 Trabzon (Turkey), E-Mail
| | - Suha Turkmen
- Department of Emergency Medicine, Faculty of Medicine, Acıbadem University, Istanbul, Turkey
| | - Nizamettin Guzel
- Department of Orthopaedics and Traumatology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ahmet Mentese
- Department of Biochemistry, Faculty of Medicine, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Suleyman Turedi
- Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Suleyman Caner Karahan
- Department of Biochemistry, Faculty of Medicine, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Esin Yulug
- Department of Histology and Embryology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Selim Demir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | - Osman Aynaci
- Department of Orthopaedics and Traumatology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Orhan Deger
- Department of Biochemistry, Faculty of Medicine, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Abdulkadir Gunduz
- Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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