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Childress PJ, Nielsen JJ, Bemenderfer TB, Dadwal UC, Chakraborty N, Harris JS, Bethel M, Alvarez MB, Tucker A, Wessel AR, Millikan PD, Wilhite JH, Engle A, Brinker A, Rytlewski JD, Scofield DC, Griffin KS, Shelley WC, Manikowski KJ, Jackson KL, Miller SA, Cheng YH, Ghosh J, Mulcrone PL, Srour EF, Yoder MC, Natoli RM, Shively KD, Gautam A, Hammamieh R, Low SA, Low PS, McKinley TO, Anglen JO, Lowery JW, Chu TMG, Kacena MA. Thrombopoietic agents enhance bone healing in mice, rats, and pigs. J Bone Miner Res 2024; 40:125-139. [PMID: 39566068 DOI: 10.1093/jbmr/zjae191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/15/2024] [Accepted: 11/19/2024] [Indexed: 11/22/2024]
Abstract
Achieving bone union remains a significant clinical dilemma. The use of osteoinductive agents, specifically bone morphogenetic proteins (BMPs), has gained wide attention. However, multiple side effects, including increased incidence of cancer, have renewed interest in investigating alternatives that provide safer, yet effective bone regeneration. Here we demonstrate the robust bone healing capabilities of the main megakaryocyte (MK) growth factor, thrombopoietin (TPO), and second-generation TPO agents using multiple animal models, including mice, rats, and pigs. This bone healing activity is shown in two fracture models (critical-sized defect [CSD] and closed fracture) and with local or systemic administration. Our transcriptomic analyses, cellular studies, and protein arrays demonstrate that TPO enhances multiple cellular processes important to fracture healing, particularly angiogenesis, which is required for bone union. Finally, the therapeutic potential of thrombopoietic agents is high since they are used in the clinic for other indications (eg, thrombocytopenia) with established safety profiles and act upon a narrowly defined population of cells.
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Affiliation(s)
- Paul J Childress
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, United States
| | - Jeffery J Nielsen
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN, 47907, United States
- Department of Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Thomas B Bemenderfer
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Ushashi C Dadwal
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, United States
| | - Nabarun Chakraborty
- Medical Readiness Systems Biology, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, United States
| | - Jonathan S Harris
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Monique Bethel
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Marta B Alvarez
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, United States
| | - Aamir Tucker
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Alexander R Wessel
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Patrick D Millikan
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Jonathan H Wilhite
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Andrew Engle
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Alexander Brinker
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Jeffrey D Rytlewski
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - David C Scofield
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Kaitlyn S Griffin
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - W Christopher Shelley
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Kelli J Manikowski
- Division of Biomedical Science, Marian University College of Osteopathic Medicine, Indianapolis, IN, 46222, United States
| | - Krista L Jackson
- Division of Biomedical Science, Marian University College of Osteopathic Medicine, Indianapolis, IN, 46222, United States
| | - Stacy-Ann Miller
- Medical Readiness Systems Biology, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, United States
| | - Ying-Hua Cheng
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Joydeep Ghosh
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Patrick L Mulcrone
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, United States
| | - Edward F Srour
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Mervin C Yoder
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Roman M Natoli
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Karl D Shively
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Aarti Gautam
- Medical Readiness Systems Biology, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, United States
| | - Rasha Hammamieh
- Medical Readiness Systems Biology, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, United States
| | - Stewart A Low
- Department of Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Philip S Low
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN, 47907, United States
- Department of Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Todd O McKinley
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Jeffrey O Anglen
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Jonathan W Lowery
- Division of Biomedical Science, Marian University College of Osteopathic Medicine, Indianapolis, IN, 46222, United States
