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de Vasconcellos JF, Zicari S, Fernicola SD, Griffin DW, Ji Y, Shin EH, Jones P, Christopherson GT, Bharmal H, Cirino C, Nguyen T, Robertson A, Pellegrini VD, Nesti LJ. In vivo model of human post-traumatic heterotopic ossification demonstrates early fibroproliferative signature. J Transl Med 2019; 17:248. [PMID: 31375141 PMCID: PMC6679453 DOI: 10.1186/s12967-019-1996-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/23/2019] [Indexed: 01/13/2023] Open
Abstract
Background The relationship between the tissue injury healing response and development of heterotopic ossification (HO) is poorly understood. Here we compare a rat blast model and human traumatized muscle from a blast injury to study the early signatures of osteogenesis and fibrosis during the formation of HO. Methods Rat and human tissues were characterized using histology, scanning electron microscopy, immunohistochemistry, as well as gene and protein expression analysis. Additionally, animals and humans were assessed radiographically for HO formation following injury. Results Markers of bone formation were dramatically increased in tissue samples from both humans and rats, and both displayed increased fibroproliferative regions within the injured tissues and elevated expression of markers of tissue fibrosis such as TGF-β1, Fibronectin, SMAD3 and PAI-1. Markers of inflammation and fibrosis (ACTA, TNFα, BMP1 and BMP3) were elevated at the RNA level in both rat and human samples. By day 42, bone formation in the rat blast model appeared similar in radiographs compared to human patients who progressed to develop post-traumatic HO. Conclusions Our data demonstrates that a similar early fibrotic response is evident in both the rat blast model and the human tissues following a traumatic injury and demonstrates the relevance of this animal model for future translational studies.
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Affiliation(s)
- Jaira F de Vasconcellos
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, MD, 20817, USA
| | - Sonia Zicari
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, MD, 20817, USA
| | - Stephen D Fernicola
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Daniel W Griffin
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Youngmi Ji
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Emily H Shin
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Patrick Jones
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Gregory T Christopherson
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Husain Bharmal
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Carl Cirino
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA
| | - Thao Nguyen
- Department of Orthopaedic Surgery, University of Maryland Medical Center, 22 S. Green St., Baltimore, MD, 21201, USA
| | - Astor Robertson
- Department of Orthopaedic Surgery, University of Maryland Medical Center, 22 S. Green St., Baltimore, MD, 21201, USA
| | - Vincent D Pellegrini
- Department of Orthopaedic Surgery, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC, 29425, USA
| | - Leon J Nesti
- Department of Surgery, Walter Reed National Military Medical Center & Uniformed Services University of Health Sciences, 4801 Rockville Pike, Bethesda, MD, 20889, USA. .,Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room A3008C, Bethesda, MD, 20892-8022, USA.
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