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Nauta S, Greven J, Hofman M, Mohren R, Meesters DM, Möckel D, Lammers T, Hildebrand F, Siegel TP, Cuypers E, Heeren RM, Poeze M. Mass Spectrometry Reveals Molecular Effects of Citrulline Supplementation during Bone Fracture Healing in a Rat Model. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2024; 35:1184-1196. [PMID: 38679918 PMCID: PMC11157653 DOI: 10.1021/jasms.4c00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024]
Abstract
Bone fracture healing is a complex process in which specific molecular knowledge is still lacking. The citrulline-arginine-nitric oxide metabolism is one of the involved pathways, and its enrichment via citrulline supplementation can enhance fracture healing. This study investigated the molecular effects of citrulline supplementation during the different fracture healing phases in a rat model. Microcomputed tomography (μCT) was applied for the analysis of the fracture callus formation. Matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) and liquid-chromatography tandem mass spectrometry (LC-MS/MS) were used for lipid and protein analyses, respectively. μCT analysis showed no significant differences in the fracture callus volume and volume fraction between the citrulline supplementation and control group. The observed lipid profiles for the citrulline supplementation and control group were distinct for the different fracture healing stages. The main contributing lipid classes were phosphatidylcholines (PCs) and lysophosphatidylcholines (LPCs). The changing effect of citrulline supplementation throughout fracture healing was indicated by changes in the differentially expressed proteins between the groups. Pathway analysis showed an enhancement of fracture healing in the citrulline supplementation group in comparison to the control group via improved angiogenesis and earlier formation of the soft and hard callus. This study showed the molecular effects on lipids, proteins, and pathways associated with citrulline supplementation during bone fracture healing, even though no effect was visible with μCT.
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Affiliation(s)
- Sylvia Nauta
- Division
of Imaging Mass Spectrometry, Maastricht MultiModal Molecular Imaging
(M4i) Institute, Maastricht University, 6229ER Maastricht, The Netherlands
- Division
of Traumasurgery, Department of Surgery, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
| | - Johannes Greven
- Department
of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Martijn Hofman
- Center
of Musculoskeletal Surgery, Bonifatius Hospital
Lingen, 49808 Lingen, Germany
| | - Ronny Mohren
- Division
of Imaging Mass Spectrometry, Maastricht MultiModal Molecular Imaging
(M4i) Institute, Maastricht University, 6229ER Maastricht, The Netherlands
| | - Dennis M. Meesters
- Department
of Genetics & Cell Biology, Maastricht
University, 6229ER Maastricht, The Netherlands
- NUTRIM, School
for Nutrition and Translational Research in Metabolism, Maastricht University, 6229ER Maastricht, The Netherlands
| | - Diana Möckel
- Department
of Nanomedicine and Theranostics, Institute for Experimental Molecular
Imaging, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Twan Lammers
- Department
of Nanomedicine and Theranostics, Institute for Experimental Molecular
Imaging, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Frank Hildebrand
- Department
of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Tiffany Porta Siegel
- Division
of Imaging Mass Spectrometry, Maastricht MultiModal Molecular Imaging
(M4i) Institute, Maastricht University, 6229ER Maastricht, The Netherlands
| | - Eva Cuypers
- Division
of Imaging Mass Spectrometry, Maastricht MultiModal Molecular Imaging
(M4i) Institute, Maastricht University, 6229ER Maastricht, The Netherlands
| | - Ron M.A. Heeren
- Division
of Imaging Mass Spectrometry, Maastricht MultiModal Molecular Imaging
(M4i) Institute, Maastricht University, 6229ER Maastricht, The Netherlands
| | - Martijn Poeze
- Division
of Traumasurgery, Department of Surgery, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
- NUTRIM, School
for Nutrition and Translational Research in Metabolism, Maastricht University, 6229ER Maastricht, The Netherlands
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van Brakel F, Zhao Y, van der Eerden BC. Fueling recovery: The importance of energy coupling between angiogenesis and osteogenesis during fracture healing. Bone Rep 2024; 21:101757. [PMID: 38577251 PMCID: PMC10990718 DOI: 10.1016/j.bonr.2024.101757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024] Open
Abstract
Approximately half of bone fractures that do not heal properly (non-union) can be accounted to insufficient angiogenesis. The processes of angiogenesis and osteogenesis are spatiotemporally regulated in the complex process of fracture healing that requires a substantial amount of energy. It is thought that a metabolic coupling between angiogenesis and osteogenesis is essential for successful healing. However, how this coupling is achieved remains to be largely elucidated. Here, we will discuss the most recent evidence from literature pointing towards a metabolic coupling between angiogenesis and osteogenesis. We will describe the metabolic profiles of the cell types involved during fracture healing as well as secreted products in the bone microenvironment (such as lactate and nitric oxide) as possible key players in this metabolic crosstalk.
