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Di Martino A, Villari E, Poluzzi R, Brunello M, Rossomando V, D’Agostino C, Ruta F, Faldini C. Role of biophysical stimulation in multimodal management of vertebral compression fractures. Comput Struct Biotechnol J 2023; 21:5650-5661. [PMID: 38047233 PMCID: PMC10692617 DOI: 10.1016/j.csbj.2023.11.023] [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: 09/28/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023] Open
Abstract
Raised life expectancy and aging of the general population are associated with an increased concern for fragility fractures due to factors such as osteoporosis, reduced bone density, and an higher risk of falls. Among these, the most frequent are vertebral compression fractures (VCF), which can be clinically occult. Once the diagnosis is made, generally thorough antero-posterior and lateral views of the affected spine at the radiographs, a comprehensive workup to assess the presence of a metabolic bone disease or secondary causes of osteoporosis and bone frailty is required. Treatment uses a multimodal management consisting of a combination of brace, pain management, bone metabolism evaluation, osteoporosis medication and has recently incorporated biophysical stimulation, a noninvasive technique that uses induced electric stimulation to improve bone recovery through the direct and indirect upregulation of bone morphogenic proteins, stimulating bone formation and remodeling. It contributes to the effectiveness of the therapy, promoting accelerated healing, supporting the reduction of bed rest and pain medications, improving patients' quality of life, and reducing the risk to undergo surgery in patients affected by VCFs. Therefore, the aim of this review is to outline the fundamental concepts of multimodal treatment for VCF, as well as the present function and significance of biophysical stimulation in the treatment of VCF patients.
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Affiliation(s)
- Alberto Di Martino
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Eleonora Villari
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Riccardo Poluzzi
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Matteo Brunello
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Valentino Rossomando
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Claudio D’Agostino
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Federico Ruta
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Cesare Faldini
- 1st Orthopaedic and Traumatologic Department, IRCCS Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
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Peng L, Wu F, Cao M, Li M, Cui J, Liu L, Zhao Y, Yang J. Effects of different physical factors on osteogenic differentiation. Biochimie 2023; 207:62-74. [PMID: 36336107 DOI: 10.1016/j.biochi.2022.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/11/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
Osteoblasts are essential for bone formation and can perceive external mechanical stimuli, which are translated into biochemical responses that ultimately alter cell phenotypes and respond to environmental stimuli, described as mechanical transduction. These cells actively participate in osteogenesis and the formation and mineralisation of the extracellular bone matrix. This review summarises the basic physiological and biological mechanisms of five different physical stimuli, i.e. light, electricity, magnetism, force and sound, to induce osteogenesis; further, it summarises the effects of changing culture conditions on the morphology, structure and function of osteoblasts. These findings may provide a theoretical basis for further studies on bone physiology and pathology at the cytological level and will be useful in the clinical application of bone formation and bone regeneration technology.
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Affiliation(s)
- Li Peng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, China; Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, China
| | - Fanzi Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, China
| | - Mengjiao Cao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, China
| | - Mengxin Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, China
| | - Jingyao Cui
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, China
| | - Lijia Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, China
| | - Yun Zhao
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, China.
| | - Jing Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, China.
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Li Z, Li D, Su H, Xue H, Tan G, Xu Z. Autophagy: An important target for natural products in the treatment of bone metabolic diseases. Front Pharmacol 2022; 13:999017. [DOI: 10.3389/fphar.2022.999017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022] Open
Abstract
Bone homeostasis depends on a precise dynamic balance between bone resorption and bone formation, involving a series of complex and highly regulated steps. Any imbalance in this process can cause disturbances in bone metabolism and lead to the development of many associated bone diseases. Autophagy, one of the fundamental pathways for the degradation and recycling of proteins and organelles, is a fundamental process that regulates cellular and organismal homeostasis. Importantly, basic levels of autophagy are present in all types of bone-associated cells. Due to the cyclic nature of autophagy and the ongoing bone metabolism processes, autophagy is considered a new participant in bone maintenance. Novel therapeutic targets have emerged as a result of new mechanisms, and bone metabolism can be controlled by interfering with autophagy by focusing on certain regulatory molecules in autophagy. In parallel, several studies have reported that various natural products exhibit a good potential to mediate autophagy for the treatment of metabolic bone diseases. Therefore, we briefly described the process of autophagy, emphasizing its function in different cell types involved in bone development and metabolism (including bone marrow mesenchymal stem cells, osteoblasts, osteocytes, chondrocytes, and osteoclasts), and also summarized research advances in natural product-mediated autophagy for the treatment of metabolic bone disease caused by dysfunction of these cells (including osteoporosis, rheumatoid joints, osteoarthritis, fracture nonunion/delayed union). The objective of the study was to identify the function that autophagy serves in metabolic bone disease and the effects, potential, and challenges of natural products for the treatment of these diseases by targeting autophagy.
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Tang Y, Mo Y, Xin D, Xiong Z, Zeng L, Luo G, Cao Y. Regulation of osteoblast autophagy based on PI3K/AKT/mTOR signaling pathway study on the effect of β-ecdysterone on fracture healing. J Orthop Surg Res 2021; 16:719. [PMID: 34924000 PMCID: PMC8684673 DOI: 10.1186/s13018-021-02862-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives To investigate the effects of β-ecdysterone on fracture healing and the underlying mechanism. Methods MTT assay was used to detect the cell viability. AO/PI and flow cytometry assays were used to determine the apoptotic rate. The expression level of RunX2, ATG7 and LC3 was evaluated by qRT-PCR and Western blot assays. X-ray and HE staining were conducted on the fractured femur. Immunohistochemical assay was used to detect the expression level of Beclin-1 and immunofluorescence assay was used to measure the expression level of LC3 in the fractured femurs. Western blot was utilized to determine the expression level of PI3K, p-AKT1, AKT1, p-mTOR, mTOR, p-p70S6K, and p70S6K. Results The ALP activity and the expression of RunX2 in fractured osteoblasts were significantly elevated, the apoptotic rate was suppressed by rapamycin, 60, and 80 μM β-ecdysterone. The state of autophagy both in fractured osteoblasts and femurs was facilitated by rapamycin and β-ecdysterone. Compared to control, Garrett score was significantly promoted in rapamycin and β-ecdysterone groups, accompanied by ameliorated pathological state. Lastly, the PI3K/AKT/mTOR pathway both in fractured osteoblasts and femurs was inhibited by rapamycin and β-ecdysterone. Conclusion β-ecdysterone might facilitate fracture healing by activating autophagy through suppressing PI3K/AKT/mTOR signal pathway.
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Affiliation(s)
- Yanghua Tang
- Department of Orthopedics, Hospital of Traditional Chinese Medicine of Xiaoshan District, No. 156, Yucai Road, Xiaoshan District, Hangzhou City, Zhejiang Province, China
| | - Yafeng Mo
- Department of Orthopedics, Hospital of Traditional Chinese Medicine of Xiaoshan District, No. 156, Yucai Road, Xiaoshan District, Hangzhou City, Zhejiang Province, China
| | - Dawei Xin
- Department of Orthopedics, Hospital of Traditional Chinese Medicine of Xiaoshan District, No. 156, Yucai Road, Xiaoshan District, Hangzhou City, Zhejiang Province, China
| | - Zhenfei Xiong
- Department of Orthopedics, Hospital of Traditional Chinese Medicine of Xiaoshan District, No. 156, Yucai Road, Xiaoshan District, Hangzhou City, Zhejiang Province, China
| | - Linru Zeng
- Department of Orthopedics, Hospital of Traditional Chinese Medicine of Xiaoshan District, No. 156, Yucai Road, Xiaoshan District, Hangzhou City, Zhejiang Province, China
| | - Gan Luo
- Department of Orthopedics, Hospital of Traditional Chinese Medicine of Xiaoshan District, No. 156, Yucai Road, Xiaoshan District, Hangzhou City, Zhejiang Province, China
| | - Yanguang Cao
- Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, No. 318, ChaoWang Road, Gongshu District, Hangzhou City, Zhejiang Province, China.
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Patel VV, Billys J, Okonkwo DO, He DY, Ryaby JT, Radcliff K. Three- and 4-Level Lumbar Arthrodesis Using Adjunctive Pulsed Electromagnetic Field Stimulation: A Multicenter Retrospective Evaluation of Fusion Rates and a Review of the Literature. Int J Spine Surg 2021; 15:228-233. [PMID: 33900979 DOI: 10.14444/8031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The incidence of 3- and 4-level lumbar arthrodesis is rising due to an aging population, and fusion rates affect clinical success in this population. Pulsed electromagnetic field (PEMF) stimulation is used as an adjunct to increase fusion rates following multilevel arthrodesis. The purpose of the study was to evaluate the fusion rates for subjects who underwent 3- and 4-level lumbar interbody arthrodesis following PEMF treatment. METHODS In this retrospective, multicenter study, patient charts that listed 3- or 4-level lumbar arthrodesis with adjunctive use of a PEMF device were evaluated. Inclusion criteria included patients who were diagnosed with lumbar degenerative disease, spinal stenosis, and/or spondylolisthesis (grade 1 or 2). A radiographic evaluation of fusion status was performed at 12 months by the treating physicians. Fusion rates were stratified by graft material, surgical interbody approach, and certain clinical risk factors for pseudoarthrosis. RESULTS A total of 55 patients were identified who had a 12-month follow-up. The radiographic fusion rate was 92.7% (51 patients) at 12 months. There were no significant differences in fusion rates for patients treated with allograft or autograft, for patients with different interbody approaches, or for those with or without certain clinical risk factors. CONCLUSIONS With modern fusion techniques and PEMF, the overall fusion rate was high following 3- and 4-level lumbar arthrodesis. LEVEL OF EVIDENCE 4. CLINICAL RELEVANCE PEMF may be a useful adjunct for treatment of patients with surgical risk factors, such as multilevel arthrodesis, and clinical risk factors.
