1
|
Yan C, Jin G, Li L. Spinal scoliosis: insights into developmental mechanisms and animal models. Spine Deform 2024:10.1007/s43390-024-00941-9. [PMID: 39164474 DOI: 10.1007/s43390-024-00941-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024]
Abstract
Spinal scoliosis, a prevalent spinal deformity impacting both physical and mental well-being, has a significant genetic component, though the exact pathogenic mechanisms remain elusive. This review offers a comprehensive exploration of current research on embryonic spinal development, focusing on the genetic and biological intricacies governing axial elongation and straightening. Zebrafish, a vital model in developmental biology, takes a prominent role in understanding spinal scoliosis. Insights from zebrafish studies illustrate genetic and physiological aspects, including notochord development and cerebrospinal fluid dynamics, revealing the anomalies contributing to scoliosis. In this review, we acknowledge existing challenges, such as deciphering the unique dynamics of human spinal development, variations in physiological curvature, and disparities in cerebrospinal fluid circulation. Further, we emphasize the need for caution when extrapolating findings to humans and for future research to bridge current knowledge gaps. We hope that this review will be a beneficial frame of reference for the guidance of future studies on animal models and genetic research for spinal scoliosis.
Collapse
Affiliation(s)
- Chongnan Yan
- Department of Spine Surgery, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Guoxin Jin
- Department of Spine Surgery, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Lei Li
- Department of Spine Surgery, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
| |
Collapse
|
2
|
Farag HI, Murphy BA, Templeman JR, Hanlon C, Joshua J, Koch TG, Niel L, Shoveller AK, Bedecarrats GY, Ellison A, Wilcockson D, Martino TA. One Health: Circadian Medicine Benefits Both Non-human Animals and Humans Alike. J Biol Rhythms 2024; 39:237-269. [PMID: 38379166 PMCID: PMC11141112 DOI: 10.1177/07487304241228021] [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] [Indexed: 02/22/2024]
Abstract
Circadian biology's impact on human physical health and its role in disease development and progression is widely recognized. The forefront of circadian rhythm research now focuses on translational applications to clinical medicine, aiming to enhance disease diagnosis, prognosis, and treatment responses. However, the field of circadian medicine has predominantly concentrated on human healthcare, neglecting its potential for transformative applications in veterinary medicine, thereby overlooking opportunities to improve non-human animal health and welfare. This review consists of three main sections. The first section focuses on the translational potential of circadian medicine into current industry practices of agricultural animals, with a particular emphasis on horses, broiler chickens, and laying hens. The second section delves into the potential applications of circadian medicine in small animal veterinary care, primarily focusing on our companion animals, namely dogs and cats. The final section explores emerging frontiers in circadian medicine, encompassing aquaculture, veterinary hospital care, and non-human animal welfare and concludes with the integration of One Health principles. In summary, circadian medicine represents a highly promising field of medicine that holds the potential to significantly enhance the clinical care and overall health of all animals, extending its impact beyond human healthcare.
Collapse
Affiliation(s)
- Hesham I. Farag
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Centre for Cardiovascular Investigations, University of Guelph, Guelph, ON, Canada
| | - Barbara A. Murphy
- School of Agriculture and Food Science, University College, Dublin, Ireland
| | - James R. Templeman
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
| | - Charlene Hanlon
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
- Department of Poultry Science, Auburn University, Auburn, Alabama, USA
| | - Jessica Joshua
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Thomas G. Koch
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Lee Niel
- Department of Pathobiology, University of Guelph, Guelph, ON, Canada
| | - Anna K. Shoveller
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
| | | | - Amy Ellison
- School of Natural Sciences, Bangor University, Bangor, UK
| | - David Wilcockson
- Department of Life Sciences, Aberystwyth University, Aberystwyth, UK
| | - Tami A. Martino
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Centre for Cardiovascular Investigations, University of Guelph, Guelph, ON, Canada
| |
Collapse
|
3
|
Ugur F, Topal K, Albayrak M, Taskin R. Pediatric Sleep Questionnaire for Sleep Apnea in Newly Diagnosed Adolescent Idiopathic Scoliosis Patients. Healthcare (Basel) 2023; 11:2506. [PMID: 37761703 PMCID: PMC10531247 DOI: 10.3390/healthcare11182506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Close association has been established between obstructive sleep apnea (OSA) and adolescent idiopathic scoliosis (AIS), with PSQ being employed as a screening method for OSA. A cross-sectional study was conducted among patients aged from 10 to 16 years who presented to a scoliosis outpatient clinic. Patient demographics, radiological assessments, and PSQ scores were gathered. A total of 299 patients were included in the study, with 28.7% males and 71.2% females. The average Cobb angle was 6.20°. PSQ scores revealed a prevalence of 33.4% for significant obstructive sleep apnea. Patients diagnosed with AIS exhibited a prevalence of 32.9% with positive PSQ results. Among those undergoing adenoid and/or tonsil surgery, 27% had positive PSQ scores. Factors such as genetics, abnormal biomechanical forces, environmental factors including melatonin, and intermittent hypoxia were explored for their potential contribution to AIS etiology. The aim of the study is to underscore the importance of early detection and intervention in OSA cases and highlights the effectiveness of the PSQ, as a screening tool in identifying sleep disorders. The findings underscore the complex relationship between OSA and AIS, and moreover any spinal curvature is in relation with OSA.
Collapse
Affiliation(s)
- Fatih Ugur
- Department of Orthopaedics and Traumatology, Kastamonu University Faculty of Medicine, Kastamonu 37150, Türkiye;
| | - Kubra Topal
- Private Practice, Department of Otorhinolaryngology, Private Clinic, Kastamonu 37100, Türkiye;
| | - Mehmet Albayrak
- Department of Orthopaedics and Traumatology, Ozel Tekirdag Yasam Hospital, Tekirdag 59020, Türkiye;
| | - Recep Taskin
- Department of Orthopaedics and Traumatology, Kastamonu University Faculty of Medicine, Kastamonu 37150, Türkiye;
| |
Collapse
|
4
|
The role of pineal gland volume in the development 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 2023; 32:181-189. [PMID: 36374335 DOI: 10.1007/s00586-022-07452-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/17/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is believed to be caused by genetic, neurological, osseous growth anomalies, histological variables including muscle fiber percentage and core structure changes, metabolic and hormonal dysfunction, vestibular dysfunction, and platelet microarchitecture. The objective of this study was to contribute to the determination of the cause of AIS by analyzing the changes in pineal gland volume in AIS cases. METHODS Study (AIS) and control group were each comprised of 26 patients who met the inclusion requirements. Scoliosis radiograph and MRI of the pineal glands were used for radiological examinations. The distribution of age, gender, Risser grading for skeletal radiological development, and sexual maturation according to Tanner categorization were uniform and statistically insignificant between groups. RESULTS When the pineal gland volumes of the cases were evaluated according to age, the AIS group was found to have significantly reduced pineal gland volumes in all age groups. The pineal gland volume was found to be 38.1% lower in the AIS group compared to the control group (p˂0.001). In the AIS group, patients aged 13 years had the lowest pineal gland volume (77.2 ± 13.86 mm3), while patients aged 15 years had the highest volume (97.9 ± 16.47 mm3). CONCLUSION Changes in pineal gland volume support the role of the pineal gland in the etiopathogenesis of AIS.
Collapse
|
5
|
Terhune EA, Monley AM, Cuevas MT, Wethey CI, Gray RS, Hadley-Miller N. Genetic animal modeling for idiopathic scoliosis research: history and considerations. Spine Deform 2022; 10:1003-1016. [PMID: 35430722 DOI: 10.1007/s43390-022-00488-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 02/19/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Idiopathic scoliosis (IS) is defined as a structural lateral spinal curvature ≥ 10° in otherwise healthy children and is the most common pediatric spinal deformity. IS is known to have a strong genetic component; however, the underlying etiology is still largely unknown. Animal models have been used historically to both understand and develop treatments for human disease, including within the context of IS. This intended audience for this review is clinicians in the fields of musculoskeletal surgery and research. METHODS In this review article, we synthesize current literature of genetic animal models of IS and introduce considerations for researchers. RESULTS Due to complex genetic and unique biomechanical factors (i.e., bipedalism) hypothesized to contribute to IS in humans, scoliosis is a difficult condition to replicate in model organisms. CONCLUSION We advocate careful selection of animal models based on the scientific question and introduce gaps and limitations in the current literature. We advocate future research efforts to include animal models with multiple characterized genetic or environmental perturbations to reflect current understanding of the human condition.