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Affiliation(s)
- Fleur van Brakel
- Calcium and Bone Metabolism Laboratory, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Yudong Zhao
- Calcium and Bone Metabolism Laboratory, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Bram C.J. van der Eerden
- Calcium and Bone Metabolism Laboratory, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
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Liang B, Shi X, Wang X, Ma C, Leslie WD, Lix LM, Shi X, Kan B, Yang S. Association between amino acids and recent osteoporotic fracture: a matched incident case-control study. Front Nutr 2024; 11:1360959. [PMID: 38567247 PMCID: PMC10985241 DOI: 10.3389/fnut.2024.1360959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Context Osteoporotic fracture is a major public health issue globally. Human research on the association between amino acids (AAs) and fracture is still lacking. Objective To examine the association between AAs and recent osteoporotic fractures. Methods This age and sex matched incident case-control study identified 44 recent x-ray confirmed fracture cases in the Second Hospital of Jilin University and 88 community-based healthy controls aged 50+ years. Plasma AAs were measured by high performance liquid chromatography coupled with mass spectrometry. After adjusting for covariates (i.e., body mass index, milk intake >1 time/week, falls and physical activity), we conducted conditional logistical regression models to test the association between AAs and fracture. Results Among cases there were 23 (52.3%) hip fractures and 21 (47.7%) non-hip fractures. Total, essential, and non-essential AAs were significantly lower in cases than in controls. In the multivariable conditional logistic regression models, after adjusting for covariates, each standard deviation increase in the total (odds ratio [OR]: 0.304; 95% confidence interval [CI]: 0.117-0.794), essential (OR: 0.408; 95% CI: 0.181-0.923) and non-essential AAs (OR: 0.290; 95%CI: 0.107-0.782) was negatively associated with recent fracture. These inverse associations were mainly found for hip fracture, rather than non-hip fractures. Among these AAs, lysine, alanine, arginine, glutamine, histidine and piperamide showed the significantly negative associations with fracture. Conclusion There was a negative relationship between AAs and recent osteoporotic fracture; such relationship appeared to be more obvious for hip fracture.
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Affiliation(s)
- Bing Liang
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi’an Jiao tong University, Xi’an, China
| | - Xinyan Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinwei Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Chao Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - William D. Leslie
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Xianbao Shi
- Department of Pharmacy, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Bo Kan
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Shuman Yang
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
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Hamad NA, Eltayeb LB, Yassin HM. Implication of Low Plasma Arginine among Patients with Diabetic Foot Ulcer (DFU). Pak J Biol Sci 2024; 27:46-51. [PMID: 38413397 DOI: 10.3923/pjbs.2024.46.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
<b>Background and Objective:</b> Diabetic foot ulcer (DFU) is a well-recognized vascular complication of uncontrolled diabetes mellitus. Unless immediate measures are taken some patients end up with amputation. The hallmarks of DFU are hyperglycemia, neuropathy, ischemia and infection (Andrew). Recent studies confirmed the role of low serum arginine in the development of foot ulcer in diabetic patients. The current study aimed to investigate the relationship between low serum magnesium and diabetic foot ulcer and to identify the incidence of low plasma arginine levels in diabetic patients with DFU in Sudan. <b>Materials and Methods:</b> A total of 120 subjects were recruited in this study and were divided into three groups, namely, diabetic with foot ulcer (group-I), diabetic without foot ulcer (group-II) and non-diabetic healthy subjects (group-III). These subjects were investigated for FBS, HbA1c and serum arginine. Data were analysed using SPSS (28th release). <b>Results:</b> Analysis of the results obtained showed significantly marked reduced plasma arginine levels in group I than the other two groups where mean plasma arginine level was 12.08, 49.25 and 94.1 micromole/L, respectively. There was no statistical difference between the duration of diabetes and DFU in diabetic patients with DFU and diabetic patients without DFU, as well as levels of HbA1c (p-value 0.457, 0.89) respectively. <b>Conclusion:</b> The low serum arginine levels were significantly associated with foot ulcers in diabetic patients and play an important role in the development of diabetic foot ulcers.