| | - Tien-Min G Chu
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, IN, 46202, United States
| | - Melissa A Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, United States
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İYİLİKCİ B, TAŞDEMİR U, ÖZMEN Ö, KIZILDAĞ A. Effect of Tideglusib with Bone Grafting on New Bone Formation. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.943229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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3
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Wolfien M, Klatt D, Salybekov AA, Ii M, Komatsu-Horii M, Gaebel R, Philippou-Massier J, Schrinner E, Akimaru H, Akimaru E, David R, Garbade J, Gummert J, Haverich A, Hennig H, Iwasaki H, Kaminski A, Kawamoto A, Klopsch C, Kowallick JT, Krebs S, Nesteruk J, Reichenspurner H, Ritter C, Stamm C, Tani-Yokoyama A, Blum H, Wolkenhauer O, Schambach A, Asahara T, Steinhoff G. Hematopoietic stem-cell senescence and myocardial repair - Coronary artery disease genotype/phenotype analysis of post-MI myocardial regeneration response induced by CABG/CD133+ bone marrow hematopoietic stem cell treatment in RCT PERFECT Phase 3. EBioMedicine 2020; 57:102862. [PMID: 32629392 PMCID: PMC7339012 DOI: 10.1016/j.ebiom.2020.102862] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 01/08/2023] Open
Abstract
Background Bone marrow stem cell clonal dysfunction by somatic mutation is suspected to affect post-infarction myocardial regeneration after coronary bypass surgery (CABG). Methods Transcriptome and variant expression analysis was studied in the phase 3 PERFECT trial post myocardial infarction CABG and CD133+ bone marrow derived hematopoetic stem cells showing difference in left ventricular ejection fraction (∆LVEF) myocardial regeneration Responders (n=14; ∆LVEF +16% day 180/0) and Non-responders (n=9; ∆LVEF -1.1% day 180/0). Subsequently, the findings have been validated in an independent patient cohort (n=14) as well as in two preclinical mouse models investigating SH2B3/LNK antisense or knockout deficient conditions. Findings 1. Clinical: R differed from NR in a total of 161 genes in differential expression (n=23, q<0•05) and 872 genes in coexpression analysis (n=23, q<0•05). Machine Learning clustering analysis revealed distinct RvsNR preoperative gene-expression signatures in peripheral blood acorrelated to SH2B3 (p<0.05). Mutation analysis revealed increased specific variants in RvsNR. (R: 48 genes; NR: 224 genes). 2. Preclinical:SH2B3/LNK-silenced hematopoietic stem cell (HSC) clones displayed significant overgrowth of myeloid and immune cells in bone marrow, peripheral blood, and tissue at day 160 after competitive bone-marrow transplantation into mice. SH2B3/LNK−/− mice demonstrated enhanced cardiac repair through augmenting the kinetics of bone marrow-derived endothelial progenitor cells, increased capillary density in ischemic myocardium, and reduced left ventricular fibrosis with preserved cardiac function. 3. Validation: Evaluation analysis in 14 additional patients revealed 85% RvsNR (12/14 patients) prediction accuracy for the identified biomarker signature. Interpretation Myocardial repair is affected by HSC gene response and somatic mutation. Machine Learning can be utilized to identify and predict pathological HSC response. Funding German Ministry of Research and Education (BMBF): Reference and Translation Center for Cardiac Stem Cell Therapy - FKZ0312138A and FKZ031L0106C, German Ministry of Research and Education (BMBF): Collaborative research center - DFG:SFB738 and Center of Excellence - DFG:EC-REBIRTH), European Social Fonds: ESF/IV-WM-B34-0011/08, ESF/IV-WM-B34-0030/10, and Miltenyi Biotec GmbH, Bergisch-Gladbach, Germany. Japanese Ministry of Health : Health and Labour Sciences Research Grant (H14-trans-001, H17-trans-002) Trial registration ClinicalTrials.gov NCT00950274
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Affiliation(s)
- Markus Wolfien
- Department of Systems Biology and Bioinformatics, University Rostock, Institute of Computer Science, Ulmenstrasse 69, 18057 Rostock, Germany.
| | - Denise Klatt
- Hannover Medical School, Institute of Experimental Hematology, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
| | - Amankeldi A Salybekov
- Department of Advanced Medicine Science, Tokai University School of Medicine, Shimokasuya 143, Isehara, Kanagawa 259-1143, Japan
| | - Masaaki Ii
- Nanobridge, LLC. 1-3-5-202, Sawaragi-Nishi Ibaraki Osaka 567-0868, Japan.
| | - Miki Komatsu-Horii
- Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan.
| | - Ralf Gaebel
- Reference and Translation Center for Cardiac Stem Cell Therapy, Department Life, Light and Matter and Department of cardiac surgery, University Medicine Rostock, Schillingallee 35, 18055 Rostock, Germany.
| | - Julia Philippou-Massier
- Ludwig-Maximilians-Universität München, LAFUGA Genomics, Gene Center, Feodor-Lynen-Strasse 25, 81377 Muenchen, Germany.
| | - Eric Schrinner
- University Medical Center Goettingen, Institute for Diagnostic and Interventional Radiology, Robert-Koch-Strasse 40, 37075 Göttingen, Germany.