Collapse
Affiliation(s)
- Elizabeth A Terhune
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12800 E 19th Ave., P18-3105, MS 8343, Aurora, CO, 80045, USA
| | - Anna M Monley
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12800 E 19th Ave., P18-3105, MS 8343, Aurora, CO, 80045, USA.,Musculoskeletal Research Center, Children's Hospital Colorado, Aurora, CO, 80045, USA
| | - Melissa T Cuevas
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12800 E 19th Ave., P18-3105, MS 8343, Aurora, CO, 80045, USA
| | - Cambria I Wethey
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12800 E 19th Ave., P18-3105, MS 8343, Aurora, CO, 80045, USA
| | - Ryan S Gray
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Nancy Hadley-Miller
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12800 E 19th Ave., P18-3105, MS 8343, Aurora, CO, 80045, USA. .,Musculoskeletal Research Center, Children's Hospital Colorado, Aurora, CO, 80045, USA.
| |
Collapse
|
6
|
Munmun F, Mohiuddin OA, Hoang VT, Burow ME, Bunnell BA, Sola VM, Carpentieri AR, Witt-Enderby PA. The role of MEK1/2 and MEK5 in melatonin-mediated actions on osteoblastogenesis, osteoclastogenesis, bone microarchitecture, biomechanics, and bone formation. J Pineal Res 2022; 73:e12814. [PMID: 35674448 DOI: 10.1111/jpi.12814] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/30/2022] [Accepted: 05/11/2022] [Indexed: 12/11/2022]
Abstract
Melatonin, the primary hormone involved in circadian entrainment, plays a significant role in bone physiology. This study aimed to assess the role of MEK1/2 and MEK5 in melatonin-mediated actions in mouse and human mesenchymal stem cells (MSCs) and on bone using small-molecule inhibitors and CRISPR/Cas9 knockout approaches. Consistent with in vitro studies performed in mMSCs and hMSCs, nightly (25 mg/kg, i.p., 45 days) injections with PD184352 (MEK1/2 inhibitor) or Bix02189 (MEK5 inhibitor) or SC-1-151 (MEK1/2/5 inhibitor) demonstrated that MEK1/2 and MEK5 were the primary drivers underlying melatonin's actions on bone density, microarchitecture (i.e., trabecular number, separation, and connectivity density), and bone mechanical properties (i.e., ultimate stress) through increases in osteogenic (RUNX2, BMP-2, FRA-1, OPG) expression and decreases in PPARγ. Furthermore, CRISPR/Cas9 knockout of MEK1 or MEK5 in mMSCs seeded on PLGA scaffolds and placed into critical-size calvarial defects in Balb(c) mice (male and female) revealed that treatment with melatonin (15 mg/L; p.o., nightly, 90 days) mediates sex-specific actions of MEK1 and MEK5 in new bone formation. This study is the first to demonstrate a role for MEK1/2 and MEK5 in modulating melatonin-mediated actions on bone formation in vivo and in a sex-specific manner.
Collapse
Affiliation(s)
- Fahima Munmun
- Division of Pharmaceutical Sciences, Duquesne University School of Pharmacy, Pittsburgh, Pennsylvania, USA
| | - Omair A Mohiuddin
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Van T Hoang
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Matthew E Burow
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Bruce A Bunnell
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Veronica M Sola
- Department of Oral Biology, Faculty of Odontology, National University of Cordoba, Cordoba, Argentina
| | - Agata R Carpentieri
- Faculty of Odontology, National University of Cordoba and National Council for Scientific and Technical Research (CONICET); Institute for Health Sciences Research (INICSA), Cordoba, Argentina
| | - Paula A Witt-Enderby
- Division of Pharmaceutical Sciences, Duquesne University School of Pharmacy, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
7
|
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
|
8
|
Idiopathic scoliosis: general characteristics and analysis of etiological theories (literature review). ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.3.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Idiopathic scoliosis is a severe pathology of the musculoskeletal system that affects children and adolescents all over the world. The disease occurs in approximately 0.2-0.6% of the general population, and is the largest subgroup of spinal curvature in humans (70-90% of all known scoliosis cases). In idiopathic scoliosis, a threedimensional deformation of the vertebral column is formed, leading to the formation of a rib hump, curvature of the ribs and chest, asymmetry of the pelvis and impaired development of internal organs. The main feature of the disease is the spontaneous development of deformity during the growth of the child and the tendency to progress. Scoliosis is not only an orthopedic disease, but also a ignificant cosmetic, and, consequently, a psychological and social problem. The standard of treatment for scoliotic disease remains unchanged for a long time: observation, corset treatment and surgical correction. The prognosis for the development of pathology varies depending on the degree of deformation. The corset-therapy, hospitalization, surgery and treatment of chronic back pain have a negative impact on the psychoemotional state of children and adolescents. Despite significant advances in the methods of diagnosis of deformity, improvement of surgical treatment methods and in the study of pathogenesis, the etiological factor of pathology is still unknown. The search for the causes of idiopathic scoliosis covers almost all aspects of its possible origin: genetic, environmental, hormonal, metabolic, biochemical, neurological, and others. In recent decades, relevant theories of the development of scoliosis have been formulated, but none of the theories reveals the essence of the pathological process and has no clear justification. The greatest number of supporters is the genetic theory: genetic factors play a key role in the occurrence and development of idiopathic scoliosis. Understanding the underlying factors of the disease will enable prevention, early diagnosis, and identification of the risk groups of the patients in question.
Collapse
|
9
|
Munmun F, Witt-Enderby PA. Melatonin effects on bone: Implications for use as a therapy for managing bone loss. J Pineal Res 2021; 71:e12749. [PMID: 34085304 DOI: 10.1111/jpi.12749] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/22/2021] [Accepted: 05/31/2021] [Indexed: 02/06/2023]
Abstract
Melatonin is the primary circadian output signal from the brain and is mainly synthesized in pinealocytes. The rhythm and secretion of melatonin are under the control of an endogenous oscillator located in the SCN or the master biological clock. Disruptions in circadian rhythms by shift work, aging, or light at night are associated with bone loss and increased fracture risk. Restoration of nocturnal melatonin peaks to normal levels or therapeutic levels through timed melatonin supplementation has been demonstrated to provide bone-protective actions in various models. Melatonin is a unique molecule with diverse molecular actions targeting melatonin receptors located on the plasma membrane or mitochondria or acting independently of receptors through its actions as an antioxidant or free radical scavenger to stimulate osteoblastogenesis, inhibit osteoclastogenesis, and improve bone density. Its additional actions on entraining circadian rhythms and improving quality of life in an aging population coupled with its safety profile make it an ideal therapeutic candidate for protecting against bone loss in susceptible populations. The intent of this review is to provide a focused discussion on bone loss and disorders of the bone as it relates to melatonin and conditions that modify melatonin levels with the hope that future therapies include those that include melatonin and correct those factors that modify melatonin levels like circadian disruption.
Collapse
Affiliation(s)
- Fahima Munmun
- Division of Pharmaceutical Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| | - Paula A Witt-Enderby
- Division of Pharmaceutical Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA
| |
Collapse
|
10
|
Zaydman AM, Strokova EL, Pahomova NY, Gusev AF, Mikhaylovskiy MV, Shevchenko AI, Zaidman MN, Shilo AR, Subbotin VM. Etiopathogenesis of adolescent idiopathic scoliosis: Review of the literature and new epigenetic hypothesis on altered neural crest cells migration in early embryogenesis as the key event. Med Hypotheses 2021; 151:110585. [PMID: 33932710 DOI: 10.1016/j.mehy.2021.110585] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/28/2021] [Accepted: 03/24/2021] [Indexed: 12/17/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) affects 2-3% of children. Numerous hypotheses on etiologic/causal factors of AIS were investigated, but all failed to identify therapeutic targets and hence failed to offer a cure. Therefore, currently there are only two options to minimize morbidity of the patients suffering AIS: bracing and spinal surgery. From the beginning of 1960th, spinal surgery, both fusion and rod placement, became the standard of management for progressive adolescent idiopathic spine deformity. However, spinal surgery is often associated with complications. These circumstances motivate AIS scientific community to continue the search for new etiologic and causal factors of AIS. While the role of the genetic factors in AIS pathogenesis was investigated intensively and universally recognized, these studies failed to nominate mutation of a particular gene or genes combination responsible for AIS development. More recently epigenetic factors were suggested to play causal role in AIS pathogenesis. Sharing this new approach, we investigated scoliotic vertebral growth plates removed during vertebral fusion (anterior surgery) for AIS correction. In recent publications we showed that cells from the convex side of human scoliotic deformities undergo normal chondrogenic/osteogenic differentiation, while cells from the concave side acquire a neuronal phenotype. Based on these facts we hypothesized that altered neural crest cell migration in early embryogenesis can be the etiological factor of AIS. In particular, we suggested that neural crest cells failed to migrate through the anterior half of somites and became deposited in sclerotome, which in turn produced chondrogenic/osteogenic-insufficient vertebral growth plates. To test this hypothesis we conducted experiments on chicken embryos with arrest neural crest cell migration by inhibiting expression of Paired-box 3 (Pax3) gene, a known enhancer and promoter of neural crest cells migration and differentiation. The results showed that chicken embryos treated with Pax3 siRNA (microinjection into the neural tube, 44 h post-fertilization) progressively developed scoliotic deformity during maturation. Therefore, this analysis suggests that although adolescent idiopathic scoliosis manifests in children around puberty, the real onset of the disease is of epigenetic nature and takes place in early embryogenesis and involves altered neural crest cells migration. If these results confirmed and further elaborated, the hypothesis may shed new light on the etiology and pathogenesis of AIS.
Collapse
Affiliation(s)
- Alla M Zaydman
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Elena L Strokova
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Nataliya Y Pahomova
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Arkady F Gusev
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Mikhail V Mikhaylovskiy
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Alexander I Shevchenko
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences", Novosibirsk, Russia
| | | | - Andrey R Shilo
- Novosibirsk Zoo named after R.A. Shilo, Novosibirsk, Russia
| | - Vladimir M Subbotin
- Arrowhead Pharmaceuticals Inc., Madison WI, USA; University of Pittsburgh, Pittsburgh PA, USA; University of Wisconsin, Madison WI, USA.
| |
Collapse
|
11
|
Li J, Yang Z, Yu M. Association study of single nucleotide polymorphism in tryptophan hydroxylase 1 gene with adolescent idiopathic scoliosis: A meta-analysis. Medicine (Baltimore) 2021; 100:e23733. [PMID: 33545939 PMCID: PMC7837909 DOI: 10.1097/md.0000000000023733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis is a common spinal deformity among children and adolescents worldwide with its etiology uncertain. Over a decade, a single nucleotide polymorphism rs10488682 in tryptophan hydroxylase 1 (TPH1) gene has been investigated in several association studies. We perform this study to summarize the current evidence of TPH1 rs10488682 polymorphisms and adolescent idiopathic scoliosis (AIS). METHODS Six databases were systematically searched: PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature, and Wanfang database. Eligible case-control studies related to TPH1 and AIS were selected. Reference lists of them were reviewed for more available studies. Two authors independently screened and evaluated the literature and extracted data. The odds ratios and 95% confidence intervals were derived in association tests. Subgroup analysis was conducted by ethnicity. Sensitivity analysis was performed to examine the stability of the overall results. RESULTS A total of 1006 cases and 1557 controls in 3 independent studies were included for meta-analysis. Statistical significance was discovered in heterozygote model (AT vs AA: OR = 1.741, 95%Cl = 1.100-2.753, P = .018 < .05, I2 = 0%), recessive model (AA vs AT + TT: OR = 0.640, 95%Cl = 0.414-0.990, P = .045 < .05, I2 = 0%) and over-dominant model (AT vs AA + TT: OR = 1.366, 95%Cl = 1.115-1.673, P = .003 < .05, I2 = 84.7%) in overall populations. Similar associations were also found in the Caucasian population. No significant associations were found in other genotypic comparisons and allelic comparisons. CONCLUSIONS Statistically significant correlations were discovered between the TPH1 rs10488682 polymorphisms and AIS. Heterozygous AT genotype seems to be risky with an over-dominant effect. Ethnicity appears to modify the disease association. REGISTRATION Not applicable.