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Miura N, Morishita K, Yasuda T, Akiduki S, Matsumoto H. Subchronic tolerance trials of graded oral supplementation with ornithine hydrochloride or citrulline in healthy adults. Amino Acids 2023; 55:299-311. [PMID: 36571619 PMCID: PMC9791970 DOI: 10.1007/s00726-022-03227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/13/2022] [Indexed: 12/27/2022]
Abstract
Ornithine and citrulline are amino acids used in dietary supplements and nutritional products consumed by healthy consumers, but the safe supplementation levels of these compounds are unknown. The objective of this study was to conduct two 4-week clinical trials to evaluate the safety and tolerability of graded dosages of oral ornithine (as hydrochloride) and citrulline. Healthy male adults (n = 60, age 41.4 ± 1.5 years) completed graded dosages of either ornithine hydrochloride (3.2, 6, 9.2, and 12 g/day) or citrulline (6, 12, 18, and 24 g/day) supplement for 4 weeks with 2-week wash-out periods in between. Primary outcomes included vitals, a broad spectrum of circulating biochemical analytes, body weight, sleep quality, and mental self-assessment. In the ornithine hydrochloride supplementation group, minor increase in plasma aspartic acid and glutamic acid concentrations was observed at the highest intake dosages. In the citrulline supplementation group, minor changes in laboratory data for serum lactate dehydrogenase and plasma amino acid concentration of lysine, methionine, threonine, aspartic acid, glutamic acid, glutamine and ornithine, arginine, and citrulline itself were measured. No other changes in measured parameters were observed, and study subjects tolerated 4-week-long oral supplementation of ornithine hydrochloride or citrulline without treatment-related adverse events. A clinical, no-observed-adverse-effect-level (NOAEL) of ornithine hydrochloride and citrulline supplementation in healthy adult males was determined to be 12 g/day and 24 g/day (4 weeks), respectively.
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Affiliation(s)
- Naoki Miura
- Miura Medical Clinic, Higashitenma, Osaka, Japan
| | - Koji Morishita
- Japan Branch of International Council for Amino Acid Science (ICAAS), Hatchobori, Tokyo, Japan
| | - Takamasa Yasuda
- Japan Branch of International Council for Amino Acid Science (ICAAS), Hatchobori, Tokyo, Japan
| | - Saori Akiduki
- Japan Branch of International Council for Amino Acid Science (ICAAS), Hatchobori, Tokyo, Japan
| | - Hideki Matsumoto
- Japan Branch of International Council for Amino Acid Science (ICAAS), Hatchobori, Tokyo, Japan.