| | - Hiroshi Akimaru
- Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan.
| | - Erika Akimaru
- Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan.
| | - Robert David
- Reference and Translation Center for Cardiac Stem Cell Therapy, Department Life, Light and Matter and Department of cardiac surgery, University Medicine Rostock, Schillingallee 35, 18055 Rostock, Germany.
| | - Jens Garbade
- Department of Cardiac Surgery, Heart Center University Medicine Leipzig, Strümpellstrasse 39, 04289 Leipzig, Germany.
| | - Jan Gummert
- Heart and diabetes center North Rhine Westfalia, University hospital of the Ruhr university Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany.
| | - Axel Haverich
- Medical school Hannover, Department of heart-, thoracic- and vascular surgery, Carl Neuberg Strasse 1, 30625 Hannover, Germany.
| | - Holger Hennig
- Department of Systems Biology and Bioinformatics, University Rostock, Institute of Computer Science, Ulmenstrasse 69, 18057 Rostock, Germany.
| | - Hiroto Iwasaki
- Department of cardiothoracic surgery, Osaka city university, 1-4-3, Asahimachi, Abeno. Osaka, 545-8585. Japan.
| | - Alexander Kaminski
- Reference and Translation Center for Cardiac Stem Cell Therapy, Department Life, Light and Matter and Department of cardiac surgery, University Medicine Rostock, Schillingallee 35, 18055 Rostock, Germany.
| | - Atsuhiko Kawamoto
- Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan.
| | - Christian Klopsch
- Reference and Translation Center for Cardiac Stem Cell Therapy, Department Life, Light and Matter and Department of cardiac surgery, University Medicine Rostock, Schillingallee 35, 18055 Rostock, Germany.
| | - Johannes T Kowallick
- University Medical Center Goettingen, Institute for Diagnostic and Interventional Radiology, Robert-Koch-Strasse 40, 37075 Göttingen, Germany.
| | - Stefan Krebs
- Ludwig-Maximilians-Universität München, LAFUGA Genomics, Gene Center, Feodor-Lynen-Strasse 25, 81377 Muenchen, Germany.
| | - Julia Nesteruk
- Reference and Translation Center for Cardiac Stem Cell Therapy, Department Life, Light and Matter and Department of cardiac surgery, University Medicine Rostock, Schillingallee 35, 18055 Rostock, Germany.
| | - Hermann Reichenspurner
- Department of Cardiac and Vascular Surgery, University heart center Hamburg, Martinistraße. 52, 20246 Hamburg, Germany.
| | - Christian Ritter
- University Medical Center Goettingen, Institute for Diagnostic and Interventional Radiology, Robert-Koch-Strasse 40, 37075 Göttingen, Germany.
| | - Christof Stamm
- German Heart Center Berlin, Department of Heart-, Thoracic- and Vascular Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Ayumi Tani-Yokoyama
- Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan.
| | - Helmut Blum
- Ludwig-Maximilians-Universität München, LAFUGA Genomics, Gene Center, Feodor-Lynen-Strasse 25, 81377 Muenchen, Germany.
| | - Olaf Wolkenhauer
- Department of Systems Biology and Bioinformatics, University Rostock, Institute of Computer Science, Ulmenstrasse 69, 18057 Rostock, Germany.
| | - Axel Schambach
- Hannover Medical School, Institute of Experimental Hematology, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
| | - Takayuki Asahara
- Department of Advanced Medicine Science, Tokai University School of Medicine, Shimokasuya 143, Isehara, Kanagawa 259-1143, Japan.
| | - Gustav Steinhoff
- Reference and Translation Center for Cardiac Stem Cell Therapy, Department Life, Light and Matter and Department of cardiac surgery, University Medicine Rostock, Schillingallee 35, 18055 Rostock, Germany.