Collapse
Affiliation(s)
- Junyu Li
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road
| | - Zexi Yang
- School of Clinical Medicine, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Miao Yu
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road
| |
Collapse
|
12
|
Addai D, Zarkos J, Bowey AJ. Current concepts in the diagnosis and management of adolescent idiopathic scoliosis. Childs Nerv Syst 2020; 36:1111-1119. [PMID: 32314025 PMCID: PMC7250959 DOI: 10.1007/s00381-020-04608-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/02/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adolescent Idiopathic Scoliosis (AIS) is a complex 3D structural disorder of the spine that has a significant impact on a person's physical and emotionalstatus. Thus, efforts have been made to identify the cause of the curvature and improve management outcomes. AIM This comprehensive review looks at the relevant literature surrounding the possible aetio-pathogenesis of AIS, its clinical features, investigations, surgicalmanagement options, and reported surgical outcomes in anterior spinal fusion, posterior spinal fusion or combined approach in the treatment of AIS.
Collapse
Affiliation(s)
- Daniel Addai
- Department of Orthopaedic Spine Surgery, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, England
| | - Jacqueline Zarkos
- Department of Orthopaedic Spine Surgery, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, England
| | - Andrew James Bowey
- Department of Orthopaedic Spine Surgery, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, England.
- Newcastle University, Newcastle upon Tyne, UK.
| |
Collapse
|
13
|
Melatonin induces mitochondrial apoptosis in osteoblasts by regulating the STIM1/cytosolic calcium elevation/ERK pathway. Life Sci 2020; 248:117455. [PMID: 32088216 DOI: 10.1016/j.lfs.2020.117455] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/04/2020] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
AIMS Idiopathic scoliosis is a common deformity of the spine that has an especially high incidence rate in adolescents. Some studies have demonstrated a close relationship between idiopathic scoliosis and melatonin deficiency. Our team's previous research showed that melatonin can inhibit the proliferation of osteoblasts, but the mechanism remains unclear. This study aimed to determine the mechanism by which melatonin inhibits the proliferation of osteoblasts. MAIN METHODS Cell viability experiment, DNA fragment detection and alkaline phosphatase (ALP) activity assays were performed to determine the effects of melatonin on the proliferation, apoptosis and differentiation of osteoblasts. We used immunofluorescence to detect the expression of STIM1 in melatonin-treated osteoblasts. STIM1 interference was achieved using a specific siRNA, and a TRPC inhibitor was used to block the influx of Ca2+. The mRNA expression was determined by RT-qPCR, and protein levels were measured by Western blot. KEY FINDINGS In this study, we found that melatonin inhibited the proliferation, differentiation and apoptosis of osteoblasts in a concentration-dependent manner. Additional studies showed that melatonin elevated cytosolic calcium levels by upregulation of STIM1, leading to osteoblast apoptosis via the mitochondrial pathway. Finally, we demonstrated that the STIM1-mediated increase in cytosolic calcium levels induced apoptosis through the ERK pathway. SIGNIFICANCE Melatonin induces mitochondrial apoptosis in osteoblasts by regulating the STIM1/cytosolic calcium elevation/ERK pathway. These basic findings provide a basis for further clinical studies on melatonin as a drug therapeutic for idiopathic scoliosis.
Collapse
|
14
|
Cervical scoliosis and torticollis: a novel skeletal anomaly in broiler chickens. Acta Vet Scand 2019; 61:47. [PMID: 31601238 PMCID: PMC6787974 DOI: 10.1186/s13028-019-0482-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 09/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background Among the most prominent health problems marring the global poultry industry for several decades are skeletal abnormalities. The aim of this study was to investigate a recent emergence of a novel form of skeletal deformity affecting cervical spine in broiler chickens. This work presents the natural history of this newly emerging skeletal anomaly along with long term observations of epidemiological trends in commercial broiler flocks, and clinical and pathological features. Results In distinction from other forms of skeletal deformities commonly reported in broiler chickens, this new form of cervical spine anomaly have been observed in newly hatched chicks and in fully developed embryos that died in the shell. On clinical and post mortem examination this condition presents characteristic features consistent with congenital cervical scoliosis and torticollis (CCST). The pathogenesis of CCST appears to be linked to pathological remodeling of the cervical vertebrae bone associated with excessive activity of osteoclasts. Long term observations indicate that the incidence of CCST showed increasing epidemiological trends over time. More recently CCST has been observed in newly hatched chicks with incidence ranging from 0.1 to > 1%, and in fully developed embryos that failed to hatch about 4 to 5%. Conclusions The increasing trends in incidence of CCST in commercial broiler flocks are of concern from an economic perspective, and also represent a very specific and important aspect of animal welfare.
Collapse
|
15
|
van der Pol CW, van Roovert-Reijrink IAM, Gussekloo SWS, Kranenbarg S, Leon-Kloosterziel KM, van Eijk-Priester MH, Zeman M, Kemp B, van den Brand H. Effects of lighting schedule during incubation of broiler chicken embryos on leg bone development at hatch and related physiological characteristics. PLoS One 2019; 14:e0221083. [PMID: 31415653 PMCID: PMC6695123 DOI: 10.1371/journal.pone.0221083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/30/2019] [Indexed: 12/12/2022] Open
Abstract
Providing a broiler chicken embryo with a lighting schedule during incubation may stimulate leg bone development. Bone development may be stimulated through melatonin, a hormone released in darkness that stimulates bone development, or increased activity in embryos exposed to a light-dark rhythm. Aim was to investigate lighting conditions during incubation and leg bone development in broiler embryos, and to reveal the involved mechanisms. Embryos were incubated under continuous cool white 500 lux LED light (24L), continuous darkness (24D), or 16h of light, followed by 8h of darkness (16L:8D) from the start of incubation until hatching. Embryonic bone development largely takes place through cartilage formation (of which collagen is an important component) and ossification. Expression of genes involved in cartilage formation (col1α2, col2α1, and col10α1) and ossification (spp1, sparc, bglap, and alpl) in the tibia on embryonic day (ED)13, ED17, and at hatching were measured through qPCR. Femur and tibia dimensions were determined at hatch. Plasma growth hormone and corticosterone and pineal melatonin concentrations were determined every 4h between ED18.75 and ED19.5. Embryonic heart rate was measured twice daily from ED12 till ED19 as a reflection of activity. No difference between lighting treatments on gene expression was found. 24D resulted in higher femur length and higher femur and tibia weight, width, and depth at hatch than 16L:8D. 24D furthermore resulted in higher femur length and width and tibia depth than 24L. Embryonic heart rate was higher for 24D and 16L:8D in both its light and dark period than for 24L, suggesting that 24L embryos may have been less active. Melatonin and growth hormone showed different release patterns between treatments, but the biological significance was hard to interpret. To conclude, 24D resulted in larger leg bones at hatch than light during incubation, but the underlying pathways were not clear from present data.
Collapse
Affiliation(s)
- Carla W. van der Pol
- Research department, HatchTech B.V., Veenendaal, the Netherlands
- Adaptation Physiology Group, Wageningen University and Research, Wageningen, the Netherlands
- * E-mail:
| | | | - Sander W. S. Gussekloo
- Experimental Zoology Group, Wageningen University and Research, Wageningen, the Netherlands
| | - Sander Kranenbarg
- Experimental Zoology Group, Wageningen University and Research, Wageningen, the Netherlands
| | | | - Margaretha H. van Eijk-Priester
- Research department, HatchTech B.V., Veenendaal, the Netherlands
- Adaptation Physiology Group, Wageningen University and Research, Wageningen, the Netherlands
| | - Michal Zeman
- Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University Bratislava, Bratislava, Slovak Republic
- Institute of Animal Biochemistry and Genetics, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Bas Kemp
- Adaptation Physiology Group, Wageningen University and Research, Wageningen, the Netherlands
| | - Henry van den Brand
- Adaptation Physiology Group, Wageningen University and Research, Wageningen, the Netherlands
| |
Collapse
|
16
|
The effect of exogenous melatonin on reducing scoliotic curvature and improving bone quality in melatonin-deficient C57BL/6J mice. Sci Rep 2019; 9:6202. [PMID: 30996275 PMCID: PMC6470154 DOI: 10.1038/s41598-019-42467-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 03/25/2019] [Indexed: 11/17/2022] Open
Abstract
It is well-documented that melatonin deficiency has been linked to the etiopathogenesis of adolescent idiopathic scoliosis. In this study, we intended to apply melatonin in melatonin-deficient mice to ascertain whether melatonin could reduce the incidence/severity of scoliosis, and investigate the role of melatonin on bone mineral density in scoliosis. A total of 80 mice were divided into 4 groups: 20 quadrupedal mice and 20 bipedal mice served as controls; 20 quadrupedal and 20 bipedal mice received oral melatonin (8 mg/kg BW) daily. After 5th, 10th, 15th and 20th weeks of treatment, radiographs and in vivo micro-CT were used to determine the incidence of scoliosis and bone qualities, respectively. Upon sacrifice, the levels of melatonin were measured in each group. At 20th week, the occurrence of scoliosis was 80%, 30%, 22% and 5% in bipedal, quadrupedal, bipedal + melatonin and quadrupedal + melatonin group, respectively. The trabecular bone quality of the vertebral body was significantly ameliorated in the melatonin-treated bipedal models. Likewise, the number of osteoclasts was significantly less in those treated with melatonin. Our results indicated that melatonin deficiency may be crucial for scoliotic development, and restoration of melatonin levels can prevent scoliotic development with the improvement in bone density.
