Organic nitrate maintains bone marrow blood perfusion in ovariectomized female rats: a dynamic, contrast-enhanced magnetic resonance imaging (MRI) study

Decrease with aging of the microcirculatory function of the lumbar vertebral marrow preceding the loss of bone material density and the onset of intervertebral discal degeneration: A study about the potential cause

Objective

Using a dynamic computed tomographic perfusion (CTP) imaging method to explore the age-related distribution of the microcirculation perfusion function in the vertebral marrow, the bone material density (BMD), and the intervertebral discal degeneration (IDD). Further, to discuss a possible causation relationship between them.

Methods

One hundred and eighty-six people were randomly enrolled by stratified sampling and grouped by age: ≤15, 16–25, 26–35, 36–45, 46–55, 56–65, 66–75, and ≥76 years old. The average CTP and BMD of the third and fourth lumbar vertebrae marrow were measured and the IDD incidence of the third-fourth vertebrae was assessed. The temporal–spatial distribution patterns of the age-related changes of the CTP, BMD, and IDD were described, and the correlations between them were calculated.

Results

The microcirculatory perfusion function of the vertebral marrow develops to maturity by 25 years and is maintained until age 35, then declines with aging. The BMD grew to a peak from 26 to 45 years old, then decreased yearly. The IDD showed a sudden increase after 45 years of age. The CTP [BF (r = 0.806, P = 0.000), BV (r = 0.685, P = 0.005) and PMB (r = 0.619, P = 0.001)] showed strong positive correlations and CTP [TTP (r = −0.211, P = 0.322) and MTT (r = −0.598, P = 0.002)] showed negative correlations with BMD. The CTP [BF (r = −0.815, P = 0.000), BV (r = −0.753, P = 0.000) and PMB (r = −0.690, P = 0.000)] had strong negative correlations, and CTP [TTP (r = 0.323, P = 0.126) and MTT (r = 0.628, P = 0.001)] had positive correlations with the incidence of IDD.

Conclusion

The decrease with aging of the microcirculatory perfusion in the lumbar vertebral marrow preceded, and is a potential causative factor for the loss of BMD and the onset of IDD.

Dysfunctional microcirculation of the lumbar vertebral marrow prior to the bone loss and intervertebral discal degeneration

STUDY DESIGN

Descriptive study, stratified sampling.

OBJECTIVE

Using dynamic computed tomographic perfusion (CTP) to explore the age-related distribution patterns of the microcirculation perfusion in the vertebral marrow, the vertebral bone mineral density (BMD), and the intervertebral discal degeneration (IDD) further to discuss the possible causation between them.

SUMMARY OF BACKGROUND DATA

A latest viewpoint deemed that reduced blood supply of the vertebral marrow was correlated with an increased incidence of IDD and loss of BMD. However, the causative relationship between them needs more investigation.

METHODS

One hundred eighty-six general people were randomly enrolled by stratified sampling and grouped by age: 15 years or less, 16 to 25 years, 26 to 35 years, 36 to 45 years, 46 to 55 years, 56 to 65 years, 66 to 75 years, and 76 years or more. Both CTP and BMD of the third and fourth lumbar vertebral marrow were measured, and the IDD incidence of the third-fourth vertebrae was assessed. The temporal-spatial distribution patterns of the age-related changes of CTP, BMD, and IDD were described, and the correlations between them were calculated.

RESULTS

Microcirculatory perfusion of the vertebral marrow developed to maturate by 25 years, maintained stable at 35 years, and then declined by age after 35 years. BMD grew to a peak phase in 26 to 45 years and then dropped by years. However, IDD presented a sudden increase after 45 years of age. CTP (blood flow [r=0.806], blood volume [r=0.685], and permeability [r=0.619]) showed strong positive correlations and CTP (time to peak [r=-0.211], mean transit time [r=-0.598]) showed negative correlations with BMD. Meanwhile, CTP (blood flow [r=-0.815], blood volume [r=-0.753], and permeability [r=-0.690]) had strong negative correlations and CTP (time to peak [r=0.323] and mean transit time [r=0.628]) had positive correlations with the incidence of IDD.

CONCLUSION

Aging-related decrease of the microcirculatory perfusion of the lumbar vertebral marrow preceded the loss of BMD and the onset of IDD, indicating their possible causal relationship.

LEVEL OF EVIDENCE

3.

Evaluation of a topical herbal agent for the promotion of bone healing

A topically used Chinese herbal paste, namely, CDNR, was designed to facilitate fracture healing which is usually not addressed in general hospital care. From our in vitro studies, CDNR significantly inhibited the release of nitric oxide from RAW264.7 cells by 51 to 77%. This indicated its anti-inflammatory effect. CDNR also promoted the growth of bone cells by stimulating the proliferation of UMR106 cells up to 18%. It also increased the biomechanical strength of the healing bone in a drill-hole defect rat model by 16.5% significantly. This result revealed its in vivo efficacy on facilitation of bone healing. Furthermore, the detection of the chemical markers of CDNR in the skin and muscle of the treatment area demonstrated its transdermal properties. However, CDNR did not affect the bone turnover markers in serum of the rats. With its anti-inflammatory and bone formation properties, CDNR is found effective in promoting bone healing.