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Bow AJ, Rifkin RE, Priester C, Christopher CJ, Grzeskowiak RM, Hecht S, Adair SH, Mulon PY, Castro HF, Campagna SR, Anderson DE. Temporal metabolic profiling of bone healing in a caprine tibia segmental defect model. Front Vet Sci 2023; 9:1023650. [PMID: 36733424 PMCID: PMC9886884 DOI: 10.3389/fvets.2022.1023650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
Bone tissue engineering is an emerging field of regenerative medicine, with a wide array of biomaterial technologies and therapeutics employed. However, it is difficult to objectively compare these various treatments during various stages of tissue response. Metabolomics is rapidly emerging as a powerful analytical tool to establish broad-spectrum metabolic signatures for a target biological system. Developing an effective biomarker panel for bone repair from small molecule data would provide an objective metric to readily assess the efficacy of novel therapeutics in relation to natural healing mechanisms. In this study we utilized a large segmental bone defect in goats to reflect trauma resulting in substantial volumetric bone loss. Characterization of the native repair capacity was then conducted over a period of 12 months through the combination of standard (radiography, computed tomography, histology, biomechanics) data and ultra-high-performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS) metabolic profiling. Standard metrics demonstrated that samples formed soft callus structures that later mineralized. Small molecule profiles showed distinct temporal patterns associated with the bone tissue repair process. Specifically, increased lactate and amino acid levels at early time points indicated an environment conducive to osteoblast differentiation and extracellular matrix formation. Citrate and pyruvate abundances increased at later time points indicating increasing mineral content within the defect region. Taurine, shikimate, and pantothenate distribution profiles appeared to represent a shift toward a more homeostatic remodeling environment with the differentiation and activity of osteoclasts offsetting the earlier deposition phases of bone repair. The generation of a comprehensive metabolic reference portfolio offers a potent mechanism for examining novel biomaterials and can serve as guide for the development of new targeted therapeutics to improve the rate, magnitude, and quality of bone regeneration.
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Affiliation(s)
- Austin J. Bow
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States,*Correspondence: Austin J. Bow ✉
| | - Rebecca E. Rifkin
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Caitlin Priester
- Department of Animal Science, University of Tennessee, Knoxville, Knoxville, TN, United States
| | | | - Remigiusz M. Grzeskowiak
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Steve H. Adair
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Pierre-Yves Mulon
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Hector F. Castro
- Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States,Biological and Small Molecule Mass Spectrometry Core and the Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Shawn R. Campagna
- Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States,Biological and Small Molecule Mass Spectrometry Core and the Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - David E. Anderson
- University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States,David E. Anderson ✉
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Meesters DM, Wijnands KAP, van Eijk HMH, Hofman M, Hildebrand F, Verbruggen JPAM, Brink PRG, Poeze M. Arginine Availability in Reamed Intramedullary Aspirate as Predictor of Outcome in Nonunion Healing. Biomedicines 2022; 10:biomedicines10102474. [PMID: 36289736 PMCID: PMC9598747 DOI: 10.3390/biomedicines10102474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/18/2022] [Accepted: 10/01/2022] [Indexed: 11/16/2022] Open
Abstract
Fracture healing and nonunion development are influenced by a range of biological factors. Adequate amino acid concentrations, especially arginine, are known to be important during normal bone healing. We hypothesize that bone arginine availability in autologous bone marrow grafting, when using the reamer-irrigator-aspirator (RIA) procedure, is a marker of bone healing capacity in patients treated for nonunion. Seventeen patients treated for atrophic long bone nonunion by autologous bone grafting by the RIA procedure were included and divided into two groups, successful treatment of nonunion and unsuccessful, and were compared with control patients after normal fracture healing. Reamed bone marrow aspirate from a site distant to the nonunion was obtained and the amino acids and enzymes relevant to arginine metabolism were measured. Arginine and ornithine concentrations were higher in patients with successful bone healing after RIA in comparison with unsuccessful healing. Ornithine concentrations and arginase-1 expression were lower in all nonunion patients compared to control patients, while citrulline concentrations were increased. Nitric oxide synthase 2 (Nos2) expression was significantly increased in all RIA-treated patients, and higher in patients with a successful outcome when compared with an unsuccessful outcome. The results indicate an influence of the arginine-nitric oxide metabolism in collected bone marrow, on the outcome of nonunion treatment, with indications for a prolonged inflammatory response in patients with unsuccessful bone grafting therapy. The determination of arginine concentrations and Nos2 expression could be used as a predictor for the successful treatment of autologous bone grafting in nonunion treatment.