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Affiliation(s)
- Vikas V Patel
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | | | - David Y He
- Analytical Solutions Group, Inc, North Potomac, Maryland
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Kar NS, Ferguson D, Zhang N, Waldorff EI, Ryaby JT, DiDonato JA. Pulsed-electromagnetic-field induced osteoblast differentiation requires activation of genes downstream of adenosine receptors A2A and A3. PLoS One 2021; 16:e0247659. [PMID: 33630907 PMCID: PMC7906300 DOI: 10.1371/journal.pone.0247659] [Citation(s) in RCA: 3] [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: 07/03/2020] [Accepted: 02/10/2021] [Indexed: 11/19/2022] Open
Abstract
Pulsed-electromagnetic-field (PEMF) treatment was found to enhance cellular differentiation of the mouse preosteoblast, MC3T3-E1, to a more osteoblastic phenotype. Differentiation genes such as Alp, BSPI, cFos, Ibsp, Osteocalcin, Pthr1 and Runx2 showed increased expression in response to PEMF stimulation. Detailed molecular mechanisms linking PEMF to the activation of these genes are limited. Two adenosine receptors known to be modulated in response to PEMF, Adora2A and Adora3, were functionally impaired by CRISPR-Cas9-mediated gene disruption, and the consequences of which were studied in the context of PEMF-mediated osteoblastic differentiation. Disruption of Adora2A resulted in a delay of Alp mRNA expression, but not alkaline phosphatase protein expression, which was similar to that found in wild type cells. However, Adora3 disruption resulted in significantly reduced responses at both the alkaline phosphatase mRNA and protein levels throughout the PEMF stimulation period. Defects observed in response to PEMF were mirrored using a chemically defined growth and differentiation-inducing media (DM). Moreover, in cells with Adora2A disruption, gene expression profiles showed a blunted response in cFos and Pthr1 to PEMF treatment; whereas cells with Adora3 disruption had mostly blunted responses in AlpI, BSPI, Ibsp, Osteocalcin and Sp7 gene activation. To demonstrate specificity for Adora3 function, the Adora3 open reading frame was inserted into the ROSA26 locus in Adora3 disrupted cells culminating in rescued PEMF responsiveness and thereby eliminating the possibility of off-target effects. These results lead us to propose that there are complementary and parallel positive roles for adenosine receptor A2A and A3 in PEMF-mediated osteoblast differentiation.
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Affiliation(s)
- Niladri S. Kar
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Daniel Ferguson
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Nianli Zhang
- Orthofix, Inc., Lewisville, TX, United States of America
| | | | - James T. Ryaby
- Orthofix, Inc., Lewisville, TX, United States of America
| | - Joseph A. DiDonato
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
- * E-mail:
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Jiao J, Feng G, Wu M, Wang Y, Li R, Liu J. MiR-140-5p promotes osteogenic differentiation of mouse embryonic bone marrow mesenchymal stem cells and post-fracture healing of mice. Cell Biochem Funct 2020; 38:1152-1160. [PMID: 33047358 PMCID: PMC7756898 DOI: 10.1002/cbf.3585] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 07/09/2020] [Accepted: 08/01/2020] [Indexed: 12/13/2022]
Abstract
MiR-140-5p is high expressed in normal fracture healing, but its specific role and mechanism in tissue-to-bone healing are rarely reported. Therefore, this study investigated the effects of miR-140-5p on tissue-to-bone healing. Clone formation experiment, flow cytometry, Alizarin Red S Staining and Oil Red O Staining were performed to investigate the biological characteristics of mouse embryonic bone marrow mesenchymal stem cells C3H10T1/2. MiR-140-5p mimic was transfected into osteogenic medium (OS)-treated C3H10T1/2 cells to investigate the effects of miR-140-5p on osteogenic differentiation. MiR-140-5p transgenic mouse model and the transgenic fracture model were established, and the effects of miR-140-5p on osteogenic differentiation, bone mineral density (BMD) and bone mass of bone tissues were detected by haematoxylin and eosin staining and computed tomography scan. The expressions of osteocalcin, differentiation-related genes (Runx2, ALP, Spp1 and Bglap3) and miR-140-5p were determined by quantitative real-time polymerase chain reaction. C3H10T1/2 cells showed the abilities of forming cloned differentiation of osteogenesis, fat cells, and its phenotypes including CD44, CD90.1 and Sca-1 but excluding CD45 haematopoietic stem cell marker. Overexpression of miR-140-5p promoted the expressions of differentiation-related genes and calcium deposition of OS-treated C3H10T1/2 cells. MiR-140-5p increased the expression of osteocalcin, BMD and bone mass and promoted bone healing of miR-140-5p-transgenic mice with fracture. MiR-140-5p promoted osteogenic differentiation of mouse embryonic bone marrow mesenchymal stem cells and post-fracture healing in mice. SIGNIFICANCE OF THE STUDY: C3H10T1/2 cells showed the abilities of forming cloned differentiation of osteogenesis, fat cells and its phenotypes including CD44, CD90.1 and Sca-1 but excluding CD45 haematopoietic stem cell marker. Overexpression of miR-140-5p promoted the expressions of differentiation-related genes and calcium deposition of osteogenic medium-treated C3H10T1/2 cells. MiR-140-5p increased the expression of osteocalcin and bone mineral density and bone mass and promoted bone healing of miR-140-5p-transgenic mice with fracture. Our results showed that miR-140-5p promoted osteogenic differentiation of mouse embryonic bone marrow mesenchymal stem cells and post-fracture healing in mice, which may be a therapeutic target for treating fractures and promoting bone healing.
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Affiliation(s)
- Jianhang Jiao
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Guang Feng
- The Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Minfei Wu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Yang Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Rui Li
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Jun Liu
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, China
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Matsui S, Yoneda N, Maezono H, Kuremoto K, Ishimoto T, Nakano T, Yumoto H, Ebisu S, Noiri Y, Hayashi M. Assessment of the functional efficacy of root canal treatment with high-frequency waves in rats. PLoS One 2020; 15:e0239660. [PMID: 32991601 PMCID: PMC7523981 DOI: 10.1371/journal.pone.0239660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to develop a high-frequency wave therapy model in rats and to investigate the influence of high-frequency waves on root canal treatment, which may provide a novel strategy for treating apical periodontitis. Root canal treatments with and without high-frequency wave irradiation were performed on the mandibular first molars of 10-week-old male Wistar rats. The mesial roots were evaluated radiologically, bacteriologically, and immunohistochemically. At 3 weeks after root canal treatment, lesion volume had decreased significantly more in the irradiated group than in the non-irradiated group, indicating successful development of the high-frequency therapy model. The use of high-frequency waves provided no additional bactericidal effect after root canal treatment. However, high-frequency wave irradiation was found to promote healing of periapical lesions on the host side through increased expression of fibroblast growth factor 2 and transforming growth factor-β1 and could therefore be useful as an adjuvant nonsurgical treatment for apical periodontitis.
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Affiliation(s)
- Saori Matsui
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Unit of Dentistry, Osaka University Hospital, Suita, Osaka, Japan
| | - Naomichi Yoneda
- Department of Dentistry and Oral Maxillofacial Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Hazuki Maezono
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
- * E-mail:
| | - Katsutaka Kuremoto
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takuya Ishimoto
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan
| | - Hiromichi Yumoto
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shigeyuki Ebisu
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuichiro Noiri
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
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The Function and Mechanisms of Autophagy in Trauma of Other Parts of the Body. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020. [PMID: 32671783 DOI: 10.1007/978-981-15-4272-5_48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Trauma is common in modern society. Besides TBI and SCI, trauma can lead to severe cardiopulmonary injury and even to death. Fracture and skin injury are also very likely to occur in our daily life. Limited studies have reported the levels of autophagy after heart and trauma, fracture, and skin injury. In this chapter, we update the current state of knowledge and recent advances in the study of autophagy after trauma including heart and lung trauma, fracture, and skin injury which we try to clarify how autophagy levels are affected by injury or trauma and how their manipulation may represent potential novel protective targets for treatments.
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10
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Bins-Ely L, Suzuki D, Magini R, Benfatti CAM, Teughels W, Henriques B, Souza JCM. Enhancing the bone healing on electrical stimuli through the dental implant. Comput Methods Biomech Biomed Engin 2020; 23:1041-1051. [DOI: 10.1080/10255842.2020.1785437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Letícia Bins-Ely
- School of Dentistry (ODT), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Daniela Suzuki
- Institute of Biomedical Engineering, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Ricardo Magini
- School of Dentistry (ODT), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Cesar A. M. Benfatti
- School of Dentistry (ODT), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Wim Teughels
- Department of Oral Health Sciences, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Bruno Henriques
- CERMAT, Department of Mechanical Engineering (EMC), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
- Department Mechanical Engineering (DEM), Center Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, Portugal
| | - Júlio C. M. Souza
- Department Mechanical Engineering (DEM), Center Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, Portugal
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, Portugal
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11
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Peng L, Fu C, Xiong F, Zhang Q, Liang Z, Chen L, He C, Wei Q. Effectiveness of Pulsed Electromagnetic Fields on Bone Healing: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Bioelectromagnetics 2020; 41:323-337. [PMID: 32495506 DOI: 10.1002/bem.22271] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/08/2020] [Accepted: 05/10/2020] [Indexed: 02/05/2023]
Abstract
The effect of pulsed electromagnetic field (PEMF) on bone healing is still uncertain and it has not been established as a standardized treatment. The aim of this systematic review and meta-analysis is to evaluate the effect of PEMF on bone healing in patients with fracture. We searched CNKI, Wan Fang, VIP, EMbase, PubMed, CENTRAL, Web of Science, Physiotherapy Evidence Database, and Open Grey websites for randomized controlled trials (published before July 2019 in English or Chinese) comparing any form of PEMF to sham. Reference lists were also searched. Related data were extracted by two investigators independently. The bias risk of the articles and the evidence strength of the outcomes were evaluated. Twenty-two studies were eligible and included in our analysis (n = 1,468 participants). The pooled results of 14 studies (n = 1,131 participants) demonstrated that healing rate in PEMF group was 79.7% (443/556), and that in the control group was 64.3% (370/575). PEMF increased healing rate (RR = 1.22; 95% confidence interval [CI] = 1.10-1.35; I2 = 48%) by the Mantel-Haenszel analysis, relieved pain (standardized mean difference (SMD) = -0.49; 95% CI = -0.88 to -0.10; I2 = 60%) by the inverse variance analysis, and accelerated healing time (SMD = -1.01; 95% CI = -2.01 to -0.00; I2 = 90%) by the inverse variance analysis. Moderate quality evidence suggested that PEMF increased healing rate and relieved pain of fracture, and very low-quality evidence showed that PEMF accelerated healing time. Larger and higher quality randomized controlled trials and pre-clinical studies of optimal frequency, amplitude, and duration parameters are needed. © 2020 Bioelectromagnetics Society.
