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Yang G, Liu K, Ma S, Qi P. PPARγ inhibition promotes osteogenic differentiation of bone marrow mesenchymal stem cells and fracture healing. J Cell Biochem 2024; 125:e30568. [PMID: 38616655 DOI: 10.1002/jcb.30568] [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: 01/17/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
This study aimed to explore the effects of peroxisome proliferator-activated receptor γ (PPARγ) inhibition on fracture healing of nonunion and the underlying mechanisms. Bone marrow mesenchymal stem cells (BMSCs) were treated with PPARγ antagonist GW9662 (5 μM, 10 μM). Alkaline phosphatase (ALP) staining and Alizarin Red S was used to assess early stage of osteogenesis and osteogenic differentiation. GW9662 (1 mg/kg/day) were administered intraperitoneally into the rats with bone fracture. Bone healing processes in the rat femur fracture model were recorded and assessed by radiographic methods on Weeks 8, 14, and 20 postoperation. Osteogenesis and angiogenesis at the fracture sites were evaluated by radiographic and histological methods on postoperative Week 20. GW9662 treatment increased ALP activity and Alp mRNA expression in rat BMSCs. Moreover, GW9662 administration increased matrix mineralization and mRNA and protein levels of Bmp2 and Runx2 in the BMSCs. In addition, GW9662 treatment improved radiographic score in the fracture rats and increased osteogenesis-related proteins, including type I collagen, osteopontin, and osteoglycin, in the bone tissues of the fracture sites. In conclusion, PPARγ inhibition promotes osteogenic differentiation of rat BMSCs, as well as improves the fracture healing of rats through Bmp2/Runx2 signaling pathway in the rat model of bone fracture.
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Affiliation(s)
- Guohui Yang
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Kexi Liu
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shengli Ma
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Peiyi Qi
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Gaddi D, Gatti SD, Piatti M, Poli A, De Rosa L, Riganti A, Zatti G, Bigoni M, Turati M. Non-Union Scoring System (NUSS): Is It Enough in Clinical Practice? Indian J Orthop 2022; 57:137-145. [PMID: 36655209 PMCID: PMC9789216 DOI: 10.1007/s43465-022-00767-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Bone consolidation defects represent a real orthopedic challenge because of the absence of validated treatment guidelines that can assist the surgeon in his choices. The aim of this study is to evaluate the appropriateness of the Non-Union Scoring System NUSS treatment protocol in the management of long bone non-unions by comparing it to the experience-based therapeutic approach carried out in our facility. MATERIALS AND METHODS We conducted a comparative outcome study of a retrospective series of 89 patients surgically treated for long bone non-union in our facility vs. clinical results reported by Calori et al. obtained following the NUSS treatment protocol. RESULTS Radiographic healing was reached in 13/13 non-unions (100%) in group NUSS 1, in 58/62 (93.5%) in group NUSS 2, and in 13/14 (92.9%) in group NUSS 3. The mean time to radiographic healing was 5.69 ± 2.09 months in group 1, 7.38 ± 3.81 months in group 2 and 9.23 ± 2.31 months in group 3. 91% of patients in group I, 69% in group II and 48% in group III received what would be considered by the NUSS treatment protocol an "overtreatment", especially from a biological stand point. The comparative outcome analysis shows that our case series achieved significantly higher global healing rates (p value = 0.017) and shorter radiological healing times in groups NUSS 1 and 2 (p value < 0.001). CONCLUSION From the results obtained, we can assume that the NUSS treatment protocol might underestimate the necessary therapies, particularly from a biological point of view.
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Affiliation(s)
- Diego Gaddi
- Department of Orthopedic Surgery, Policlinico San Pietro, Strada Statale 18, 23826 IT Mandello del Lario, LC Italy
| | - Simone D. Gatti
- School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy
| | - Massimiliano Piatti
- Department of Orthopedic Surgery, Policlinico San Pietro, Strada Statale 18, 23826 IT Mandello del Lario, LC Italy
| | - Andrea Poli
- Orthopedic Department, Carate Brianza Hospital, Via Don Luigi Monza 14/B Carate B.Za, 23900 IT Lecco, LC Italy
| | - Laura De Rosa
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy ,School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy
| | - Andrea Riganti
- Department of Economics, Management and Quantitative Methods, University of Milano Statale, Via Speri Della Chiesa 28, 21100 IT Milan, VA Italy
| | - Giovanni Zatti
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy ,School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy
| | - Marco Bigoni
- School of Medicine and Surgery, University of Milano-Bicocca, Via Rismondo 62, Seregno, 20831 IT Monza, MB Italy ,Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Hospital Couple Enfant, Via Marcona 15, 20100 IT Grenoble, MI France ,Department of Orthopedic Surgery, Policlinico San Pietro, Strada Statale 18, 23826 IT Mandello del Lario, LC Italy
| | - Marco Turati
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy ,Department of Paediatric Orthopedic Surgery, Hospital Couple Enfants, Grenoble Alpes University, Via Filzi 34, Giussano, 20833 IT Grenoble, MB France ,School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy
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Gaddi D, Mosca A, Piatti M, Munegato D, Catalano M, Di Lorenzo G, Turati M, Zanchi N, Piscitelli D, Chui K, Zatti G, Bigoni M. Acute Ankle Sprain Management: An Umbrella Review of Systematic Reviews. Front Med (Lausanne) 2022; 9:868474. [PMID: 35872766 PMCID: PMC9301067 DOI: 10.3389/fmed.2022.868474] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/27/2022] [Indexed: 12/26/2022] Open
Abstract
Even though ankle sprains are among the most frequent musculoskeletal injuries seen in emergency departments, management of these injuries continues to lack standardization. Our objective was to carry out an umbrella review of systematic reviews to collect the most effective evidence-based treatments and to point out the state-of-the-art management for this injury. PubMed, Scopus, Web of Science, and the Cochrane library were searched from January 2000 to September 2020. After removing duplicates and applying the eligibility criteria, based on titles and abstracts, 32 studies were screened. At the end of the process, 24 articles were included in this umbrella review with a mean score of 7.7/11 on the AMSTAR quality assessment tool. We found evidence supporting the effectiveness of non-surgical treatment in managing acute ankle sprain; moreover, functional treatment seems to be preferable to immobilization. We also found evidence supporting the use of paracetamol or opioids as effective alternatives to non-steroidal anti-inflammatory drugs to reduce pain. Furthermore, we found evidence supporting the effectiveness of manipulative and supervised exercise therapy to prevent re-injury and restore ankle dorsiflexion.
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Affiliation(s)
- Diego Gaddi
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Angelo Mosca
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Massimiliano Piatti
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Daniele Munegato
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Marcello Catalano
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giorgia Di Lorenzo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Turati
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Paediatric Orthopedic Surgery, University Hospital Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Hospital Couple Enfant, Grenoble, France
- *Correspondence: Marco Turati
| | - Nicolò Zanchi
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Daniele Piscitelli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Kevin Chui
- Department of Physical Therapy, Waldron College of Health and Human Services, Radford University, Roanoke, VA, United States
| | - Giovanni Zatti
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Hospital Couple Enfant, Grenoble, France
| | - Marco Bigoni
- Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Hospital Couple Enfant, Grenoble, France
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