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Affiliation(s)
- Dennis M. Meesters
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center +, 6200 MD Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-433-881-891
| | - Karolina A. P. Wijnands
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center +, 6200 MD Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Hans M. H. van Eijk
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center +, 6200 MD Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Martijn Hofman
- Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Frank Hildebrand
- Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Jan P. A. M. Verbruggen
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center +, 6200 MD Maastricht, The Netherlands
| | - Peter R. G. Brink
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center +, 6200 MD Maastricht, The Netherlands
| | - Martijn Poeze
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center +, 6200 MD Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
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Canintika AF, Dilogo IH, Putera GU, Yafidy M. Oral L-arginine supplementation for fracture healing: a systematic review of preclinical studies. Acta Orthop Belg 2022; 88:609-615. [PMID: 36791716 DOI: 10.52628/88.3.7541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Introduction Approximately 5 to 10% of all patients with fractures experience deficient fracture healing that results in fracture nonunions. Previous studies have shown that nitric oxide production from arginine could improve fracture healing by improving local blood supply, supplementing growth factors, and improving collagen synthesis. Apart from its simple oral mode of administration, this amino acid provides a non-toxic and inexpensive option for fracture healing. To date, no systematic reviews regarding oral L-arginine supplementation for fracture healing are available. We present the first systematic review of oral L-arginine supplementation for fracture healing. Methods A systematic literature search was carried out using PubMed, Google Scholar, and ScienceDirect until February 1, 2021 using a combination of text words. No date limits were set. Studies investigating the use of oral L-arginine supplementation for fracture healing were included. Reference lists of relevant publications were assessed for additional references. In addition, bibliographies from other reviews were searched. Results Four studies were included. Of these, 3 were animal studies, and the other one was an in vitro study. Animals that were given oral L-arginine supplementation had significantly increased angiogenesis, reduced defect area, higher osteoblasts and osteoclasts, and higher rate of bone formation compared to controls. Conclusions The available preclinical studies suggest that oral L-arginine supplementation is a potential new therapy for fracture healing. This amino acid supplement is not only affordable and non-toxic; it is also simple. Further clinical studies are required to investigate the optimal dose of oral L-arginine supplementation for fracture healing in human subjects.
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Shen J, Li YZ, Yao S, Zhu ZW, Wang X, Sun HH, Ji WF. Hu’po Anshen Decoction Accelerated Fracture-Healing in a Rat Model of Traumatic Brain Injury Through Activation of PI3K/AKT Pathway. Front Pharmacol 2022; 13:952696. [PMID: 35924045 PMCID: PMC9341486 DOI: 10.3389/fphar.2022.952696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
Hu’po Anshen decoction (HPASD) is a traditional Chinese medicine formula comprising five herbal medicines for the treatment of concussion and fracture healing, but its pharmacological mechanism is still unclear. Ultra-performance liquid chromatography coupled with quadrupole time of flight mass spectrometry (UPLC/Q-TOF MS) was used to analyze the main active components of HPASD. Rats were randomly assigned to fracture group, fracture combined with traumatic brain injury (TBI) group (FBI) and FBI combined with HPASD treatment group (FBIH). Rats in the FBIH group were given oral doses of HPASD (2.4 g/kg, 4.8 g/kg and 9.6 g/kg) for 14 or 21 consecutive days. The fracture callus formation and fracture sites were determined by radiographic analysis and micron-scale computed tomography (micro-CT) analysis. Hematoxylin and eosin (H&E) staining and a three-point bending test were applied to assess histological lesions and biomechanical properties, respectively. The levels of cytokines-/protein-related to bone formation and differentiation as well as PI3K/AKT pathway-related proteins were determined by Enzyme-linked immunosorbent assay (ELISA), quantitative reverse transcription-polymerase chain reaction (qRT-PCR), or western blot assays, respectively. UPLC-Q/TOF-MS-based serum metabolomic analysis was also performed to investigate the therapeutic effects of HPASD in the treatment of FBI. UPLC/Q-TOF MS analysis showed the chemical components in HPASD, including flavonoids, amino acids, saponins, and phenylpropanoid constituents, etc. HPASD dose-dependently promoted callus formation, increased bone density, improved mechanical parameters and morphological scores, and facilitated the expressions of VEGF, PDGF, bFGF, VEGFA, CoL1A1, RUNX2, BMP2, and Aggrecan, inhibited the expression of MMP13, and activated PI3K/AKT pathway. Metabolomics analysis revealed abnormalities of malate-aspartate shuttle and glucose-alanine. HPASD accelerates fracture healing by promoting bone formation and regulating the malate-aspartate shuttle and glucose-alanine cycle, which might be associated with the activation of the PI3K/AKT pathway.