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Affiliation(s)
- Lihong Peng
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China
| | - Chenying Fu
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Feng Xiong
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China
| | - Qing Zhang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China
| | - Zejun Liang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China
| | - Li Chen
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China
| | - Chengqi He
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China
| | - Quan Wei
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China
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12
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Zhang W, Zhao H, Chen K, Huang Y. Overexpressing of POU2F2 accelerates fracture healing via regulating HMGA1/Wnt/β-catenin signaling pathway. Biosci Biotechnol Biochem 2019; 84:491-499. [PMID: 31782345 DOI: 10.1080/09168451.2019.1695574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
To elucidate the role of POU2F2 (POU class 2 homeobox 2) in fracture healing, 30 rats with femoral fracture were randomly grouped into three groups: FF group, LV-POU2F2 group and LV-scramble group. Rats were injected with PBS, lentivirus expressing POU2F2 or scramble lentivirus once a week for 4 weeks. Results showed that overexpressing of POU2F2 promoted fracture healing and callus growth. Besides, overexpressing of POU2F2 promoted protein and mRNA expression of Col10a1, Runx2, Osterix, and Osteocalcin. High Mobility Group AT-hook 1 (HMGA1) is a non-histone protein participating in chromatin remodeling of cells. Western blotting manifested HMGA1/Wnt/β-catenin pathway was activated in POU2F2 group. Moreover, in-vitro study of hMSCs cells supported the above data. In conclusion, POU2F2 promotes fracture healing via activating the HMGA1/Wnt/β-catenin signaling pathway.
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Affiliation(s)
- Wei Zhang
- Department of Emergency Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hanke Zhao
- Department of Orthopedics, Changzhou Wujin People's Hospital, Changzhou, China
| | - Kun Chen
- Department of Orthopedics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ye Huang
- Department of Orthopedics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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13
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Mu D, Yu J, Lin J, Li C, Hao B, Gu F, Liu C, Tan L, Zhu D, Zhang X. Intermittent vibrations accelerate fracture healing in sheep. Acta Cir Bras 2019; 34:e201900702. [PMID: 31531537 PMCID: PMC6746562 DOI: 10.1590/s0102-865020190070000002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/15/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To investigate the effect of intermittent vibration at different intervals on bone fracture healing and optimize the vibration interval. METHODS Ninety sheep were randomized to receive no treatment (the control group), incision only (the sham control group), internal fixation with or without metatarsal fracture (the internal fixation group), and continuous vibration in addition to internal fixation of metatarsal fracture, or intermittent vibration at 1, 2, 3, 5, 7 and 17-day interval in addition to internal fixation of metatarsal fracture (the vibration group). Vibration was done at frequency F=35 Hz, acceleration a=0.25g, 15 min each time 2 weeks after bone fracture. Bone healing was evaluated by micro-CT scan, bone microstructure and mechanical compression of finite element simulation. RESULTS Intermittent vibration at 7-day interval significantly improved bone fracture healing grade. However, no significant changes on microstructure parameters and mechanical properties were observed among sheep receiving vibration at different intervals. CONCLUSIONS Clinical healing effects should be the top concern. Quantitative analyses of bone microstructure and of finite element mechanics on the process of fracture healing need to be further investigated.
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Affiliation(s)
- Degong Mu
- Bachelor, Operating Theatre 3, the First Hospital of Jilin University, Changchun, China. Conception and design of the study, analysis and interpretation of data, manuscript writing
| | - Jing Yu
- Master, Operating Theatre 1, the First Hospital of Jilin University, Changchun, China. Manuscript writing
| | - Junhao Lin
- Master, College of Mechanical Science and Engineering, Jilin University, Changchun, China. Statistics analysis
| | - Chen Li
- Master, Department of Orthopedic Traumatology, the First Hospital of Jilin University, Changchun, China. Technical procedures
| | - Baohui Hao
- Master, Department of Orthopedic Traumatology, the First Hospital of Jilin University, Changchun, China. Technical procedures, interpretation of data, critical revision
| | - Feng Gu
- Master, Department of Orthopedic Traumatology, the First Hospital of Jilin University, Changchun, China. Technical procedures, interpretation of data
| | - Chao Liu
- Master, Department of Orthopedic Traumatology, the First Hospital of Jilin University, Changchun, China. Statistics analysis
| | - Lei Tan
- PhD, Department of Orthopedic Traumatology, the First Hospital of Jilin University, Changchun, China. Analysis and interpretation of data, critical revision
| | - Dong Zhu
- PhD, Department of Orthopedic Traumatology, the First Hospital of Jilin University, Changchun, China. Conception and design of the study, analysis and interpretation of data, critical revision
| | - Xizheng Zhang
- PhD, Institute of Medical Equipment, Academy of Military Medical Sciences, Tianjin, China. Critical revision
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14
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Su Y, Meng X, Wang W, Gu G, Chen Y. LncRNA HOTAIR regulates fracture healing in osteoporotic rats through inhibition on MiR-17-5p. Minerva Med 2019; 112:525-527. [PMID: 31359738 DOI: 10.23736/s0026-4806.19.06246-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Yun Su
- Department of Orthopedics, Affiliated Zhongshan Hospital Dalian University, Dalian, China
| | - Xiangjun Meng
- Department of Orthopedics, Affiliated Zhongshan Hospital Dalian University, Dalian, China
| | - Weiming Wang
- Department of Orthopedics, Affiliated Zhongshan Hospital Dalian University, Dalian, China -
| | - Guishan Gu
- Department of Orthopedics, The First Hospital, Jilin University, Changchun, China
| | - Yiqing Chen
- Department of Orthopedics, Affiliated Zhongshan Hospital Dalian University, Dalian, China
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15
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Wang W, Junior JRP, Nalesso PRL, Musson D, Cornish J, Mendonça F, Caetano GF, Bártolo P. Engineered 3D printed poly(ɛ-caprolactone)/graphene scaffolds for bone tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 100:759-770. [PMID: 30948113 DOI: 10.1016/j.msec.2019.03.047] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/06/2019] [Accepted: 03/13/2019] [Indexed: 12/11/2022]
Abstract
Scaffolds are important physical substrates for cell attachment, proliferation and differentiation. Multiple factors could influence the optimal design of scaffolds for a specific tissue, such as the geometry, the materials used to modulate cell proliferation and differentiation, its biodegradability and biocompatibility. The optimal design of a scaffold for a specific tissue strongly depends on both materials and manufacturing processes. Previous studies of human adipose-derived stem cells (hADSCs) seeded on poly(ε-caprolactone) (PCL)/graphene scaffolds have proved that the addition of small concentrations of graphene to PCL scaffolds improves cell proliferation. Based on such results, this paper further investigates, for the first time, both in vitro and in vivo characteristics of 3D printed PCL/graphene scaffolds. Scaffolds were evaluated from morphological, biological and short term immune response points of view. Results show that the produced scaffolds induce an acceptable level of immune response, suggesting high potential for in vivo applications. Finally, the scaffolds were used to treat a rat calvaria critical size defect with and without applying micro electrical stimulation (10 μA). Quantification of connective and new bone tissue formation and the levels of ALP, RANK, RANKL, OPG were considered. Results show that the use of scaffolds containing graphene and electrical stimulation seems to increase cell migration and cell influx, leading to new tissue formation, well-organized tissue deposition and bone remodelling.
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Affiliation(s)
- Weiguang Wang
- School of Mechanical, Aerospace and Civil Engineering, The University of Manchester, Manchester M13 9PL, UK
| | | | - Paulo Roberto Lopes Nalesso
- Graduate Program in Biomedical Sciences, Hermínio Ometto University Centre, Araras 13607339, Sao Paulo, Brazil
| | - David Musson
- Bone and Joint Research Group, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Jillian Cornish
- Bone and Joint Research Group, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Fernanda Mendonça
- Graduate Program in Biomedical Sciences, Hermínio Ometto University Centre, Araras 13607339, Sao Paulo, Brazil
| | - Guilherme Ferreira Caetano
- Graduate Program in Biomedical Sciences, Hermínio Ometto University Centre, Araras 13607339, Sao Paulo, Brazil
| | - Paulo Bártolo
- School of Mechanical, Aerospace and Civil Engineering, The University of Manchester, Manchester M13 9PL, UK.