Collapse
|
17
|
Li Z, Li X, Bi J, Chan MTV, Wu WKK, Shen J. Melatonin protected against the detrimental effects of microRNA-363 in a rat model of vitamin A-associated congenital spinal deformities: Involvement of Notch signaling. J Pineal Res 2019; 66:e12558. [PMID: 30653707 DOI: 10.1111/jpi.12558] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 12/30/2018] [Accepted: 12/30/2018] [Indexed: 12/18/2022]
Abstract
Congenital spinal deformities are a result of defective somitogenesis and are associated with vitamin A deficiency (VAD). However, the molecular mechanisms of VAD-associated congenital spinal deformities remain largely unknown. Increasing number of studies suggested that microRNAs and melatonin played important roles in the development of congenital spinal deformities. In this study, we showed that the whole-embryo expression of miR-363 was upregulated in VAD rats. Furthermore, we demonstrated that miR-363 inhibited the proliferation and neuronal differentiation of primary cultured NSCs, accompanied by downregulation of Notch1. To this end, melatonin suppressed miR-363 expression and rescued the effects of miR-363 on NSC proliferation and neuronal differentiation together with restoration of Notch signaling. The present study provided new insights into the mechanism of VAD-associated spinal deformities and the therapeutic effect of melatonin that may lead to novel understanding of the molecular mechanisms of congenital spinal deformities.
Collapse
Affiliation(s)
- Zheng Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xingye Li
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Jishuitan Orthopaedic College of Tsinghua University, Beijing, China
| | - Jiaqi Bi
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Matthew T V Chan
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William Ka Kei Wu
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Jianxiong Shen
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
18
|
Li T, Jiang S, Lu C, Yang W, Yang Z, Hu W, Xin Z, Yang Y. Melatonin: Another avenue for treating osteoporosis? J Pineal Res 2019; 66:e12548. [PMID: 30597617 DOI: 10.1111/jpi.12548] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/24/2018] [Accepted: 12/24/2018] [Indexed: 12/28/2022]
Abstract
Melatonin is a signal molecule that modulates the biological circadian rhythms of vertebrates. Melatonin deficiency is thought to be associated with several disorders, including insomnia, cancer, and cardiovascular and neurodegenerative diseases. Accumulating evidence has also indicated that melatonin may be involved in the homeostasis of bone metabolism. Age-related reductions in melatonin are considered to be critical factors in bone loss and osteoporosis with aging. Thus, serum melatonin levels might serve as a biomarker for the early detection and prevention of osteoporosis. Compared to conventional antiosteoporosis medicines, which primarily inhibit bone loss, melatonin both suppresses bone loss and promotes new bone formation. Mechanistically, by activating melatonin receptor 2 (MT2), melatonin upregulates the gene expression of alkaline phosphatase (ALP), bone morphogenetic protein 2 (BMP2), BMP6, osteocalcin, and osteoprotegerin to promote osteogenesis while inhibiting the receptor activator of NF-kB ligand (RANKL) pathway to suppress osteolysis. In view of the distinct actions of melatonin on bone metabolism, we hypothesize that melatonin may be a novel remedy for the prevention and clinical treatment of osteoporosis.
Collapse
Affiliation(s)
- Tian Li
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences, Northwest University, Xi'an, China
- School of Basic Medicine, The Fourth Military Medical University, Xi'an, China
| | - Shuai Jiang
- Department of Aerospace Medicine, The Fourth Military Medical University, Xi'an, China
| | - Chenxi Lu
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences, Northwest University, Xi'an, China
| | - Wenwen Yang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences, Northwest University, Xi'an, China
| | - Zhi Yang
- School of Basic Medicine, The Fourth Military Medical University, Xi'an, China
| | - Wei Hu
- School of Basic Medicine, The Fourth Military Medical University, Xi'an, China
| | - Zhenlong Xin
- Graduate School, The Fourth Military Medical University, Xi'an, China
| | - Yang Yang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences, Northwest University, Xi'an, China
| |
Collapse
|
19
|
Light-dark rhythms during incubation of broiler chicken embryos and their effects on embryonic and post hatch leg bone development. PLoS One 2019; 14:e0210886. [PMID: 30682088 PMCID: PMC6347197 DOI: 10.1371/journal.pone.0210886] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/03/2019] [Indexed: 11/19/2022] Open
Abstract
There are indications that lighting schedules applied during incubation can affect leg health at hatching and during rearing. The current experiment studied effects of lighting schedule: continuous light (24L), 12 hours of light, followed by 12 hours of darkness (12L:12D), or continuous darkness (24D) throughout incubation of broiler chicken eggs on the development and strength of leg bones, and the role of selected hormones in bone development. In the tibiatarsus and femur, growth and ossification during incubation and size and microstructure at day (D)0, D21, and D35 post hatching were measured. Plasma melatonin, growth hormone, and IGF-I were determined perinatally. Incidence of tibial dyschondroplasia, a leg pathology resulting from poor ossification at the bone’s epiphyseal plates, was determined at slaughter on D35. 24L resulted in lower embryonic ossification at embryonic day (E)13 and E14, and lower femur length, and lower tibiatarsus weight, length, cortical area, second moment of area around the minor axis, and mean cortical thickness at hatching on D0 compared to 12L:12D especially. Results were long term, with lower femur weight and tibiatarsus length, cortical and medullary area of the tibiatarsus, and second moment of area around the minor axis, and a higher incidence of tibial dyschondroplasia for 24L. Growth hormone at D0 was higher for 24D than for 12L:12D, with 24L intermediate, but plasma melatonin and IGF-I did not differ between treatments, and the role of plasma melatonin, IGF-I, and growth hormone in this process was therefore not clear. To conclude, in the current experiment, 24L during incubation of chicken eggs had a detrimental effect on embryonic leg bone development and later life leg bone strength compared to 24D and 12L:12D, while the light-dark rhythm of 12L:12D may have a stimulating effect on leg health.
Collapse
|
20
|
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
|
21
|
Blecher R, Heinemann-Yerushalmi L, Assaraf E, Konstantin N, Chapman JR, Cope TC, Bewick GS, Banks RW, Zelzer E. New functions for the proprioceptive system in skeletal biology. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170327. [PMID: 30249776 PMCID: PMC6158198 DOI: 10.1098/rstb.2017.0327] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 01/13/2023] Open
Abstract
Muscle spindles and Golgi tendon organs (GTOs) are two types of sensory receptors that respond to changes in length or tension of skeletal muscles. These mechanosensors have long been known to participate in both proprioception and stretch reflex. Here, we present recent findings implicating these organs in maintenance of spine alignment as well as in realignment of fractured bones. These discoveries have been made in several mouse lines lacking functional mechanosensors in part or completely. In both studies, the absence of functional spindles and GTOs produced a more severe phenotype than that of spindles alone. Interestingly, the spinal curve phenotype, which appeared during peripubertal development, bears resemblance to the human condition adolescent idiopathic scoliosis. This similarity may contribute to the study of the disease by offering both an animal model and a clue as to its aetiology. Moreover, it raises the possibility that impaired proprioceptive signalling may be involved in the aetiology of other conditions. Overall, these new findings expand considerably the scope of involvement of proprioception in musculoskeletal development and function.This article is part of the Theo Murphy meeting issue 'Mechanics of development'.