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Affiliation(s)
- Jing Shen
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan-Ze Li
- Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Sai Yao
- Department of Orthopedics and Traumatology of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhou-Wei Zhu
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiang Wang
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hui-Hui Sun
- Department of Orthopaedics, LanXi People's Hospital, Jinhua, China
- *Correspondence: Hui-Hui Sun, ; Wei-Feng Ji,
| | - Wei-Feng Ji
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- *Correspondence: Hui-Hui Sun, ; Wei-Feng Ji,
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10
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Reis J, Ramos A. In Sickness and in Health: The Oxygen Reactive Species and the Bone. Front Bioeng Biotechnol 2021; 9:745911. [PMID: 34888300 PMCID: PMC8650620 DOI: 10.3389/fbioe.2021.745911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022] Open
Abstract
Oxidative stress plays a central role in physiological and pathological bone conditions. Its role in signalment and control of bone cell population differentiation, activity, and fate is increasingly recognized. The possibilities of its use and manipulation with therapeutic goals are virtually unending. However, how redox balance interplays with the response to mechanical stimuli is yet to be fully understood. The present work summarizes current knowledge on these aspects, in an integrative and broad introductory perspective.
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Affiliation(s)
- Joana Reis
- Agronomic and Veterinary Sciences, School of Agriculture, Polytechnic Institute of Viana Do Castelo, Ponte de Lima, Portugal
| | - António Ramos
- TEMA, Mechanical Engineering Department, University of Aveiro, Aveiro, Portugal
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Chitwood JR, Chakraborty N, Hammamieh R, Moe SM, Chen NX, Kacena MA, Natoli RM. Predicting fracture healing with blood biomarkers: the potential to assess patient risk of fracture nonunion. Biomarkers 2021; 26:703-717. [PMID: 34555995 DOI: 10.1080/1354750x.2021.1985171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Fracture non-union is a significant orthopaedic problem affecting a substantial number of patients yearly. Treatment of nonunions is devastating to patients and costly to the healthcare system. Unfortunately, the diagnosis of non-union is typically made in a reactionary fashion by an orthopaedic surgeon based on clinical assessment and radiographic features several months into treatment. For this reason, investigators have been trying to develop prediction algorithms; however, these have relied on population-based approaches and lack the predictive capability necessary to make individual treatment decisions. There is also a growing body of literature focussed on identifying blood biomarkers that are associated with non-union. This review describes the research that has been done in this area. Further studies of patient-centered, precision medicine approaches will likely improve fracture non-union diagnostic/prognostic capabilities.
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Affiliation(s)
- Joseph R Chitwood
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nabarun Chakraborty
- Medical Readiness Systems Biology, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Rasha Hammamieh
- Medical Readiness Systems Biology, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Sharon M Moe
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Neal X Chen
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Melissa A Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Roman M Natoli
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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Shiferaw YF, Engidaw MT, Kedir M, Tsegaye AT. Wealth index is significantly associated with the early phase of fracture healing among fractured patients at the University of Gondar Specialized Hospital, Northwest Ethiopia. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01559-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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13
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Shah FA, Ruscsák K, Palmquist A. Mapping Bone Surface Composition Using Real-Time Surface Tracked Micro-Raman Spectroscopy. Cells Tissues Organs 2021; 209:266-275. [PMID: 33540403 DOI: 10.1159/000511079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/10/2020] [Indexed: 11/19/2022] Open
Abstract
The surface of bone tells a story - one that is worth a thousand words - of how it is built and how it is repaired. Chemical (i.e., composition) and physical (i.e., morphology) characteristics of the bone surface are analogous to a historical record of osteogenesis and provide key insights into bone quality. Analysis of bone chemistry is of particular relevance to the advancement of human health, cell biology, anthropology/archaeology, and biomedical engineering. Although scanning electron microscopy remains a popular and versatile technique to image bone across multiple length scales, limited chemical information can be obtained. Micro-Raman spectroscopy is a valuable tool for nondestructive chemical/compositional analysis of bone. However, signal integrity losses occur frequently during wide-field mapping of non-planar surfaces. Samples for conventional Raman imaging are, therefore, rendered planar through polishing or sectioning to ensure uniform signal quality. Here, we demonstrate ν1 PO43- and ν1 CO32- peak intensity losses where the sample surface and the plane of focus are offset by over 1-2 μm when underfocused and 2-3 μm when overfocused at 0.5-1 s integration time (15 mW, 633 nm laser). A technique is described for mapping the composition of the inherently irregular/non-planar surface of bone. The challenge posed by the native topology characteristic of this unique biological system is circumvented via real-time focus-tracking based on laser focus optimization by continuous closed-loop feedback. At the surface of deproteinized and decellularized/defatted sheep tibial cortical bone, regions of interest up to 1 mm2 were scanned at micrometer and submicrometer resolution. Despite surface height deviations exceeding 100 μm, it is possible to seamlessly probe local gradients in organic and inorganic constituents of the extracellular matrix as markers of bone metabolism and bone turnover, blood vessels and osteocyte lacunae, and the rope-like mineralized bundles that comprise the mineral phase at the bone surface.