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16
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Haglin JM, Jain S, Eltorai AEM, Daniels AH. Bone Growth Stimulation: A Critical Analysis Review. JBJS Rev 2019; 5:e8. [PMID: 28806266 DOI: 10.2106/jbjs.rvw.16.00117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jack M Haglin
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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17
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Hu W, Chen T, Tsao C, Cheng Y. The effects of substrate‐mediated electrical stimulation on the promotion of osteogenic differentiation and its optimization. J Biomed Mater Res B Appl Biomater 2018; 107:1607-1619. [DOI: 10.1002/jbm.b.34253] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/29/2018] [Accepted: 09/08/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Wei‐Wen Hu
- Department of Chemical and Materials EngineeringNational Central University Zhongli District, Taoyuan City Taiwan
- Center for Biocellular EngineeringNational Central University Zhongli District, Taoyuan City Taiwan
| | - Tun‐Chi Chen
- Department of Chemical and Materials EngineeringNational Central University Zhongli District, Taoyuan City Taiwan
| | - Chia‐Wen Tsao
- Center for Biocellular EngineeringNational Central University Zhongli District, Taoyuan City Taiwan
- Department of Mechanical EngineeringNational Central University Zhongli District, Taoyuan City Taiwan
| | - Yu‐Che Cheng
- Center for Biocellular EngineeringNational Central University Zhongli District, Taoyuan City Taiwan
- School of MedicineFu Jen Catholic University New Taipei City Taiwan
- Proteomics Laboratory, Department of Medical ResearchCathay General Hospital Taipei Taiwan
- Department of Biomedical Sciences and EngineeringNational Central University Zhongli Taiwan
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18
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Li X, Ji J, Wei W, Liu L. MiR-25 promotes proliferation, differentiation and migration of osteoblasts by up-regulating Rac1 expression. Biomed Pharmacother 2018; 99:622-628. [DOI: 10.1016/j.biopha.2018.01.103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/15/2018] [Accepted: 01/24/2018] [Indexed: 12/27/2022] Open
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19
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Coric D, Bullard DE, Patel VV, Ryaby JT, Atkinson BL, He D, Guyer RD. Pulsed electromagnetic field stimulation may improve fusion rates in cervical arthrodesis in high-risk populations. Bone Joint Res 2018; 7:124-130. [PMID: 29437635 PMCID: PMC5895946 DOI: 10.1302/2046-3758.72.bjr-2017-0221.r1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Pulsed electromagnetic field (PEMF) stimulation was evaluated after anterior cervical discectomy and fusion (ACDF) procedures in a randomized, controlled clinical study performed for United States Food and Drug Administration (FDA) approval. PEMF significantly increased fusion rates at six months, but 12-month fusion outcomes for subjects at elevated risk for pseudoarthrosis were not thoroughly reported. The objective of the current study was to evaluate the effect of PEMF treatment on subjects at increased risk for pseudoarthrosis after ACDF procedures. METHODS Two evaluations were performed that compared fusion rates between PEMF stimulation and a historical control (160 subjects) from the FDA investigational device exemption (IDE) study: a post hoc (PH) analysis of high-risk subjects from the FDA study (PH PEMF); and a multicentre, open-label (OL) study consisting of 274 subjects treated with PEMF (OL PEMF). Fisher's exact test and multivariate logistic regression was used to compare fusion rates between PEMF-treated subjects and historical controls. RESULTS In separate comparisons of PH PEMF and OL PEMF groups to the historical control group, PEMF treatment significantly (p < 0.05, Fisher's exact test) increased the fusion rate at six and 12 months for certain high-risk subjects who had at least one clinical risk factor of being elderly, a nicotine user, osteoporotic, or diabetic; and for those with at least one clinical risk factor and who received at least a two- or three-level arthrodesis. CONCLUSION Adjunctive PEMF treatment can be recommended for patients who are at high risk for pseudoarthrosis.Cite this article: D. Coric, D. E. Bullard, V. V. Patel, J. T. Ryaby, B. L. Atkinson, D. He, R. D. Guyer. Pulsed electromagnetic field stimulation may improve fusion rates in cervical arthrodesis in high-risk populations. Bone Joint Res 2018;7:124-130. DOI: 10.1302/2046-3758.72.BJR-2017-0221.R1.
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Affiliation(s)
- D Coric
- Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina, USA
| | - D E Bullard
- Triangle Neurosurgery, 1540 Sunday Drive, Suite 214, Raleigh, North Carolina 27607, USA
| | - V V Patel
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, Colorado 80045, USA
| | - J T Ryaby
- Clinical Affairs Department, Orthofix, Inc., 3451 Plano Parkway, Lewisville, Texas 75056, USA
| | - B L Atkinson
- Atkinson Biologics Consulting, Highlands Ranch, Colorado, USA
| | - D He
- Analytical Solutions Group, Inc, North Potomac, Maryland, USA
| | - R D Guyer
- TBIRF, Texas Back Institute, 6020 West Parker Road Suite 200, Plano, Texas 75093, USA
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20
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Tu M, Tang J, He H, Cheng P, Chen C. MiR-142-5p promotes bone repair by maintaining osteoblast activity. J Bone Miner Metab 2017; 35:255-264. [PMID: 27085967 DOI: 10.1007/s00774-016-0757-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/11/2016] [Indexed: 12/19/2022]
Abstract
MicroRNAs play important roles in regulating bone regeneration and remodeling. However, the pathophysiological roles of microRNAs in bone repair remain unclear. Here we identify a significant upregulation of miR-142-5p correlated with active osteoblastogenesis during the bone healing process. In vitro, miR-142-5p promoted osteoblast activity and matrix mineralization by targeting the gene encoding WW-domain-containing E3 ubiquitin protein ligase 1. We also found that the expression of miR-142-5p in the callus of aged mice was lower than that in the callus of young mice and directly correlated with the age-related delay in bone healing. Furthermore, treatment with agomir-142-5p in the fracture areas stimulated osteoblast activity which repaired the bone fractures in aged mice. Thus, our study revealed that miR-142-5p plays a crucial role in healing fractures by maintaining osteoblast activity, and provided a new molecular target therapeutic strategy for bone healing.
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Affiliation(s)
- Manli Tu
- Institute of Endocrinology and Metabolism, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, People's Republic of China
| | - Juanjuan Tang
- Department of Gynaecology and Obstetrics, The First Hospital Affiliated to Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Hongbo He
- Department of Orthopedics, Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Peng Cheng
- Department of Gerontology, The First Hospital Affiliated to Nanjing Medical University, Nanjing, 210029, Jiangsu, People's Republic of China.
| | - Chao Chen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, People's Republic of China.
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21
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Jakus AE, Shah RN. Multi and mixed 3D-printing of graphene-hydroxyapatite hybrid materials for complex tissue engineering. J Biomed Mater Res A 2016; 105:274-283. [PMID: 26860782 DOI: 10.1002/jbm.a.35684] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/26/2016] [Accepted: 02/05/2016] [Indexed: 01/24/2023]
Abstract
With the emergence of three-dimensional (3D)-printing (3DP) as a vital tool in tissue engineering and medicine, there is an ever growing need to develop new biomaterials that can be 3D-printed and also emulate the compositional, structural, and functional complexities of human tissues and organs. In this work, we probe the 3D-printable biomaterials spectrum by combining two recently established functional 3D-printable particle-laden biomaterial inks: one that contains hydroxyapatite microspheres (hyperelastic bone, HB) and another that contains graphene nanoflakes (3D-graphene, 3DG). We demonstrate that not only can these distinct, osteogenic, and neurogenic inks be co-3D-printed to create complex, multimaterial constructs, but that composite inks of HB and 3DG can also be synthesized. Specifically, the printability, microstructural, mechanical, electrical, and biological properties of a hybrid material comprised of 1:1 HA:graphene by volume is investigated. The resulting HB-3DG hybrid exhibits mixed characteristics of the two distinct systems, while maintaining 3D-printability, electrical conductivity, and flexibility. In vitro assessment of HB-3DG using mesenchymal stem cells demonstrates the hybrid material supports cell viability and proliferation, as well as significantly upregulates both osteogenic and neurogenic gene expression over 14 days. This work ultimately demonstrates a significant step forward towards being able to 3D-print graded, multicompositional, and multifunctional constructs from hybrid inks for complex composite tissue engineering. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 274-283, 2017.
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Affiliation(s)
- Adam E Jakus
- 303 E Superior Str., 11th Floor, SQI, Chicago, llinois, 60611
| | - Ramille N Shah
- 303 E Superior Str., 11th Floor, SQI, Chicago, llinois, 60611
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22
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Peña-Martínez V, Lara-Arias J, Vilchez-Cavazos F, Álvarez-Lozano E, Montes de Oca-Luna R, Mendoza-Lemus Ó. [Interosseous electrostimulation in a model of lengthening with external fixation]. CIR CIR 2016; 85:127-134. [PMID: 27633464 DOI: 10.1016/j.circir.2016.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/03/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND A fracture repair involves complex cellular processes. However, despite optimal treatment, some fractures heal slowly or do not repair. These complications support the need for innovative therapies. Electromagnetic stimulation is a non-invasive technology that could have a direct impact on many cellular pathways. OBJECTIVE To demonstrate the effectiveness of electro-stimulation by alternating current applied during bone elongation to accelerate the consolidation process for 30 days in an animal model. MATERIALS AND METHODS A device with closed circuit and graduated voltage was designed and kept in contact with the external fixator. Group A was elongated without electro-stimulation and group B was electro-stimulated since the beginning of the distraction. Radiographs were taken at 15 and 30 days post-surgical. Haematoxylin and eosin staining and Masson's trichrome stain were performed. RESULTS No significant difference were observed in bone density of group A (4.05±3.24, P=0.163). In group B there was a significant difference (61.06±20.17, P=0.03) in bone density. Group A maintained a fibrous tissue repair, with areas of cartilage and bone matrix. Group B had more organised tissue in the stages of bone repair. CONCLUSION Because there is a significant difference in the growth and callus formation at 15 and 30 days between groups, electro-stimulation could be considered as an adjuvant during bone elongation.