Collapse
Affiliation(s)
- Ronen Blecher
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 76100, Israel
- Department of Orthopedic Surgery, Assaf HaRofeh Medical Center, Zerrifin 70300, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Swedish Neuroscience Institute, Seattle, WA 98122, USA
| | | | - Eran Assaraf
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 76100, Israel
- Department of Orthopedic Surgery, Assaf HaRofeh Medical Center, Zerrifin 70300, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Nitzan Konstantin
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 76100, Israel
| | | | - Timothy C Cope
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA 30332, USA
| | - Guy S Bewick
- Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Robert W Banks
- Department of Biosciences, Durham University, Durham DH1 3LE, UK
| | - Elazar Zelzer
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 76100, Israel
| |
Collapse
|
22
|
Tanabe H, Aota Y, Yamaguchi Y, Kaneko K, Imai S, Takahashi M, Taguri M, Saito T. Minodronate treatment improves low bone mass and reduces progressive thoracic scoliosis in a mouse model of adolescent idiopathic scoliosis. PLoS One 2018; 13:e0202165. [PMID: 30138335 PMCID: PMC6107151 DOI: 10.1371/journal.pone.0202165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 07/30/2018] [Indexed: 02/02/2023] Open
Abstract
Recent studies have shown an association between osteopenia and adolescent idiopathic scoliosis (AIS) and implied that osteopenia plays a causative role in AIS development. This study aimed to determine if minodronate (MIN) treatment could prevent curve progression by increasing bone mass in a thoracic restraint (TR) mouse model, which develops causes the development of thoracic scoliosis similar to human AIS. A total of 100 young female C57BL6J mice were divided into four groups: (1) control with vehicle (CON/VEH; n = 20), (2) control with MIN (CON/MIN; n = 20), (3) TR with vehicle (TR/VEH; n = 30), or (4) TR with MIN (TR/MIN; n = 30). MIN (0.01 mg/kg/week) and vehicle were administered intraperitoneally to their respective groups. TR was performed at age 4 weeks, and the mice were sacrificed at age 9 weeks. Body weights, spine radiographs, femoral bone mineral density (BMD), serum bone marker levels, and histomorphometry of the cancellous bone of the thoracic vertebrae were analyzed. TR significantly reduced weight gain in the TR/VEH group relative to the CON/VEH group. TR also induced osteoporosis with accelerated bone resorption, as indicated by decreases in femoral BMDs and thoracic cancellous bone volume and increases in serum bone resorption marker levels and histomorphometric resorption parameters in the TR/VEH group. MIN partially improved body weight gain and improved poor bone structure relative to the TR/VEH group by suppressing high bone resorption in the TR/MIN mice. MIN significantly reduced the curve magnitudes, as indicated by a 43% lower curve magnitude in the TR/MIN mice than in the TR/VEH mice (17.9 ± 8.9° vs. 31.5 ± 13.1°; p< 0.001). The administration of MIN increased bone mass and reduced the severity of scoliosis in the TR mice. MIN was suggested as a possible inhibitor of scoliosis development.
Collapse
Affiliation(s)
- Hironori Tanabe
- Department of Orthopedic Surgery, Yokohama City University, Yokohama, Japan
- * E-mail:
| | - Yoichi Aota
- Department of Spine & Spinal Cord, Yokohama Brain & Spine Center, Yokohama, Japan
| | - Yasuteru Yamaguchi
- Department of Orthopedic Surgery, Yokohama City University, Yokohama, Japan
| | - Kanichiro Kaneko
- Department of Orthopedic Surgery, Yokohama City University, Yokohama, Japan
| | - Sousuke Imai
- Department of Orthopedic Surgery, Yokohama City University, Yokohama, Japan
| | - Masaki Takahashi
- Yokohama City University Center for Novel and Exploratory Clinical Trials, Yokohama City University, Yokohama, Japan
| | - Masataka Taguri
- Department of Biostatistics, Yokohama City University, Yokohama, Japan
| | - Tomoyuki Saito
- Department of Orthopedic Surgery, Yokohama City University, Yokohama, Japan
| |
Collapse
|
23
|
Hamad A, Ahmed EB, Tsirikos AI. Adolescent idiopathic scoliosis: a comprehensive approach to aetiology, diagnostic assessment and treatment. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.mporth.2017.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
24
|
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
|
25
|
Blecher R, Krief S, Galili T, Biton IE, Stern T, Assaraf E, Levanon D, Appel E, Anekstein Y, Agar G, Groner Y, Zelzer E. The Proprioceptive System Masterminds Spinal Alignment: Insight into the Mechanism of Scoliosis. Dev Cell 2017; 42:388-399.e3. [DOI: 10.1016/j.devcel.2017.07.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 06/10/2017] [Accepted: 07/24/2017] [Indexed: 12/18/2022]
|
26
|
Interleukin 6 gene polymorphism in patients with degenerative lumbar scoliosis: a cohort study. 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 2017; 27:607-612. [DOI: 10.1007/s00586-017-5074-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 03/05/2017] [Accepted: 03/27/2017] [Indexed: 01/02/2023]
|
27
|
Grauers A, Einarsdottir E, Gerdhem P. Genetics and pathogenesis of idiopathic scoliosis. SCOLIOSIS AND SPINAL DISORDERS 2016; 11:45. [PMID: 27933320 PMCID: PMC5125035 DOI: 10.1186/s13013-016-0105-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 11/15/2016] [Indexed: 03/06/2023]
Abstract
Idiopathic scoliosis (IS), the most common spinal deformity, affects otherwise healthy children and adolescents during growth. The aetiology is still unknown, although genetic factors are believed to be important. The present review corroborates the understanding of IS as a complex disease with a polygenic background. Presumably IS can be due to a spectrum of genetic risk variants, ranging from very rare or even private to very common. The most promising candidate genes are highlighted.
Collapse
Affiliation(s)
- A Grauers
- Department of Orthopaedics, Sundsvall and Härnösand County Hospital, Sundsvall, Sweden ; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86 Stockholm, Sweden
| | - E Einarsdottir
- Molecular Neurology Research Program, University of Helsinki and Folkhälsan Institute of Genetics, Helsinki, Finland ; Department of Biosciences and Nutrition, Karolinska Institutet, SE-141 83 Huddinge, Sweden
| | - P Gerdhem
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86 Stockholm, Sweden ; Department of Orthopaedics, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| |
Collapse
|
28
|
Balasubramanian S, Peters JR, Robinson LF, Singh A, Kent RW. Thoracic spine morphology of a pseudo-biped animal model (kangaroo) and comparisons with human and quadruped animals. 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 2016; 25:4140-4154. [PMID: 27704284 DOI: 10.1007/s00586-016-4776-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 07/22/2016] [Accepted: 09/09/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Based on the structural anatomy, loading condition and range of motion (ROM), no quadruped animal has been shown to accurately mimic the structure and biomechanical function of the human spine. The objective of this study is to quantify the thoracic vertebrae geometry of the kangaroo, and compare with adult human, pig, sheep, and deer. METHODS The thoracic vertebrae (T1-T12) from whole body CT scans of ten juvenile kangaroos (ages 11-14 months) were digitally reconstructed and geometric dimensions of the vertebral bodies, endplates, pedicles, spinal canal, processes, facets and intervertebral discs were recorded. Similar data available in the literature on the adult human, pig, sheep, and deer were compared to the kangaroo. A non-parametric trend analysis was performed. RESULTS Thoracic vertebral dimensions of the juvenile kangaroo were found to be generally smaller than those of the adult human and quadruped animals. The most significant (p < 0.001) correlations (Rho) found between the human and kangaroo were in vertebrae and endplate dimensions (0.951 ≤ Rho ≤ 0.963), pedicles (0.851 ≤ Rho ≤ 0.951), and inter-facet heights (0.891 ≤ Rho ≤ 0.967). The deer displayed the least similar trends across vertebral levels. CONCLUSIONS Similarities in thoracic spine vertebral geometry, particularly of the vertebrae, pedicles and facets may render the kangaroo a more clinically relevant human surrogate for testing spinal implants. The pseudo-biped kangaroo may also be a more suitable model for the human thoracic spine for simulating spine deformities, based on previously published similarities in biomechanical loading, posture and ROM.
Collapse
Affiliation(s)
- Sriram Balasubramanian
- School of Biomedical Engineering, Science and Health Systems, Drexel University, 3141 Chestnut Street, Bossone 718, Philadelphia, PA, 19104, USA.
| | - James R Peters
- School of Biomedical Engineering, Science and Health Systems, Drexel University, 3141 Chestnut Street, Bossone 718, Philadelphia, PA, 19104, USA
| | - Lucy F Robinson
- Department of Epidemiology & Biostatistics, School of Public Health, Drexel University, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Anita Singh
- Department of Biomedical Engineering, Widener University, One University Place, Chester, PA, 19013, USA
| | - Richard W Kent
- Mechanical and Aerospace Department, University of Virginia, 122 Engineer's Way, P.O. Box 400746, Charlottesville, VA, 22904-4746, USA
| |
Collapse
|
29
|
Nikolova ST, Yablanski VT, Vlaev EN, Savov AS, Kremensky IM. Investigation of Predictive Potential of TPH1 Common Polymorphism in Idiopathic Scoliosis. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2016. [DOI: 10.5799/jcei.328607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
30
|
Park YS, Suh KT, Shin JK, Lee JS. Estrogen receptor gene polymorphism in patients with degenerative lumbar scoliosis. Br J Neurosurg 2016; 31:63-66. [PMID: 27399961 DOI: 10.1080/02688697.2016.1206186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the association between development of degenerative lumbar scoliosis (DLS) and sex hormones. METHODS We investigated the association between DLS and estrogen receptor alpha (ERα) gene polymorphisms in 184 patients with a diagnosis of DLS, by determining the presences of the Pvu II and Xba I polymorphisms, measuring bone mineral densities at the lumbar spine (LSBMD) and femoral neck (FNBMD), and by investigating biochemical markers of bone turnover and comparing these results with those of 220 healthy normal controls. RESULTS Genotype frequencies in DLS patients and controls revealed a significant difference for the Pvu II polymorphism only (p = 0.0287). No significant difference was found between the DLS and control groups with respect to the Xba I polymorphism, bone mineral density (BMD), or biochemical markers. Furthermore, no significant association was observed between the Pvu II polymorphism and BMD, lumbar scoliosis, lateral listhesis, or biochemical markers in patients with DLS. CONCLUSION These results suggest that the ERα Pvu II polymorphism influences the prevalence of DLS.