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Affiliation(s)
- Furqan A Shah
- Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,
| | - Krisztina Ruscsák
- Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Palmquist
- Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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14
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Designing topographically textured microparticles for induction and modulation of osteogenesis in mesenchymal stem cell engineering. Biomaterials 2020; 266:120450. [PMID: 33096376 DOI: 10.1016/j.biomaterials.2020.120450] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/03/2020] [Accepted: 10/10/2020] [Indexed: 12/26/2022]
Abstract
Mesenchymal stem cells are the focus of intense research in bone development and regeneration. The potential of microparticles as modulating moieties of osteogenic response by utilizing their architectural features is demonstrated herein. Topographically textured microparticles of varying microscale features are produced by exploiting phase-separation of a readily soluble sacrificial component from polylactic acid. The influence of varying topographical features on primary human mesenchymal stem cell attachment, proliferation and markers of osteogenesis is investigated. In the absence of osteoinductive supplements, cells cultured on textured microparticles exhibit notably increased expression of osteogenic markers relative to conventional smooth microparticles. They also exhibit varying morphological, attachment and proliferation responses. Significantly altered gene expression and metabolic profiles are observed, with varying histological characteristics in vivo. This study highlights how tailoring topographical design offers cell-instructive 3D microenvironments which allow manipulation of stem cell fate by eliciting the desired downstream response without use of exogenous osteoinductive factors.
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15
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Meesters DM, Wijnands KAP, Brink PRG, Poeze M. Malnutrition and Fracture Healing: Are Specific Deficiencies in Amino Acids Important in Nonunion Development? Nutrients 2018; 10:E1597. [PMID: 30384490 PMCID: PMC6266771 DOI: 10.3390/nu10111597] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 02/07/2023] Open
Abstract
With the increasing incidence of fractures now, and in the future, the absolute number of bone-healing complications such as nonunion development will also increase. Next to fracture-dependent factors such as large bone loss volumes and inadequate stabilization, the nutritional state of these patients is a major influential factor for the fracture repair process. In this review, we will focus on the influence of protein/amino acid malnutrition and its influence on fracture healing. Mainly, the arginine-citrulline-nitric oxide metabolism is of importance since it can affect fracture healing via several precursors of collagen formation, and through nitric oxide synthases it has influences on the bio-molecular inflammatory responses and the local capillary growth and circulation.
