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Hassan MG, Horenberg AL, Coler-Reilly A, Grayson WL, Scheller EL. Role of the Peripheral Nervous System in Skeletal Development and Regeneration: Controversies and Clinical Implications. Curr Osteoporos Rep 2023; 21:503-518. [PMID: 37578676 PMCID: PMC10543521 DOI: 10.1007/s11914-023-00815-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE OF REVIEW This review examines the diverse functional relationships that exist between the peripheral nervous system (PNS) and bone, including key advances over the past century that inform our efforts to translate these discoveries for skeletal repair. RECENT FINDINGS The innervation of the bone during development, homeostasis, and regeneration is highly patterned. Consistent with this, there have been nearly 100 studies over the past century that have used denervation approaches to isolate the effects of the different branches of the PNS on the bone. Overall, a common theme of balance emerges whereby an orchestration of both local and systemic neural functions must align to promote optimal skeletal repair while limiting negative consequences such as pain. An improved understanding of the functional bidirectional pathways linking the PNS and bone has important implications for skeletal development and regeneration. Clinical advances over the next century will necessitate a rigorous identification of the mechanisms underlying these effects that is cautious not to oversimplify the in vivo condition in diverse states of health and disease.
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Affiliation(s)
- Mohamed G Hassan
- Department of Medicine, Division of Bone and Mineral Diseases, Washington University, 660 South Euclid Avenue, Campus Box 8301, St. Louis, MO, 63110, USA
| | - Allison L Horenberg
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
- Translational Tissue Engineering Center, Johns Hopkins University, Baltimore, MD, USA
| | - Ariella Coler-Reilly
- Department of Medicine, Division of Bone and Mineral Diseases, Washington University, 660 South Euclid Avenue, Campus Box 8301, St. Louis, MO, 63110, USA
| | - Warren L Grayson
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
- Translational Tissue Engineering Center, Johns Hopkins University, Baltimore, MD, USA
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA
| | - Erica L Scheller
- Department of Medicine, Division of Bone and Mineral Diseases, Washington University, 660 South Euclid Avenue, Campus Box 8301, St. Louis, MO, 63110, USA.
- Department of Biomedical Engineering, Washington University, MO, St. Louis, USA.
- Department of Cell Biology and Physiology, Washington University, MO, St. Louis, USA.
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Gkiatas I, Kostas-Agnantis I, Batistatou A, Kosmas D, Korompilia M, Gelalis I, Pakos E, Vekris M, Korompilias A. Neonatal brachial plexus injuries and their impact on growing bone. An experimental study. Injury 2020; 51:2851-2854. [PMID: 32122625 DOI: 10.1016/j.injury.2020.02.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 02/02/2023]
Abstract
Neonatal brachial plexus palsy remains a problem, even in light of current advances in perinatal care. While many cases resolve spontaneously, the concern remains on the best means of surgical management for restoration of elbow flexion and shoulder reanimation. The present experimental study in an animal model examines the evidence that supports that neonatal brachial plexus injuries result in structural changes in the affected bone. The study suggests that if the microsurgical reinnervation takes place early enough, these changes may be diminished. On the other hand there is no way to identify at birth, which injuries will be permanent and will need surgical repair and which will spontaneously improve.
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Affiliation(s)
- Ioannis Gkiatas
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece.
| | - Ioannis Kostas-Agnantis
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Anna Batistatou
- Department of Pathology, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Dimitrios Kosmas
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Maria Korompilia
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Ioannis Gelalis
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Emilios Pakos
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Marios Vekris
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Anastasios Korompilias
- Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece
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