Collapse
Affiliation(s)
- Yang Soo Park
- a Department of Orthopaedic Surgery , Sehung Hospital , Busan , Republic of Korea
| | - Kuen Tak Suh
- b Department of Orthopaedic Surgery, Medical Research Institute , Pusan National University Yangsan Hospital , Yangsan , Republic of Korea
| | - Jong Ki Shin
- c Department of Orthopaedic Surgery, Medical Research Institute , Pusan National University School of Medicine , Busan , Republic of Korea
| | - Jung Sub Lee
- c Department of Orthopaedic Surgery, Medical Research Institute , Pusan National University School of Medicine , Busan , Republic of Korea
| |
Collapse
|
31
|
Hwang DW, Kim KT, Lee SH, Kim JY, Kim DH. Association of COL2A1 gene polymorphism with degenerative lumbar scoliosis. Clin Orthop Surg 2014; 6:379-84. [PMID: 25436060 PMCID: PMC4233215 DOI: 10.4055/cios.2014.6.4.379] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 12/16/2013] [Indexed: 11/25/2022] Open
Abstract
Background Degenerative lumbar scoliosis (DLS) progresses with aging after 50-60 years, and the genetic association of DLS remains largely unclear. In this study, the genetic association between collagen type II alpha 1 (COL2A1) gene and DLS was investigated. Methods COL2A1 gene polymorphism was investigated in DLS subjects compared to healthy controls to investigate the possibility of its association with COL2A1 gene. Based on a single nucleotide polymorphism (SNP) database, SNP (rs2276454) in COL2A1 were selected and genotyped using direct sequencing in 51 patients with DLS and 235 healthy controls. The SNP effects were analyzed using three models of codominant, dominant, and recessive. Logistic regression models were calculated for odds ratios (ORs) with 95% confidence intervals (CIs) and corresponding p-values, controlling age and gender as co-variables. Results SNP (rs2276454) in COL2A1 was significantly associated with the degenerative lumbar scoliosis in the codominant (OR, 1.90; 95% CI, 1.17 to 3.10; p = 0.008) and dominant models (OR, 3.58; 95% CI, 1.59 to 9.29; p = 0.001). Conclusions The results suggest that COL2A1 is associated with the risk of DLS in Korean population.
Collapse
Affiliation(s)
- Dae Woo Hwang
- Department of Orthopedic Surgery, Bando Hospital, Seoul, Korea
| | - Ki Tack Kim
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sang Hoon Lee
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Jung Youn Kim
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Dong Hwan Kim
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| |
Collapse
|
32
|
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
|
33
|
Skovrlj B, Al Maaieh M, Guzman J, Caridi J, Cho SK. The 100 Classic Papers in Spinal Deformity Surgery. Spine Deform 2014; 2:241-247. [PMID: 27927344 DOI: 10.1016/j.jspd.2014.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 04/06/2014] [Indexed: 10/25/2022]
Abstract
STUDY DESIGN Bibliometric review of the literature. OBJECTIVE To identify and analyze the top 100 cited articles in spinal deformity surgery. SUMMARY OF BACKGROUND DATA The field of spinal deformity surgery is an ever-growing and complex field that owes its development to the work and visions of many dedicated individuals. METHODS The authors searched the Thomson Reuters Web of Knowledge for citations of all articles relevant to scoliosis and spinal deformity surgery. The number of citations, authorship, year, journal, and country and institution of publication were recorded for each article. RESULTS The most cited article was the 2001 work by Lenke et al. describing a new 2-dimensional classification system of adolescent idiopathic scoliosis used to determine the appropriate vertebral levels to be included in an arthrodesis. The second most cited was Harrington's 1962 article describing the first instrumented method for the treatment of scoliosis. The third most cited article was the 1983 study by King et al. recommending specific vertebral levels for inclusion into spinal arthrodesis. Most articles originated in the United States (62), and most were published in Spine (32). Most were published in the 1990s (28), and the 3 most common topics, in descending order, were adolescent idiopathic scoliosis (28), spinal instrumentation (18), and surgical complications (5). Author Suk had 5 articles in the top 100 list, whereas authors Kim, Liljenqvist, Lonstein, and Weinstein had 3 each. Washington University in St. Louis had 7 articles in the top 100 list. CONCLUSIONS This report's identification of the 100 classic articles in spinal deformity surgery allows insight into the development and trends of this challenging subspecialty of spine surgery. Furthermore, this article identifies individuals who have contributed the most to the advancement of spinal deformity surgery and the body of knowledge used to guide evidence-based clinical decision making in spinal deformity surgery today.
Collapse
Affiliation(s)
- Branko Skovrlj
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1136, New York, NY 10029, USA
| | - Motasem Al Maaieh
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1188, New York, NY 10029, USA
| | - Javier Guzman
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1188, New York, NY 10029, USA
| | - John Caridi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1136, New York, NY 10029, USA
| | - Samuel K Cho
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1188, New York, NY 10029, USA.
| |
Collapse
|
34
|
Schlösser TPC, van der Heijden GJMG, Versteeg AL, Castelein RM. How 'idiopathic' is adolescent idiopathic scoliosis? A systematic review on associated abnormalities. PLoS One 2014; 9:e97461. [PMID: 24820478 PMCID: PMC4018432 DOI: 10.1371/journal.pone.0097461] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 04/20/2014] [Indexed: 11/23/2022] Open
Abstract
Background Despite more than a century of dedicated research, the etiology and pathogenesis of adolescent idiopathic scoliosis (AIS) remain unclear. By definition, ‘idiopathic’ implies an unknown cause. Nevertheless, many abnormalities concomitant to AIS have been described, often with the suggestion that these abnormalities are related to etio-pathogenesis. Insight in the concomitant abnormalities may assist in improving the understanding of the etiological pathways of AIS. We aimed to systematically review and synthesize available studies on abnormalities concomitant to AIS. Methods Original studies comparing untreated AIS patients with healthy adolescents on abnormalities other than the deformity of the spine were retrieved from PubMed and Embase. We followed PRISMA guidelines and to quantify the relationship between each abnormality and AIS we used a best-evidence-syntheses for relating risk-of-bias to consistency of effect sizes. Results We identified 88 relevant citations, forty-seven carried high risk-of-bias and twenty studies did not report quantitative data in a sufficient manner. The remaining twenty-one publications failed to report data from before initiation of the deformity and blind assessments. These cross-sectional studies provided data on fourteen abnormalities concomitant to AIS. With our best-evidence-syntheses we were unable to find both strong evidence and a consistent pattern of occurrence for AIS and any of these abnormalities. From moderate risk-of-bias studies a relatively consistent pattern of occurrence for AIS and impaired gait control (4 studies; 155 subjects; Cohen’s d = 1.00) and decreased bone mineral density (2 studies; 954 subjects; Cohen’s d = −0.83) was found. For nine abnormalities a consistent pattern of occurrence with AIS was found, but the evidence for these was weak. Conclusions Based on the available literature, strong evidence is lacking for a consistent pattern of occurrence of AIS and any abnormality. The relevance for understanding the multifactorial etiology of AIS is very limited.
Collapse
Affiliation(s)
- Tom P. C. Schlösser
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Geert J. M. G. van der Heijden
- Department of Epidemiology, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam, VU Amsterdam University and University of Amsterdam, Amsterdam, the Netherlands
| | - Anne L. Versteeg
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - René M. Castelein
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- * E-mail:
| |
Collapse
|
35
|
Maria S, Witt-Enderby PA. Melatonin effects on bone: potential use for the prevention and treatment for osteopenia, osteoporosis, and periodontal disease and for use in bone-grafting procedures. J Pineal Res 2014; 56:115-25. [PMID: 24372640 DOI: 10.1111/jpi.12116] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 12/20/2013] [Indexed: 12/20/2022]
Abstract
An important role for melatonin in bone formation and restructuring has emerged, and studies demonstrate the multiple mechanisms for these beneficial actions. Statistical analysis shows that even with existing osteoporotic therapies, bone-related disease, and mortality are on the rise, creating a huge financial burden for societies worldwide. These findings suggest that novel alternatives need to be developed to either prevent or reverse bone loss to combat osteoporosis-related fractures. The focus of this review describes melatonin's role in bone physiology and discusses how disruption of melatonin rhythms by light exposure at night, shift work, and disease can adversely impact on bone. The signal transduction mechanisms underlying osteoblast and osteoclast differentiation and coupling with one another are discussed with a focus on how melatonin, through the regulation of RANKL and osteoprotegerin synthesis and release from osteoblasts, can induce osteoblastogenesis while inhibiting osteoclastogenesis. Also, melatonin's free-radical scavenging and antioxidant properties of this indoleamine are discussed as yet an additional mechanism by which melatonin can maintain one's bone health, especially oral health. The clinical use for melatonin in bone-grafting procedures, in reversing bone loss due to osteopenia and osteoporosis, and in managing periodontal disease is discussed.
Collapse
Affiliation(s)
- Sifat Maria
- Division of Pharmaceutical Sciences, School of Pharmacy, Duquesne University, Pittsburgh, PA, USA
| | | |
Collapse
|
36
|
Yagi M, Machida M, Asazuma T. Pathogenesis of Adolescent Idiopathic Scoliosis. JBJS Rev 2014; 2:01874474-201401000-00004. [DOI: 10.2106/jbjs.rev.m.00037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
37
|
|
38
|
Amstrup AK, Sikjaer T, Mosekilde L, Rejnmark L. Melatonin and the skeleton. Osteoporos Int 2013; 24:2919-27. [PMID: 23716040 DOI: 10.1007/s00198-013-2404-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/15/2013] [Indexed: 12/15/2022]
Abstract
Melatonin may affect bone metabolism through bone anabolic as well as antiresorptive effects. An age-related decrease in peak melatonin levels at nighttime is well documented, which may increase bone resorption and bone loss in the elderly. In vitro, melatonin reduces oxidative stress on bone cells by acting as an antioxidant. Furthermore, melatonin improves bone formation by promoting differentiation of human mesenchymal stem cell (hMSC) into the osteoblastic cell linage. Bone resorption is reduced by increased synthesis of osteoprogeterin (OPG), a decoy receptor that prevents receptor activator of NK-κB ligand (RANKL) in binding to its receptor. Moreover, melatonin is believed to reduce the synthesis of RANKL preventing further bone resorption. In ovariectomized as well as nonovariectomized rodents, melatonin has shown beneficial effects on bone as assessed by biochemical bone turnover markers, DXA, and μCT scans. Furthermore, in pinealectomized animals, bone mineral density (BMD) is significantly decreased compared to controls, supporting the importance of sufficient melatonin levels. In humans, dysfunction of the melatonin signaling pathway may be involved in idiopathic scoliosis, and the increased fracture risk in nighttime workers may be related to changes in the circadian rhythm of melatonin. In the so-far only randomized study on melatonin treatment, no effects were, however, found on bone turnover markers. In conclusion, melatonin may have beneficial effects on the skeleton, but more studies on humans are warranted in order to find out whether supplementation with melatonin at bedtime may preserve bone mass and improve bone biomechanical competence.