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Affiliation(s)
- Víctor Peña-Martínez
- Servicio de Ortopedia y Traumatología, Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
| | - Jorge Lara-Arias
- Servicio de Ortopedia y Traumatología, Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Félix Vilchez-Cavazos
- Servicio de Ortopedia y Traumatología, Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Eduardo Álvarez-Lozano
- Servicio de Ortopedia y Traumatología, Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Roberto Montes de Oca-Luna
- Departamento de Histología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Óscar Mendoza-Lemus
- Servicio de Ortopedia y Traumatología, Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
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Bins-Ely LM, Cordero EB, Souza JCM, Teughels W, Benfatti CAM, Magini RS. In vivoelectrical application on titanium implants stimulating bone formation. J Periodontal Res 2016; 52:479-484. [DOI: 10.1111/jre.12413] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2016] [Indexed: 11/28/2022]
Affiliation(s)
- L. M. Bins-Ely
- Center for Research on Dental Implants (CEPID); School of Dentistry (ODT); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - E. B. Cordero
- Center for Research on Dental Implants (CEPID); School of Dentistry (ODT); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - J. C. M. Souza
- Center for Research on Dental Implants (CEPID); School of Dentistry (ODT); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - W. Teughels
- Department of Oral Health Sciences and University Hospitals Leuven; Katholieke Universiteit Leuven; Leuven Belgium
| | - C. A. M. Benfatti
- Center for Research on Dental Implants (CEPID); School of Dentistry (ODT); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
| | - R. S. Magini
- Center for Research on Dental Implants (CEPID); School of Dentistry (ODT); Universidade Federal de Santa Catarina (UFSC); Florianópolis Santa Catarina Brazil
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Coronado LM, Montealegre S, Chaverra Z, Mojica L, Espinosa C, Almanza A, Correa R, Stoute JA, Gittens RA, Spadafora C. Blood Stage Plasmodium falciparum Exhibits Biological Responses to Direct Current Electric Fields. PLoS One 2016; 11:e0161207. [PMID: 27537497 PMCID: PMC4990222 DOI: 10.1371/journal.pone.0161207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/01/2016] [Indexed: 11/18/2022] Open
Abstract
The development of resistance to insecticides by the vector of malaria and the increasingly faster appearance of resistance to antimalarial drugs by the parasite can dangerously hamper efforts to control and eradicate the disease. Alternative ways to treat this disease are urgently needed. Here we evaluate the in vitro effect of direct current (DC) capacitive coupling electrical stimulation on the biology and viability of Plasmodium falciparum. We designed a system that exposes infected erythrocytes to different capacitively coupled electric fields in order to evaluate their effect on P. falciparum. The effect on growth of the parasite, replication of DNA, mitochondrial membrane potential and level of reactive oxygen species after exposure to electric fields demonstrate that the parasite is biologically able to respond to stimuli from DC electric fields involving calcium signaling pathways.
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Affiliation(s)
- Lorena M. Coronado
- Center of Cellular and Molecular Biology of Diseases (CBCMe), Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama, Republic of Panama
- Department of Biotechnology, Acharya Nagarjuna University, Guntur, 522 510, A.P., India
| | - Stephania Montealegre
- School of Biotechnology, Facultad de Ciencias de la Salud “William C. Gorgas”, Universidad Latina, Panama, Republic of Panama
| | - Zumara Chaverra
- School of Biotechnology, Facultad de Ciencias de la Salud “William C. Gorgas”, Universidad Latina, Panama, Republic of Panama
| | - Luis Mojica
- National Center for Metrology of Panama (CENAMEP AIP), City of Knowledge, Panama, Republic of Panama
| | - Carlos Espinosa
- National Center for Metrology of Panama (CENAMEP AIP), City of Knowledge, Panama, Republic of Panama
| | - Alejandro Almanza
- Center of Cellular and Molecular Biology of Diseases (CBCMe), Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama, Republic of Panama
| | - Ricardo Correa
- Center of Cellular and Molecular Biology of Diseases (CBCMe), Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama, Republic of Panama
- Department of Biotechnology, Acharya Nagarjuna University, Guntur, 522 510, A.P., India
| | - José A. Stoute
- Department of Medicine, Division of Infectious Diseases and Epidemiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States of America
| | - Rolando A. Gittens
- Center for Biodiversity & Drug Discovery (CBDD), INDICASAT AIP, City of Knowledge, Panama, Republic of Panama
| | - Carmenza Spadafora
- Center of Cellular and Molecular Biology of Diseases (CBCMe), Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama, Republic of Panama
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25
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Extracorporeal shockwave therapy (ESWT) ameliorates healing of tibial fracture non-union unresponsive to conventional therapy. Injury 2016; 47:1506-13. [PMID: 27158008 DOI: 10.1016/j.injury.2016.04.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/29/2016] [Accepted: 04/11/2016] [Indexed: 02/02/2023]
Abstract
Tibial non-unions are common cause of demanding revision surgeries and are associated with a significant impact on patients' quality of life and health care costs. Extracorporeal shockwave therapy (ESWT) has been shown to improve osseous healing in vitro and in vivo. The main objective of present study was to evaluate the efficacy of ESWT in healing of tibial non-unions unresponsive to previous surgical and non-surgical measures. A retrospective multivariant analysis of a prospective open, single-centre, clinical trial of tibia non-union was conducted. 56 patients with 58 eligible fractures who met the FDA criteria were included. All patients received 3000-4000 impulses of electrohydraulic shockwaves at an energy flux density of 0.4mJ/mm(2) (-6dB). On average patients underwent 1.9 times (±1.3SD) surgical interventions prior to ESWT displaying the rather negatively selected cohort and its limited therapy responsiveness. In 88.5% of patients receiving ESWT complete bone healing was observed after six months irrespective of underlying pathology. The multivariant analysis showed that time of application is important for therapy success. Patients achieving healing received ESWT earlier: mean number of days between last surgical intervention and ESWT (healed - 355.1 days±167.4SD vs. not healed - 836.7 days±383.0SD; p<0.0001). ESWT proved to be a safe, effective and non-invasive treatment modality in tibial non-unions recalcitrant to standard therapies. The procedure is well tolerated, time-saving, lacking side effects, with potential to significantly decrease health care costs. Thus, in our view, ESWT should be considered the treatment of first choice in established tibial non-unions.
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Santos LJ, Reis RL, Gomes ME. Harnessing magnetic-mechano actuation in regenerative medicine and tissue engineering. Trends Biotechnol 2015; 33:471-9. [DOI: 10.1016/j.tibtech.2015.06.006] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/20/2015] [Accepted: 06/01/2015] [Indexed: 01/09/2023]
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Perinavicular Arthrodesis as Treatment of Advanced Navicular Osteonecrosis. TECHNIQUES IN FOOT AND ANKLE SURGERY 2015. [DOI: 10.1097/btf.0000000000000090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ikegami A, Ueshima K, Saito M, Ikoma K, Fujioka M, Hayashi S, Ishida M, Fujiwara H, Mazda O, Kubo T. Femoral perfusion after pulsed electromagnetic field stimulation in a steroid-induced osteonecrosis model. Bioelectromagnetics 2015; 36:349-57. [PMID: 25808585 DOI: 10.1002/bem.21910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 02/22/2015] [Indexed: 11/07/2022]
Abstract
This study was designed to evaluate femoral perfusion after pulsed electromagnetic field (PEMF) stimulation in a steroid-induced osteonecrosis rabbit model by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Steroid-induced osteonecrosis was produced by single intramuscular injection of methylprednisolone in 15 rabbits. Eight rabbits underwent PEMF stimulation (PEMF group) and seven did not (control group). DCE-MRI was performed before PEMF stimulation, immediately before steroid administration, and 1, 5, 10, and 14 days after steroid administration. Regions of interest were set in the bilateral proximal femora. Enhancement ratio (ER), initial slope (IS), and area under the curve (AUC) were analyzed. ER, IS, and AUC in the control group significantly decreased after steroid administration compared with before administration (P<0.05). In PEMF group, IS significantly decreased; however, ER and AUC showed no significant differences after steroid administration compared with before. ER and IS in PEMF group were higher than in control group until 10th day, and AUC was higher until 5th day after steroid administration (P<0.05). PEMF stimulation restrains the decrease in blood flow after steroid administration.
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Affiliation(s)
- Akira Ikegami
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keiichiro Ueshima
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masazumi Saito
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuya Ikoma
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mikihiro Fujioka
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeki Hayashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masashi Ishida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroyoshi Fujiwara
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Osam Mazda
- Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshikazu Kubo
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Kfuri M, de Freitas RL, Batista BB, Salim R, Castiglia MT, Tavares RA, Araújo PH. Updates in biological therapies for knee injuries: bone. Curr Rev Musculoskelet Med 2014; 7:220-7. [PMID: 25030275 PMCID: PMC4596166 DOI: 10.1007/s12178-014-9225-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Bone is a unique tissue because of its mechanical properties, ability for self-repair, and enrollment in different metabolic processes such as calcium homeostasis and hematopoietic cell production. Bone barely tolerates deformation and tends to fail when overloaded. Fracture healing is a complex process that in particular cases is impaired. Osteoprogenitor cells proliferation, growth factors, and a sound tridimensional scaffold at fracture site are key elements for new bone formation and deposition. Mechanical stability and ample vascularity are also of great importance on providing a proper environment for bone healing. From mesenchymal stem cells delivery to custom-made synthetic scaffolds, many are the biological attempts to enhance bone healing. Impaired fracture healing represents a real burden to contemporary society. Sound basic science knowledge has contributed to newer approaches aimed to accelerate and improve the quality of bone healing.