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Chen J, Ashames A, Buabeid MA, Fahelelbom KM, Ijaz M, Murtaza G. Nanocomposites drug delivery systems for the healing of bone fractures. Int J Pharm 2020; 585:119477. [PMID: 32473968 DOI: 10.1016/j.ijpharm.2020.119477] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/20/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
The skeletal system is fundamental for the structure and support of the body consisting of bones, cartilage, and connective tissues. Poor fracture healing is a chief clinical problem leading to disability, extended hospital stays and huge financial liability. Even though most fractures are cured using standard clinical methods, about 10% of fractures are delayed or non-union. Despite decades of progress, the bone-targeted delivery system is still restricted due to the distinctive anatomical bone features. Recently, various novel nanocomposite systems have been designed for the cell-specific targeting of bone, enhancing drug solubility, improving drug stability and inhibiting drug degradation so that it can reach its target site without being removed in the systemic circulation. Such targeting systems could consist of biological compounds i.e. bone marrow stem cells (BMSc), growth factors, RNAi, parathyroid hormone or synthetic compounds, i.e. bisphosphonates (BPs) and calcium phosphate cement. Hydrogels and nanoparticles are also being employed for fracture healing. In this review, we discussed the normal mechanism of bone healing and all the possible drug delivery systems being employed for the healing of the bone fracture.
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Affiliation(s)
- Jianxian Chen
- School of Economics, Capital University of Economics and Business, Beijing, China
| | - Akram Ashames
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates.
| | - Manal Ali Buabeid
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Khairi Mustafa Fahelelbom
- Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Muhammad Ijaz
- Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, 54000, Pakistan
| | - Ghulam Murtaza
- Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, 54000, Pakistan.
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Tanjaya J, Lord EL, Wang C, Zhang Y, Kim JK, Nguyen A, Baik L, Pan HC, Chen E, Kwak JH, Zhang X, Wu B, Soo C, Ting K. The Effects of Systemic Therapy of PEGylated NEL-Like Protein 1 (NELL-1) on Fracture Healing in Mice. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 188:715-727. [PMID: 29294300 PMCID: PMC5840496 DOI: 10.1016/j.ajpath.2017.11.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/04/2017] [Accepted: 11/21/2017] [Indexed: 01/05/2023]
Abstract
Fractures are common, with an incidence of 13.7 per 1000 adults annually. Systemic agents have been widely used for enhancing bone regeneration; however, the efficacy of these therapeutics for the management and prevention of fracture remains unclear. NEL-like protein 1 (NELL-1) is a potent pro-osteogenic cytokine that has been modified with polyethylene glycol (PEG)ylation [PEGylated NELL-1 (NELL-PEG)] to enhance its pharmacokinetics for systemic therapy. Our aim was to investigate the effects of systemic administration of NELL-PEG on fracture healing in mice and on overall bone properties in uninjured bones. Ten-week-old CD-1 mice were subjected to an open osteotomy of bilateral radii and treated with weekly injections of NELL-PEG or PEG phosphate-buffered saline as control. Systemic injection of NELL-PEG resulted in improved bone mineral density of the fracture site and accelerated callus union. After 4 weeks of treatment, mice treated with NELL-PEG exhibited substantially enhanced callus volume, callus mineralization, and biomechanical properties. NELL-PEG injection significantly augmented bone regeneration, as confirmed by high expression of bone turnover rate, bone formation rate, and mineral apposition rate. Consistently, the immunohistochemistry results also confirmed a high bone remodeling activity in the NELL-PEG-treated group. Our findings suggest that weekly injection of NELL-PEG may have the clinical potential to accelerate fracture union and enhance overall bone properties, which may help prevent subsequent fractures.
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Affiliation(s)
- Justine Tanjaya
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Elizabeth L Lord
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, University of California, Los Angeles, Los Angeles, California
| | - Chenchao Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Plastic Surgery, First Hospital of China Medical University, Shenyang, China
| | - Yulong Zhang
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California; Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, California
| | - Jong K Kim
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Alan Nguyen
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Llyod Baik
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Hsin C Pan
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Eric Chen
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Jin H Kwak
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Xinli Zhang
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California
| | - Benjamin Wu
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California; Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, California
| | - Chia Soo
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, University of California, Los Angeles, Los Angeles, California; Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Kang Ting
- Division of Growth and Development and the Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, California.