Collapse
Affiliation(s)
- A K Amstrup
- Department of Internal Medicine and Endocrinology (MEA), THG Tage-Hansens Gade 2, Aarhus University Hospital, 8000 Aarhus, Denmark,
| | | | | | | |
Collapse
|
39
|
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: 18] [Impact Index Per Article: 1.6] [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
|
40
|
Selective estrogen receptor modulation prevents scoliotic curve progression: radiologic and histomorphometric study on a bipedal C57Bl6 mice model. 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; 23:455-62. [PMID: 24136418 DOI: 10.1007/s00586-013-3072-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 10/11/2013] [Accepted: 10/11/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Previous work has suggested that progression of experimental scoliotic curves in pinealectomized chicken and bipedal C57BL6 mice models may be prevented and reversed with Tamoxifen treatment. Raloxifene is another Selective Estrogen Receptor Modulator (SERM) with estrogen agonist effects on bone and increases bone density but with fewer side effects on humans. To investigate whether scoliosis progression in bipedal C57Bl6 mice model could be prevented with SERM treatment and the mechanisms associated with this effect. METHODS Eighty C57BL6 mice were rendered bipedal and divided into Tamoxifen (TMX), Raloxifene (RLX) and control groups. TMX and RLX groups received orally administered TMX and RLX for 40 weeks. Anteroposterior X-ray imaging and histomorphometric analysis (at 20th and 40th weeks) were performed. RESULTS At 20th week, TMX and RLX groups displayed higher rates (p = 0.033, p = 0.029) and larger curve magnitudes (p = 0.018). At 40th week, curve rates were similar between the groups but the curve magnitudes in TMX and RLX groups were smaller (p = 0.001). Histomorphometry revealed that treated animals had higher trabecular density (p = 0.04), lower total intervertebral disc (p = 0.038) and growth plate volumes (p = 0.005) and smaller vertebral bodies (p = 0.016). CONCLUSIONS Treatment with TMX or RLX did not reduce the incidence of scoliosis but decreased the curve magnitudes at 40 weeks. The underlying mechanism associated with the decrease in curve magnitudes may be the early maturation of growth plates, thereby possible deceleration of the growth rate of the vertebral column and increase in bone density. RLX is as effective as TMX in preventing the progression of scoliotic curves in melatonin deficient bipedal mice.
Collapse
|
41
|
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
|
42
|
Taylor AC, Horvat-Gordon M, Moore A, Bartell PA. The effects of melatonin on the physical properties of bones and egg shells in the laying hen. PLoS One 2013; 8:e55663. [PMID: 23468846 PMCID: PMC3585294 DOI: 10.1371/journal.pone.0055663] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/29/2012] [Indexed: 11/18/2022] Open
Abstract
Laying hens often experience unbalanced calcium utilization which can cause deficiencies in bone and egg mineralization. Because melatonin has been shown to affect bone mineralization in other animals, we examined whether treating hens with melatonin would affect eggshell thickness and improve skeletal performance, thereby reducing skeletal and egg shell defects. Birds were given a diet containing either low (30 µg/kg), medium (300 µg/kg), or high (3 mg/kg) concentrations of melatonin, or control feed through approximately one laying cycle. We examined the weight, length, and strength of egg, femur, tibia, and keel. Hens treated with a high concentration of melatonin showed significant strengthening in their femur and tibia, as measured by maximum force sustained and breaking force, compared to controls. Egg weights from hens treated with melatonin were significantly greater than those from hens that were not treated with melatonin. Conversely, egg shell mass of hens treated with melatonin was significantly lower than those of hens not treated with melatonin. Our data suggest that melatonin may affect the allocation of calcium to bone at the expense of egg shell mineralization.
Collapse
Affiliation(s)
- Alexander C. Taylor
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, United States of America
- Intercollege Graduate Degree Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Maria Horvat-Gordon
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Ashli Moore
- Department of Biology, University of Virginia, Charlottesville, Virginia, United States of America
| | - Paul A. Bartell
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, United States of America
- Intercollege Graduate Degree Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
- * E-mail:
| |
Collapse
|
43
|
Dayer R, Haumont T, Belaieff W, Lascombes P. Idiopathic scoliosis: etiological concepts and hypotheses. J Child Orthop 2013; 7:11-6. [PMID: 24432053 PMCID: PMC3566252 DOI: 10.1007/s11832-012-0458-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 07/11/2012] [Indexed: 02/03/2023] Open
Abstract
Scoliosis is diagnosed as idiopathic in 70 % of structural deformities affecting the spine in children and adolescents, probably reflecting our current misunderstanding of this disease. By definition, a structural scoliosis should be the result of some primary disorder. The goal of this article is to give a comprehensive overview of the currently proposed etiological concepts in idiopathic scoliosis regarding genetics, molecular biology, biomechanics, and neurology, with particular emphasis on adolescent idiopathic scoliosis (AIS). Despite the fact that numerous potential etiologies for idiopathic scoliosis have been formulated, the primary etiology of AIS remains unknown. Beyond etiology, identification of prognostic factors of AIS progression would probably be more relevant in our daily practice, with the hope of reducing repetitive exposure to radiation, unnecessary brace treatments, psychological implications, and costs-of-care related to follow-up in low-risk patients.
Collapse
Affiliation(s)
- Romain Dayer
- />Department of Pediatric Orthopaedics, Child and Adolescent Department, University Hospitals of Geneva, Rue Willy-Donzé 6, 1211 Geneva 14, Switzerland
| | - Thierry Haumont
- />Department of Pediatric Orthopaedic Surgery, Children’s Hospital, University Hospitals of Nancy, Nancy, France
| | - Wilson Belaieff
- />Department of Pediatric Orthopaedics, Child and Adolescent Department, University Hospitals of Geneva, Rue Willy-Donzé 6, 1211 Geneva 14, Switzerland
| | - Pierre Lascombes
- />Department of Pediatric Orthopaedic Surgery, Children’s Hospital, University Hospitals of Nancy, Nancy, France , />Department of Pediatric Orthopaedics, Child and Adolescent Department, University Hospitals of Geneva, Rue Willy-Donzé 6, 1211 Geneva 14, Switzerland
| |
Collapse
|
44
|
Abstract
Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformities which affect the coronal and sagittal planes, as well as the rib cage, waistline symmetry, and shoulder balance. Patient's dissatisfaction in terms of physical appearance and mechanical back pain, as well as the risk for curve deterioration are usually the reasons for treatment. Conservative management involves mainly bracing with the aim to stop or slow down scoliosis progression during growth and if possible prevent the need for surgical treatment. This is mainly indicated in young compliant patients with a large amount of remaining growth and progressive curvatures. Scoliosis correction is indicated for severe or progressive curves which produce significant cosmetic deformity, muscular pain, and patient discontent. Posterior spinal arthrodesis with Harrington instrumentation and bone grafting was the first attempt to correct the coronal deformity and replace in situ fusion. This was associated with high pseudarthrosis rates, need for postoperative immobilization, and flattening of sagittal spinal contour. Segmental correction techniques were introduced along with the Luque rods, Harri-Luque, and Wisconsin systems. Correction in both coronal and sagittal planes was not satisfactory and high rates of nonunion persisted until Cotrel and Dubousset introduced the concept of global spinal derotation. Development of pedicle screws provided a powerful tool to correct three-dimensional vertebral deformity and opened a new era in the treatment of scoliosis.
Collapse
Affiliation(s)
- Alok Sud
- Commonwealth Travelling Spinal Fellow, Honorary Clinical Senior Lecturer, Scottish National Spine Deformity Center, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF, UK
| | - Athanasios I Tsirikos
- Consultant Orthopaedic and Spine Surgeon, Honorary Clinical Senior Lecturer, Scottish National Spine Deformity Center, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF, UK,Address for correspondence: Mr. Athanasios I. Tsirikos, Honorary Clinical Senior Lecturer-University of Edinburgh, Scottish National Spine Deformity Center, Sciennes Road, Edinburgh, EH9 1LF, UK. E-mail:
| |
Collapse
|
45
|
Witt-Enderby PA, Slater JP, Johnson NA, Bondi CD, Dodda BR, Kotlarczyk MP, Clafshenkel WP, Sethi S, Higginbotham S, Rutkowski JL, Gallagher KM, Davis VL. Effects on bone by the light/dark cycle and chronic treatment with melatonin and/or hormone replacement therapy in intact female mice. J Pineal Res 2012; 53:374-84. [PMID: 22639972 DOI: 10.1111/j.1600-079x.2012.01007.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this study, the effects of the light/dark cycle, hormone replacement therapy (HRT), and nocturnal melatonin supplementation on osteogenic markers and serum melatonin levels were examined in a blind mouse model (MMTV-Neu transgenic mice). Melatonin levels in this mouse strain (FVB/N) with retinal degeneration (rd-/-) fluctuate in a diurnal manner, suggesting that these mice, although blind, still perceive light. Real-time RT-PCR analyses demonstrated that Runx2, Bmp2, Bmp6, Bglap, and Per2 mRNA levels coincide with melatonin levels. The effect of chronic HRT (0.5 mg 17β-estradiol + 50 mg progesterone in 1800 kcal of diet) alone and in combination with melatonin (15 mg/L drinking water) on bone quality and density was also assessed by histomorphometry and microcomputed tomography, respectively. Bone density was significantly increased (P < 0.05) after 1 yr of treatment with the individual therapies, HRT (22% increase) and nocturnal melatonin (20% increase) compared to control. Hormone replacement therapy alone also increased surface bone, decreased trabecular space, and decreased the number of osteoclasts without affecting osteoblast numbers compared to the control group (P < 0.05). Chronic HRT + melatonin therapy did not significantly increase bone density, even though this combination significantly increased Bglap mRNA levels. These data suggest that the endogenous melatonin rhythm modulates markers important to bone physiology. Hormone replacement therapy with or without nocturnal melatonin in cycling mice produces unique effects on bone markers and bone density. The effects of these therapies alone and combined may improve bone health in women in perimenopause and with low nocturnal melatonin levels from too little sleep, too much light, or age.