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Affiliation(s)
- Mauricio Kfuri
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor - Hospital das Clinicas - Campus USP Av. Bandeirantes 3900 - 11o andar, 14048-900, Ribeirão Preto, SP, Brazil,
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Sathyendra V, Donahue HJ, Vrana KE, Berg A, Fryzel D, Gandhi J, Reid JS. Single Nucleotide Polymorphisms in Osteogenic Genes in Atrophic Delayed Fracture-Healing: A Preliminary Investigation. J Bone Joint Surg Am 2014; 96:1242-1248. [PMID: 25100770 DOI: 10.2106/jbjs.m.00453] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
UNLABELLED UpdateThis article was updated on September 10, 2014, because of a previous error. On page 1242, in the byline, and on page 1247, in the author addresses, the academic degree for Henry J. Donahue had previously read "MD." The degree now reads "PhD." BACKGROUND We propose that fracture-healing potential is affected by the patient's genome. This genotype is then phenotypically expressed by the patient at the time of injury. We examined the hypothesis that patients who exhibit delayed or impaired fracture-healing may have one or more single nucleotide polymorphisms (SNPs) within a series of genes related to bone formation. METHODS We performed a population-based, case-controlled study of delayed fracture-healing. Sixty-two adults with a long-bone fracture were identified from a surgical database. Thirty-three patients had an atrophic nonunion (delayed healing), and twenty-nine displayed normal fracture-healing. These patients underwent buccal mucosal cell harvesting. SNP genotyping was performed with use of bead array technology. One hundred and forty-four SNPs (selected from HapMap) within thirty genes associated with fracture-healing were investigated. Three SNPs did not segregate in the population and were excluded from the analysis. Eight of the remaining SNPs failed the test for Hardy-Weinberg equilibrium (p value smaller than the Bonferroni-corrected level of 0.05/141 = 0.000355) and were excluded. RESULTS Five SNPs on four genes were found to have a p value of <0.05 in the additive genetic model. Of these five significant SNPs, three had an odds ratio (OR) of >1, indicating that the presence of the allele increased the risk of nonunion. The rs2853550 SNP, which had the largest effect (OR = 5.9, p = 0.034), was on the IL1B gene, which codes for interleukin 1 beta. The rs2297514 SNP (OR = 3.98, p = 0.015) and the rs2248814 SNP (OR = 2.27, p = 0.038) were on the NOS2 gene coding for nitric oxide synthase. The remaining two SNPs had an OR of <1, indicating that the presence of the allele may be protective against nonunion. The rs3819089 SNP (OR = 0.26, p = 0.026) was on the MMP13 gene for matrix metallopeptidase 13, and the rs270393 SNP (OR = 0.30, p = 0.015) was on the BMP6 gene for bone morphogenetic protein 6. CONCLUSIONS Variations in the IL1B and NOS2 genes may contribute to delayed fracture-healing and warrant further investigation. CLINICAL RELEVANCE Impaired fracture union may have genetic contributions.
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Affiliation(s)
- Vikram Sathyendra
- Departments of Orthopaedics and Rehabilitation (V.S., H.J.D., D.F., J.G., and J.S.R.), Pharmacology (K.E.V.), and Public Health Sciences (A.B.), Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail address for J.S. Reid:
| | - Henry J Donahue
- Departments of Orthopaedics and Rehabilitation (V.S., H.J.D., D.F., J.G., and J.S.R.), Pharmacology (K.E.V.), and Public Health Sciences (A.B.), Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail address for J.S. Reid:
| | - Kent E Vrana
- Departments of Orthopaedics and Rehabilitation (V.S., H.J.D., D.F., J.G., and J.S.R.), Pharmacology (K.E.V.), and Public Health Sciences (A.B.), Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail address for J.S. Reid:
| | - Arthur Berg
- Departments of Orthopaedics and Rehabilitation (V.S., H.J.D., D.F., J.G., and J.S.R.), Pharmacology (K.E.V.), and Public Health Sciences (A.B.), Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail address for J.S. Reid:
| | - David Fryzel
- Departments of Orthopaedics and Rehabilitation (V.S., H.J.D., D.F., J.G., and J.S.R.), Pharmacology (K.E.V.), and Public Health Sciences (A.B.), Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail address for J.S. Reid:
| | - Jonathan Gandhi
- Departments of Orthopaedics and Rehabilitation (V.S., H.J.D., D.F., J.G., and J.S.R.), Pharmacology (K.E.V.), and Public Health Sciences (A.B.), Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail address for J.S. Reid:
| | - J Spence Reid
- Departments of Orthopaedics and Rehabilitation (V.S., H.J.D., D.F., J.G., and J.S.R.), Pharmacology (K.E.V.), and Public Health Sciences (A.B.), Penn State Hershey College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail address for J.S. Reid:
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Clark CC, Wang W, Brighton CT. Up-regulation of expression of selected genes in human bone cells with specific capacitively coupled electric fields. J Orthop Res 2014; 32:894-903. [PMID: 24644137 DOI: 10.1002/jor.22595] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 01/17/2014] [Indexed: 02/04/2023]
Abstract
The objective of the described experiments was to determine the electrical parameters that lead to optimal expression of a number of bone-related genes in cultured human bone cells exposed to a capacitively coupled electric field. Human calvarial osteoblasts were grown in modified plastic Cooper dishes in which the cells could be exposed to various capacitively coupled electric fields. The optimal duration of stimulation and optimal duration of response to the electrical field, and the optimal amplitude, frequency and duty cycle were all determined for each of the genes analyzed. Results indicated that a capacitively coupled electric field of 60 kHz, 20 mV/cm, 50% duty cycle for 2 h duration per day significantly up-regulated mRNA expression of a number of transforming growth factor (TGF)-β family genes (bone morphogenetic proteins (BMP)-2 and -4, TGF-β1, - β2 and -β3) as well as fibroblast growth factor (FGF)-2, osteocalcin (BGP) and alkaline phosphatase (ALP). Protein levels of BMP-2 and -4, and TGF-β1 and - β2 were also elevated. The clinical relevance of these findings in the context of a noninvasive treatment modality for delayed union and nonunion fracture healing is discussed.
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Affiliation(s)
- Charles C Clark
- Department of Orthopaedic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, 19104
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Morino-Koga S, Yano S, Kondo T, Shimauchi Y, Matsuyama S, Okamoto Y, Suico MA, Koga T, Sato T, Shuto T, Arima H, Wada I, Araki E, Kai H. Insulin receptor activation through its accumulation in lipid rafts by mild electrical stress. J Cell Physiol 2013; 228:439-46. [PMID: 22740366 DOI: 10.1002/jcp.24149] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Insulin resistance is due to the reduced cellular response to insulin in peripheral tissues. The interaction of insulin with its receptor is the first step in insulin action and thus the identified target of insulin resistance. It has been well established that defects or mutations in the insulin receptor (IR) cause insulin resistance. Therefore, an IR activator might be a novel therapeutic approach for insulin resistance. Our previous report showed that mild electrical stress (MES) enhanced the insulin-induced signaling pathway. However, the molecular mechanism of the effect of MES remains unclear. We assessed the effect of MES, which is characterized by low-intensity direct current, on insulin signaling in vitro and in vivo. Here, we showed that MES activated the insulin signaling in an insulin-independent manner and improved insulin resistance in peripheral tissues of high fat-fed mice. Moreover, we found that MES increased the localization of IR in lipid rafts and enhanced the level of phosphorylated Akt in insulin-resistant hepatic cells. Ablation of lipid rafts disrupted the effect of MES on Akt activation. Our findings indicate that MES has potential as an activator of IR in an insulin-independent manner, and might be beneficial for insulin resistance in type 2 diabetes.
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Affiliation(s)
- Saori Morino-Koga
- Department of Molecular Medicine, Global COE Cell Fate Regulation Research and Education Unit, Kumamoto University, Kumamoto, Japan
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Gao J, Gong H, Huang X, Fang J, Zhu D, Fan Y. Relationship between microstructure, material distribution, and mechanical properties of sheep tibia during fracture healing process. Int J Med Sci 2013; 10:1560-9. [PMID: 24046532 PMCID: PMC3775115 DOI: 10.7150/ijms.6611] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 08/13/2013] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to investigate the relationship between microstructural parameters, material distribution, and mechanical properties of sheep tibia at the apparent and tissue levels during the fracture healing process. Eighteen sheep underwent tibial osteotomy and were sacrificed at 4, 8, and 12 weeks. Radiographs and micro-computed tomography (micro-CT) scanning were taken for microstructural assessment, material distribution evaluation, and micro-finite element analysis. A displacement of 5% compressive strain on the longitudinal direction was applied to the micro-finite element model, and apparent and tissue-level mechanical properties were calculated. Principle component analysis and linear regression were used to establish the relationship between principle components (PCs) and mechanical parameters. Visible bony callus formation was observed throughout the healing process from radiographic assessment. Apparent mechanical property increased at 8 weeks, but tissue-level mechanical property did not increase significantly until 12 weeks. Three PCs were extracted from microstructural parameters and material distribution, which accounted for 87.592% of the total variation. The regression results showed a significant relationship between PCs and mechanical parameters (R>0.8, P<0.05). Results of this study show that microstructure and material distribution based on micro-CT imaging could efficiently predict bone strength and reflect the bone remodeling process during fracture healing, which provides a basis for exploring the fracture healing mechanism and may be used as an approach for fractured bone strength assessment.
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Affiliation(s)
- Jiazi Gao
- 1. Department of Engineering Mechanics, Jilin University, Changchun (130022), People's Republic of China
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Riboh JC, Leversedge FJ. The use of low-intensity pulsed ultrasound bone stimulators for fractures of the hand and upper extremity. J Hand Surg Am 2012; 37:1456-61. [PMID: 22030208 DOI: 10.1016/j.jhsa.2011.08.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 08/28/2011] [Indexed: 02/02/2023]
Affiliation(s)
- Jonathan C Riboh
- Department of Orthopaedic Surgery, Duke University, Durham, NC 27710, USA
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Non-invasive electromagnetic field therapy produces rapid and substantial pain reduction in early knee osteoarthritis: a randomized double-blind pilot study. Rheumatol Int 2012; 33:2169-73. [PMID: 22451021 DOI: 10.1007/s00296-012-2366-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 03/11/2012] [Indexed: 12/30/2022]
Abstract
This study examined whether a non-thermal, non-invasive, pulsed electromagnetic field (PEMF), known to modulate the calmodulin (CaM)-dependent nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling pathway, could reduce pain in early knee OA. This randomized, placebo-controlled, double-blind pilot clinical study enrolled 34 patients. Patient selection required initial VAS ≥4, 2 h of standing activity per day, and no recent interventions such as cortisone injections or surgery. Results showed VAS pain score decreased in the active cohort by 50 ± 11% versus baseline starting at day 1 and persisting to day 42 (P < 0.001). There was no significant decrease in VAS versus baseline at any time point in the sham cohort (P = 0.227). The overall decrease in mean VAS score for the active cohort was nearly threefold that of the sham cohort (P < 0.001). The results suggest that non-thermal, non-invasive PEMF therapy can have a significant and rapid impact on pain from early knee OA and that larger clinical trials are warranted.