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Affiliation(s)
- Dennis M Meesters
- Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
- NUTRIM School for Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Karolina A P Wijnands
- Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
- NUTRIM School for Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Peter R G Brink
- Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Martijn Poeze
- Department of Surgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
- NUTRIM School for Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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16
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Ding ZC, Lin YK, Gan YK, Tang TT. Molecular pathogenesis of fracture nonunion. J Orthop Translat 2018; 14:45-56. [PMID: 30035032 PMCID: PMC6019407 DOI: 10.1016/j.jot.2018.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 02/07/2023] Open
Abstract
Fracture nonunion, a serious bone fracture complication, remains a challenge in clinical practice. Although the molecular pathogenesis of nonunion remains unclear, a better understanding may provide better approaches for its prevention, diagnosis and treatment at the molecular level. This review tries to summarise the progress made in studies of the pathogenesis of fracture nonunion. We discuss the evidence supporting the concept that the development of nonunion is related to genetic factors. The importance of several cytokines that regulate fracture healing in the pathogenesis of nonunion, such as tumour necrosis factor-α, interleukin-6, bone morphogenetic proteins, insulin-like growth factors, matrix metalloproteinases and vascular endothelial growth factor, has been proven in vitro, in animals and in humans. Nitric oxide and the Wnt signalling pathway also play important roles in the development of nonunion. We present potential strategies for the prevention, diagnosis and treatment of nonunion, and the interaction between genetic alteration and abnormal cytokine expression warrants further investigation. The translational potential of this article A better understanding of nonunion molecular pathogenesis may provide better approaches for its prevention, diagnosis and treatment in clinical practice.
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Affiliation(s)
- Zi-Chuan Ding
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, 639 Zhizaoju Road, Shanghai, China
| | - Yi-Kai Lin
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, 639 Zhizaoju Road, Shanghai, China
| | - Yao-Kai Gan
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, 639 Zhizaoju Road, Shanghai, China
| | - Ting-Ting Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, 639 Zhizaoju Road, Shanghai, China
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17
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Meesters DM, Neubert S, Wijnands KAP, Heyer FL, Zeiter S, Ito K, Brink PRG, Poeze M. Deficiency of inducible and endothelial nitric oxide synthase results in diminished bone formation and delayed union and nonunion development. Bone 2016; 83:111-118. [PMID: 26555548 DOI: 10.1016/j.bone.2015.11.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND Between 5% and 10% of all fractures fail to heal adequately resulting in nonunion of the fracture fragments. This can significantly decrease a patient's quality of life and create associated psychosocial and socio-economic problems. Nitric oxide (NO) and nitric oxide synthases (NOS) have been found to be involved in fracture healing, but until now it is not known if disturbances in these mechanisms play a role in nonunion and delayed union development. In this study, we explored the role of endothelial and inducible NOS deficiency in a delayed union model in mice. MATERIALS AND METHODS A 0.45mm femur osteotomy with periosteal cauterization followed by plate-screw osteosynthesis was performed in the left leg of 20-24week old wild type, Nos2(-/-) and Nos3(-/-) mice. Contralateral unfractured legs were used as a control. Callus volume was measured using micro-computed tomography (μCT) after 28 and 42days of fracture healing. Immuno histochemical myeloperoxidase (MPO) staining was performed on paraffin embedded sections to assess neutrophil influx in callus tissue and surrounding proximal and distal marrow cavities of the femur. After 7 and 28days of fracture healing, femurs were collected for amino acid and RNA analysis to study arginine-NO metabolism. RESULTS With μCT, delayed union was observed in wild type animals, whereas in both Nos2(-/-) and Nos3(-/-) mice nonunion development was evident. Both knock-out strains also showed a significantly increased influx of MPO when compared with wild type mice. Concentrations of amino acids and expression of enzymes related to the arginine-NO metabolism were aberrant in NOS deficient mice when compared to contralateral control femurs and wild type samples. DISCUSSION AND CONCLUSION In the present study we show for the first time that the absence of nitric oxide synthases results in a disturbed arginine-NO metabolism and inadequate fracture healing with the transition of delayed union into a nonunion in mice after a femur osteotomy. Based on these data we suggest that the arginine-NO metabolism may play a role in the prevention of delayed unions and nonunions.
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Affiliation(s)
- D M Meesters
- Department of Surgery and Trauma surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - S Neubert
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos, Switzerland
| | - K A P Wijnands
- Department of Surgery and Trauma surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - F L Heyer
- Department of Surgery and Trauma surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - S Zeiter
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos, Switzerland
| | - K Ito
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos, Switzerland
| | - P R G Brink
- Department of Surgery and Trauma surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - M Poeze
- Department of Surgery and Trauma surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, PO Box 616, 6200 MD, Maastricht, The Netherlands
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