Collapse
Affiliation(s)
- Paula A Witt-Enderby
- Division of Pharmaceutical Sciences, School of Pharmacy, Duquesne University, Pittsburgh, PA 15282, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Gorman KF, Julien C, Moreau A. The genetic epidemiology of idiopathic 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 2012; 21:1905-19. [PMID: 22695700 PMCID: PMC3463687 DOI: 10.1007/s00586-012-2389-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 05/17/2012] [Accepted: 05/22/2012] [Indexed: 12/23/2022]
Abstract
Purpose Idiopathic scoliosis is a complex developmental syndrome defined by an abnormal structural curvature of the spine. High treatment costs, chronic pain/discomfort, and the need for monitoring at-risk individuals contribute to the global healthcare burden of this musculoskeletal disease. Although many studies have endeavored to identify underlying genes, little progress has been made in understanding the etiopathogenesis. The objective of this comprehensive review was to summarize genetic associations/linkages with idiopathic scoliosis, as well as explore the strengths and weaknesses of each study, such that it may serve as a guide for the design and interpretation of future genetic studies in scoliosis. Methods We searched PubMed and Human Genome Epidemiology (HuGE) Navigator using the search terms “gene and scoliosis”. Linkage or association studies published in English and available full-text were further analyzed as regards results, experimental design, and statistical approach. Results We identified and analyzed 50 studies matching our criteria. These consisted of 34 candidate gene studies (6 linkage, 28 association) and 16 genome-wide studies [14 pedigree-based linkage, 2 genome-wide association studies (GWAS)]. Findings involved genes related to connective tissue structure, bone formation/metabolism, melatonin signaling pathways, puberty and growth, and axon guidance pathways. Variability in results between studies suggested ethnic and/or genetic heterogeneity. Conclusions The major difficulty in idiopathic scoliosis research is phenotypic and genetic heterogeneity. Genetic research was overrepresented by underpowered studies. The use of biological endophenotypes, as well as restricted clinical definitions, may help to partition variation and increase the power of studies to detect or confirm an effect.
Collapse
Affiliation(s)
- Kristen Fay Gorman
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Sainte Justine University Hospital Research Center, Montreal, QC, Canada
| | | | | |
Collapse
|
47
|
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
|
48
|
Kotlarczyk MP, Lassila HC, O'Neil CK, D'Amico F, Enderby LT, Witt-Enderby PA, Balk JL. Melatonin osteoporosis prevention study (MOPS): a randomized, double-blind, placebo-controlled study examining the effects of melatonin on bone health and quality of life in perimenopausal women. J Pineal Res 2012; 52:414-26. [PMID: 22220591 DOI: 10.1111/j.1600-079x.2011.00956.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The purpose of this double-blind study was to assess the effects of nightly melatonin supplementation on bone health and quality of life in perimenopausal women. A total of 18 women (ages 45-54) were randomized to receive melatonin (3mg, p.o., n=13) or placebo (n=5) nightly for 6months. Bone density was measured by calcaneal ultrasound. Bone turnover marker (osteocalcin, OC for bone formation and NTX for bone resorption) levels were measured bimonthly in serum. Participants completed Menopause-Specific Quality of Life-Intervention (MENQOL) and Pittsburgh Sleep Quality Index (PSQI) questionnaires before and after treatment. Subjects also kept daily diaries recording menstrual cycling, well-being, and sleep patterns. The results from this study showed no significant change (6-month-baseline) in bone density, NTX, or OC between groups; however, the ratio of NTX:OC trended downward over time toward a ratio of 1:1 in the melatonin group. Melatonin had no effect on vasomotor, psychosocial, or sexual MENQOL domain scores; however, it did improve physical domain scores compared to placebo (mean change melatonin: -0.6 versus placebo: 0.1, P<0.05). Menstrual cycling was reduced in women taking melatonin (mean cycles melatonin: 4.3 versus placebo: 6.5, P<0.05), and days between cycles were longer (mean days melatonin: 51.2 versus placebo: 24.1, P<0.05). No differences in duration of menses occurred between groups. The overall PSQI score and average number of hours slept were similar between groups. These findings show that melatonin supplementation was well tolerated, improved physical symptoms associated with perimenopause, and may restore imbalances in bone remodeling to prevent bone loss. Further investigation is warranted.
Collapse
Affiliation(s)
- Mary P Kotlarczyk
- Division of Pharmaceutical Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA 15282, USA
| | | | | | | | | | | | | |
Collapse
|
49
|
Microcomputed tomographic evaluation of vertebral microarchitecture in pinealectomized scoliosis chickens. J Pediatr Orthop B 2011; 20:382-8. [PMID: 21792070 DOI: 10.1097/bpb.0b013e3283474c6e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pinealectomy was used to induce scoliosis in Broiler chickens, and the bone microarchitecture of the concave and convex sides in pinealectomized scoliosis chickens was assessed by microcomputed tomography (micro-CT). Few studies have assessed the vertebrae bone microarchitecture of the concave and convex sides in scoliosis although the curvature of the coronal plane is the main deformity in scoliosis. The purpose of this study was to determine whether there are differences in the bone microarchitecture of the concave and convex sides in pinealectomized scoliosis chickens by the technique of micro-CT. The etiology and the pathogenesis of the idiopathic scoliosis remain unclear. Limited information is available on the microarchitecture of vertebrae bone of the concave and convex sides of scoliosis, especially in the earlier stage in scoliosis development. One hundred female Broiler chickens were divided into three groups as follows: the control group (n=20), the sham operation group (n=20), and the pinealectomy group (n=60). Then the pinealectomy group was divided into three groups according to the time of killing the chickens: 1-week after the operation (group P-1 w, n=20), 2 weeks after the operation (group P-2 w, n=20), and 3 weeks after the operation (group P-3 w, n=20), respectively. Posteroanterior radiographs of the spine were taken to detect spinal curvature. Using micro-CT, the bone volume/tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation of the concave and convex sides of the apex vertebrae in the scoliotic chickens were determined. Independent t-tests were used to assess differences of bone parameter of the concave and convex sides in each pinealectomized group. The incidences of scoliosis in the pinealectomized Broiler chickens were 84.2% (group P-1 w), 88.9% (group P-2 w), and 89.5% (group P-3 w), respectively. In groups P-1 w and P-2 w, there were no differences between the concave and convex trabecular bone microarchitectures. In group 3 w, the BV/TV, Tb.Th, and Tb.N of the concave side were significantly greater than those of the convex side. In the earlier stage of pinealectomized scoliosis chickens, there are no histological evidence of a metabolic abnormality. The greater BV/TV, Tb.Th, and Tb.N of the concave side in group P-3 w may be consistent with Wolff's law and are the secondary response to the scoliotic deformity.
Collapse
|
50
|
Kono H, Machida M, Saito M, Nishiwaki Y, Kato H, Hosogane N, Chiba K, Miyamoto T, Matsumoto M, Toyama Y. Mechanism of osteoporosis in adolescent idiopathic scoliosis: experimental scoliosis in pinealectomized chickens. J Pineal Res 2011; 51:387-93. [PMID: 21649717 DOI: 10.1111/j.1600-079x.2011.00901.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To clarify the mechanism of osteoporosis in adolescent idiopathic scoliosis (AIS), we investigated radiological and histological changes in the cervical vertebrae of a chicken thoracic scoliosis model. Forty newly hatched broiler chicks were randomly divided into four equal groups: sham-operated chickens serving as control (CON), pinealectomized chickens (PNX), sham-operated (CON + MLT) and pinealectomized chickens (PNX + MLT) that received intraperitoneal administration of melatonin. Pinealectomy was performed at the age of 3 days, and the chickens were killed at 2 months of age. Postmortem X-rays were examined for the presence of scoliosis, and micro-computed tomography (micro-CT) images were taken to evaluate the microstructure of the cervical vertebrae. Histological specimens of the scanned cervical vertebra were prepared, and a midsagittal section was stained with hematoxylin and eosin and tartrate-resistant acid phosphatase to evaluate the numbers of osteoblasts and osteoclasts, respectively. Scoliosis developed at the thoracic spine in all chickens of the PNX and in two of the PNX + MLT group. Micro-CT data revealed that chickens in the PNX group had a greater degree of generalized osteoporosis compared with the other birds. The number of osteoblasts was significantly decreased in the PNX group, while no significant difference was observed among chickens in the numbers of osteoclasts. Our results suggest that melatonin deficiency reduces osteoblast proliferation and leads to the development of scoliosis and osteoporosis. The restoration of melatonin prevented the development of scoliosis and osteoporosis, indicating that melatonin levels may be crucial to the development of deformity and osteoporosis in AIS.
Collapse
Affiliation(s)
- Hitoshi Kono
- Department of Orthopaedic Surgery School of Medicine, Keio University, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|