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Varani K, Vincenzi F, Targa M, Corciulo C, Fini M, Setti S, Cadossi R, Borea PA. Effect of pulsed electromagnetic field exposure on adenosine receptors in rat brain. Bioelectromagnetics 2011; 33:279-87. [PMID: 22012856 DOI: 10.1002/bem.20704] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 08/24/2011] [Indexed: 01/14/2023]
Abstract
Different effects of pulsed electromagnetic field (PEMF) exposure on brain tissue have been described in pre-clinical models and in clinical settings. Nevertheless, the mechanism of action and the possible interaction with membrane receptors such as adenosine receptors (ARs) has not been investigated. The present study focused on the effect of PEMFs on A1 and A2A ARs in the rat cerebral cortex and cortical neurons. Affinity and density of ARs were evaluated by means of saturation binding experiments while mRNA expression was investigated through retro-transcription polymerase chain reaction (RT-PCR). PEMF treatment of the intact rat cerebral cortex or cortical neurons at 1.5 mT mediated a transient and significant increase in A2A ARs after 4 h (2.0-fold increase) and 6 h (1.4- and 1.8-fold increase, respectively) of exposure. In addition, PEMF treatment of the rat cerebral cortex and rat cortical neurons at 3 mT upregulated A2A ARs after 2 h (2.0- and 2.2-fold increase, respectively) and 4 h (1.6- and 1.9-fold increase, respectively). The treatment of rat cortex membranes with PEMFs at 1.5 and 3 mT induced an increase in A2A AR density after 2 h (1.9- and 2.2-fold increase, respectively) and was constant at all incubation times investigated. In rat cortical neurons, mRNA levels of A1 and A2A ARs were not affected by PEMF exposure for the times and intensities used. These results suggest that PEMF treatment has different biological effects in whole organs or cells in comparison with isolated membranes.
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Affiliation(s)
- Katia Varani
- Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
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Paskalev M, Goranov N, Sotirov L, Krastev S, Roydev R. Effect of therapeutic ultrasound on bone healing and blood bone markers in dogs with experimental tibial osteotomies. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s00580-011-1333-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Adie S, Harris IA, Naylor JM, Rae H, Dao A, Yong S, Ying V. Pulsed electromagnetic field stimulation for acute tibial shaft fractures: a multicenter, double-blind, randomized trial. J Bone Joint Surg Am 2011; 93:1569-76. [PMID: 21915570 DOI: 10.2106/jbjs.j.00869] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Tibial shaft fractures are sometimes complicated by delayed union and nonunion, necessitating further surgical interventions. Pulsed electromagnetic field stimulation is an effective treatment for delayed unions and nonunions, but its efficacy in preventing healing complications in patients with acute fractures is largely untested. The purpose of this pragmatic trial was to determine whether adjuvant pulsed electromagnetic field therapy for acute tibial shaft fractures reduces the rate of surgical revision because of delayed union or nonunion. METHODS In a double-blind randomized trial involving six metropolitan trauma hospitals, 259 participants with acute tibial shaft fractures (AO/OTA type 42) were randomized by means of external allocation to externally identical active and inactive pulsed electromagnetic field devices. Participants were instructed to wear the device for ten hours daily for twelve weeks. Management was otherwise unaltered. The primary outcome was the proportion of participants requiring a secondary surgical intervention because of delayed union or nonunion within twelve months after the injury. Secondary outcomes included surgical intervention for any reason, radiographic union at six months, and the Short Form-36 Physical Component Summary and Lower Extremity Functional Scales at twelve months. Main analyses were by intention to treat. RESULTS Two hundred and eighteen participants (84%) completed the twelve-month follow-up. One hundred and six patients were allocated to the active device group, and 112 were allocated to the placebo group. Compliance was moderate, with 6.2 hours of average daily use. Overall, sixteen patients in the active group and fifteen in the inactive group experienced a primary outcome event (risk ratio, 1.02; 95% confidence interval, 0.95 to 1.14; p = 0.72). According to per-protocol analysis, there were six primary events (12.2%) in the active, compliant group and twenty-six primary events (15.1%) in the combined placebo and active, noncompliant group (risk ratio, 0.97; 95% confidence interval, 0.86 to 1.10; p = 0.61). No between-group differences were found with regard to surgical intervention for any reason, radiographic union, or functional measures. CONCLUSIONS Adjuvant pulsed electromagnetic field stimulation does not prevent secondary surgical interventions for delayed union or nonunion and does not improve radiographic union or patient-reported functional outcomes in patients with acute tibial shaft fractures.
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Affiliation(s)
- Sam Adie
- Orthopaedic Department, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW Australia.
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Abstract
The current management for chronic osteomyelitis centers on adequate antibiotic coverage and surgical debridement of nonviable tissue. The eradication of osteomyelitis, however, often involves a prolonged and frustrating course of management. Nonsurgical adjunctive modalities have not been widely used, mostly due to a lack of perceived efficacy, and have remained in a state of infancy. In this article, we will outline the rationale, current status, and evidence for several potential adjuncts to osteomyelitis management.
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Affiliation(s)
- Robert C Fang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Hannemann P, Göttgens KWA, van Wely BJ, Kolkman KA, Werre AJ, Poeze M, Brink PRG. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial. BMC Musculoskelet Disord 2011; 12:90. [PMID: 21548951 PMCID: PMC3107178 DOI: 10.1186/1471-2474-12-90] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 05/06/2011] [Indexed: 11/18/2022] Open
Abstract
Background The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences. Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. Methods/Design This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning). Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory. Study parameters are clinical consolidation, radiological consolidation evaluated by CT-scanning, functional status of the wrist, including assessment by means of the patient rated wrist evaluation (PRWE) questionnaire and quality of life using SF-36 health survey questionnaire. Primary endpoint is number of scaphoid unions at six weeks, secondary endpoints are time interval to clinical and radiological consolidation, number of non-unions, functional status at 52 weeks and non-adherence to the treatment protocol. Trial registration Netherlands Trial Register (NTR): NTR2064
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Affiliation(s)
- Pascal Hannemann
- Department of surgery, Maastricht University Medical Center, PO box 5800, 6226 AZ, Maastricht, The Netherlands.
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Kasturi GC, Adler RA. Osteoporosis: nonpharmacologic management. PM R 2011; 3:562-72. [PMID: 21478069 DOI: 10.1016/j.pmrj.2010.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 12/10/2010] [Accepted: 12/17/2010] [Indexed: 01/01/2023]
Abstract
Osteoporosis is a chronic disorder of the skeleton causing increased bone fragility and fractures. In the second of our 3-part series, we discuss the beneficial effects of nonpharmacologic agents in the management of osteoporosis. We review the evidence supporting the use of exercise, whole-body vibration, hip protectors, low-intensity pulsed ultrasound, bracing, and vertebral augmentation procedures. The mechanism of action, precautions, and expected outcomes are discussed. Nonpharmacologic management of osteoporosis blends in very well with an overall exercise prescription. The nonpharmacologic interventions discussed are readily available and easy to implement. The use of such techniques demonstrates the important role of the physiatrist in the management of osteoporosis.
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Affiliation(s)
- Gopi C Kasturi
- Department of Neurology/Rehabilitation, VA Central California Health Care System, 2615 E Clinton Ave, Fresno, CA 93703, USA.
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Moncada ME, Sarmiento C, Martinez C, Martinez A. Magnetic stimulation for fracture consolidation--clinical study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2011; 2011:1141-1144. [PMID: 22254516 DOI: 10.1109/iembs.2011.6090267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper presents a randomized clinical design for evaluating magnetic fields in the consolidation of femoral shaft fractures. The study involved the design and construction of 20 devices (stimulators and placebos) and the development of 3D computer models of stimulated patient's thighs. A total of 64 patients were included in the study. Follow up time was 8 weeks with 1 hour of stimulation a day. The electrical signals estimated in the computer models were magnetic field, current density and voltage for different frequencies and currents. The results revealed 83% consolidated cases, and 7% with nonunion within the stimulation group, and 72% of consolidated cases and 14% with non-union for the control group. The consolidation results of patients who received stimulation were superior in time and number, but were not statistically significant. The values of electrical variables estimated by the computational model were found to be within a range not harmful to the patient (μA/m2, μT, nV).
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Affiliation(s)
- Maria E Moncada
- Instituto Tecnológico Metropolitano, Research Center, Medellin-Colombia.
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Naruse K, Sekiya H, Harada Y, Iwabuchi S, Kozai Y, Kawamata R, Kashima I, Uchida K, Urabe K, Seto K, Itoman M, Mikuni-Takagaki Y. Prolonged endochondral bone healing in senescence is shortened by low-intensity pulsed ultrasound in a manner dependent on COX-2. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:1098-1108. [PMID: 20620697 DOI: 10.1016/j.ultrasmedbio.2010.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 03/15/2010] [Accepted: 04/19/2010] [Indexed: 05/29/2023]
Abstract
To test whether mechanical loading produces faster healing in aged mice, fractured femurs of aged 1-year-old mice were subjected to low-intensity pulsed ultrasound (LIPUS), a treatment that is routinely used to help heal fractures in humans. Cyclooxygenase-2 knockout mice (COX-2(-/-)), which lack an immediate early mediator of mechanical stimulation, were also studied by histochemistry, microcomputed tomography and quantitative polymerase chain reaction to determine the role of COX-2. The healing in the aged COX-2(-/-) mice is slow during the endochondral bone remodeling (>30 d), a period generally prolonged in senescence. For aged wild-type mice, LIPUS halved the endochondral phase to about 10 d, whereas that was not the case for aged COX-2(-/-) mice, which showed no apparent shortening of the prolonged endochondral-phase healing time. Injecting prostaglandin E(2) receptor agonists, however, rescued the COX-2(-/-) callus from insensitivity to LIPUS. In conclusion, COX-2 is a limiting factor in the delayed endochondral bone healing and is induced by LIPUS, which normalizes healing rate to the wild-type level.
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Affiliation(s)
- Kouji Naruse
- Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
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Lu MH, Zheng YP, Huang QH, Lu HB, Qin L. Low intensity pulsed ultrasound increases the mechanical properties of the healing tissues at bone-tendon junction. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2010; 2009:2141-4. [PMID: 19964584 DOI: 10.1109/iembs.2009.5333960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The re-establishment of bone-tendon junction (BTJ) tissues is involved in many trauma and reconstructive surgeries. A direct BTJ repair requires a long period of immobilization which may be associated with a postoperative weak knee. In this study, we investigated if low-intensity pulsed ultrasound treatment increases the material properties of healing tissues at bone-tendon junction (BTJ) after partial patellectomy using rabbit models. Standard partial patellectomy was conducted on one knee of twenty four rabbits which were randomly divided into an ultrasound group and a control group. The bony changes of BTJ complexes around the BTJ healing interface were measured by anteroposterior x-ray radiographs; then the volumetric bone-mineral density (BMD) of the new bone was assessed using a peripheral computed tomography scanner (pQCT). The stiffness of patellar cartilage, fibrocartilage at the healing interface and the tendon were measured in situ using a novel noncontact ultrasound water jet indentation system. Not only significantly more newly formed bone at the BTJ healing interface but also increased stiffness of the junction tissues were found in the ultrasound group compared with the controls at week 18. In addition, the ultrasound group also showed significantly 44% higher BMD at week 6 than controls.
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Affiliation(s)
- Min-Hua Lu
- Department of Biomedical Engineering, Shenzhen University, Guangdong, P.R.China 518060. luminhua@ szu.edu.cn
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Abstract
This article provides an overview of the biology behind the use of electrical stimulation in fracture healing and discusses the current methods of electrical bone growth stimulation. In addition, we review the best available clinical evidence for the use of electrical stimulation in the treatment of delayed and nonunions of fractures. Our search identified 4 meta-analyses on the use of electrical stimulation on fracture healing. The most methodologically rigorous and recent meta-analysis suggests that the current evidence is insufficient to conclude a benefit of electromagnetic stimulation in improving the rate of union in patients with a fresh fracture, osteotomy, delayed union, or nonunion. The other 3 meta-analyses that we identified suggested a more significant treatment effect from electrical stimulation. Although the evidence supporting electrical stimulation does trend in favor of its use to help achieve bony union, further large, multicenter, randomized, controlled trials are required to resolve the current uncertainty surrounding the use of electrical stimulation and fracture healing.
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Kai H, Suico MA, Morino S, Kondo T, Oba M, Noguchi M, Shuto T, Araki E. A novel combination of mild electrical stimulation and hyperthermia: general concepts and applications. Int J Hyperthermia 2010; 25:655-60. [PMID: 20021226 DOI: 10.3109/02656730903039605] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This review discusses the basic concepts, effects and applications of hyperthermia and mild electrical stimulation (MES) using low-intensity direct current. It also proposes a novel combinatorial use of MES and hyperthermia, and briefly outlines the rationale and the effects of MES and hyperthermia combination treatment on certain diseases (diabetes, hepatic ischaemia/reperfusion injury and gastric ulcer). The integrated modalities of MES and hyperthermia might find therapeutic applications to stress-induced diseases and intractable diseases of dysregulated signalling pathways.
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Affiliation(s)
- Hirofumi Kai
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Global COE Cell Fate Regulation Research and Education Unit, Kumamoto University, Kumamoto, Japan.
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Cottrell JA, O'Connor JP. Pharmacological inhibition of 5-lipoxygenase accelerates and enhances fracture-healing. J Bone Joint Surg Am 2009; 91:2653-65. [PMID: 19884440 DOI: 10.2106/jbjs.h.01844] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Loss of cyclooxygenase-2 activity is known to impair fracture-healing in animal models and to inhibit heterotopic ossification in humans. Cyclooxygenase-2 is the rate-limiting enzyme involved in the conversion of arachidonic acid into prostaglandins. Arachidonic acid also is a substrate for 5-lipoxygenase, which catalyzes the initial steps in leukotriene synthesis. In contrast to cyclooxygenase-2, genetic ablation of 5-lipoxygenase accelerates and enhances fracture-healing in mice. The goal of this study was to determine if systemic inhibition of 5-lipoxygenase with an orally delivered drug could accelerate fracture-healing. METHODS Closed femoral fractures were made in Sprague-Dawley rats. The rats were treated with oral doses of vehicle (ninety-five rats), celecoxib (fifty-nine rats), or AA-861 (a 5-lipoxygenase inhibitor; eighty-nine rats). Fracture-healing was measured with use of radiographs, histomorphometry, and biomechanical testing. Effects of drug treatments on callus cell proliferation and gene expression were determined by incorporation of bromodeoxyuridine and quantitative polymerase chain reactions, respectively. RESULTS AA-861 treatment decreased fracture-bridging time, significantly increased early callus cartilage (5.6-fold; p < 0.001) and bone formation (4.2-fold; p = 0.015), and significantly increased callus mechanical properties compared with the vehicle-treated rat fractures. Callus cell proliferation rate was increased by AA-861 treatment, compared with vehicle, at day 2 after fracture (3.68% compared with 2.08%; p < 0.001; 95% confidence interval, -2.81 to -0.039) but was reduced by celecoxib treatment at day 4 after fracture (4.22% compared with 1.84%; p < 0.001; 95% confidence interval, 2.27 to 4.07). At day 10 after fracture, AA-861 and celecoxib treatment increased Type-II collagen mRNA levels (16.0-fold and 6.1-fold, respectively; p < 0.001 for both), but only AA-861 treatment caused an increase in Type-X collagen mRNA (6.3-fold; p < 0.001). AA-861 treatment significantly increased cyclooxygenase-2 (4.0-fold at day 10; p < 0.001) and osteopontin mRNA levels (3.6-fold at day 7; p = 0.024), while decreasing 5-lipoxygenase mRNA levels (5.6-fold at day 4; p < 0.001). CONCLUSIONS Systemic inhibition of 5-lipoxygenase with an orally delivered drug significantly accelerated and enhanced fracture-healing in this rat model. Gene expression analysis indicates that cyclooxygenase-2 is necessary for callus chondrocytes to progress into hypertrophy so as to complete endochondral ossification. Conversely, inhibition of 5-lipoxygenase alters the inflammatory response, which enhances callus chondrocyte hypertrophy and accelerates endochondral ossification.
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Affiliation(s)
- Jessica A Cottrell
- Department of Biochemistry and Molecular Biology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, MSB E-659/Biochem, 185 South Orange Avenue, Newark, NJ 07103, USA
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Tosounidis T, Kontakis G, Nikolaou V, Papathanassopoulos A, Giannoudis PV. Fracture healing and bone repair: an update. TRAUMA-ENGLAND 2009. [DOI: 10.1177/1460408609335922] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bone healing represents a physiological process of repair and restoration of function. Recent advances in a variety of medical disciplines have enabled scientists and clinicians to characterise this phenomenon at the molecular level. A number of molecular mediators and cells interact utilising different pathways. Despite the involvement of many local and systemic factors failure of the naturally occurring mechanisms can occur leading to either delayed union or non-union. This review article is focused on the recent understanding of the mechanisms governing the bone repair process.
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Affiliation(s)
| | - George Kontakis
- Department of Orthopaedics and Traumatology, University of Crete, Greece
| | - Vassilis Nikolaou
- Academic Department of Trauma and Orthopaedics, University of Leeds, UK
| | | | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, University of Leeds, UK,
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Ercan B, Webster TJ. Greater osteoblast proliferation on anodized nanotubular titanium upon electrical stimulation. Int J Nanomedicine 2009; 3:477-85. [PMID: 19337416 PMCID: PMC2636582 DOI: 10.2147/ijn.s3780] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Currently used orthopedic implants composed of titanium have a limited functional lifetime of only 10-15 years. One of the reasons for this persistent problem is the poor prolonged ability of titanium to remain bonded to juxtaposed bone. It has been proposed to modify titanium through anodization to create a novel nanotubular topography in order to improve cytocompatibility properties necessary for the prolonged attachment of orthopedic implants to surrounding bone. Additionally, electrical stimulation has been used in orthopedics to heal bone non-unions and fractures in anatomically difficult to operate sites (such as the spine). In this study, these two approaches were combined as the efficacy of electrical stimulation to promote osteoblast (bone forming cell) density on anodized titanium was investigated. To do this, osteoblast proliferation experiments lasting up to 5 days were conducted as cells were stimulated with constant bipolar pulses at a frequency of 20 Hz and a pulse duration of 0.4 ms each day for 1 hour. The stimulation voltages were 1 V, 5 V, 10 V, and 15 V. Results showed for the first time that under electrical stimulation, osteoblast proliferation on anodized titanium was enhanced at lower voltages compared to what was observed on conventional (nonanodized) titanium. In addition, compared to nonstimulated conventional titanium, osteoblast proliferation was enhanced 72% after 5 days of culture on anodized nanotubular titanium at 15 V of electrical stimulation. Thus, results of this study suggest that coupling the positive influences of electrical stimulation and nanotubular features on anodized titanium may improve osteoblast responses necessary for enhanced orthopedic implant efficacy.
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Affiliation(s)
- Batur Ercan
- Division of Engineering, Brown University, Providence, RI 02912, USA
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