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Wang Y, Newman MR, Benoit DSW. Development of controlled drug delivery systems for bone fracture-targeted therapeutic delivery: A review. Eur J Pharm Biopharm 2018; 127:223-236. [PMID: 29471078 DOI: 10.1016/j.ejpb.2018.02.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/17/2018] [Accepted: 02/17/2018] [Indexed: 01/09/2023]
Abstract
Impaired fracture healing is a major clinical problem that can lead to patient disability, prolonged hospitalization, and significant financial burden. Although the majority of fractures heal using standard clinical practices, approximately 10% suffer from delayed unions or non-unions. A wide range of factors contribute to the risk for nonunions including internal factors, such as patient age, gender, and comorbidities, and external factors, such as the location and extent of injury. Current clinical approaches to treat nonunions include bone grafts and low-intensity pulsed ultrasound (LIPUS), which realizes clinical success only to select patients due to limitations including donor morbidities (grafts) and necessity of fracture reduction (LIPUS), respectively. To date, therapeutic approaches for bone regeneration rely heavily on protein-based growth factors such as INFUSE, an FDA-approved scaffold for delivery of bone morphogenetic protein 2 (BMP-2). Small molecule modulators and RNAi therapeutics are under development to circumvent challenges associated with traditional growth factors. While preclinical studies has shown promise, drug delivery has become a major hurdle stalling clinical translation. Therefore, this review overviews current therapies employed to stimulate fracture healing pre-clinically and clinically, including a focus on drug delivery systems for growth factors, parathyroid hormone (PTH), small molecules, and RNAi therapeutics, as well as recent advances and future promise of fracture-targeted drug delivery.
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Affiliation(s)
- Yuchen Wang
- Department of Biomedical Engineering, 308 Robert B. Goergen Hall, University of Rochester, Rochester, NY 14627, USA; Center for Musculoskeletal Research, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA.
| | - Maureen R Newman
- Department of Biomedical Engineering, 308 Robert B. Goergen Hall, University of Rochester, Rochester, NY 14627, USA; Center for Musculoskeletal Research, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA.
| | - Danielle S W Benoit
- Department of Biomedical Engineering, 308 Robert B. Goergen Hall, University of Rochester, Rochester, NY 14627, USA; Center for Musculoskeletal Research, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA; Department of Chemical Engineering, 4517 Wegmans Hall, University of Rochester, Rochester, NY 14627, USA; Department of Orthopaedics, 601 Elmwood Ave, University of Rochester, Rochester, NY 14642, USA; Department of Biomedical Genetics, 601 Elmwood Ave, University of Rochester, Rochester, NY 14642, USA; Center for Oral Biology, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA.
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7
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The Use of Endothelial Progenitor Cells for the Regeneration of Musculoskeletal and Neural Tissues. Stem Cells Int 2017; 2017:1960804. [PMID: 28458693 PMCID: PMC5387841 DOI: 10.1155/2017/1960804] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 03/12/2017] [Indexed: 12/18/2022] Open
Abstract
Endothelial progenitor cells (EPCs) derived from bone marrow and blood can differentiate into endothelial cells and promote neovascularization. In addition, EPCs are a promising cell source for the repair of various types of vascularized tissues and have been used in animal experiments and clinical trials for tissue repair. In this review, we focused on the kinetics of endogenous EPCs during tissue repair and the application of EPCs or stem cell populations containing EPCs for tissue regeneration in musculoskeletal and neural tissues including the bone, skeletal muscle, ligaments, spinal cord, and peripheral nerves. EPCs can be mobilized from bone marrow and recruited to injured tissue to contribute to neovascularization and tissue repair. In addition, EPCs or stem cell populations containing EPCs promote neovascularization and tissue repair through their differentiation to endothelial cells or tissue-specific cells, the upregulation of growth factors, and the induction and activation of endogenous stem cells. Human peripheral blood CD34(+) cells containing EPCs have been used in clinical trials of bone repair. Thus, EPCs are a promising cell source for the treatment of musculoskeletal and neural tissue injury.
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Ghadakzadeh S, Mekhail M, Aoude A, Hamdy R, Tabrizian M. Small Players Ruling the Hard Game: siRNA in Bone Regeneration. J Bone Miner Res 2016; 31:475-87. [PMID: 26890411 DOI: 10.1002/jbmr.2816] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/02/2016] [Accepted: 02/16/2016] [Indexed: 12/17/2022]
Abstract
Silencing gene expression through a sequence-specific manner can be achieved by small interfering RNAs (siRNAs). The discovery of this process has opened the doors to the development of siRNA therapeutics. Although several preclinical and clinical studies have shown great promise in the treatment of neurological disorders, cancers, dominant disorders, and viral infections with siRNA, siRNA therapy is still gaining ground in musculoskeletal tissue repair and bone regeneration. Here we present a comprehensive review of the literature to summarize different siRNA delivery strategies utilized to enhance bone regeneration. With advancement in understanding the targetable biological pathways involved in bone regeneration and also the rapid progress in siRNA technologies, application of siRNA for bone regeneration has great therapeutic potential. High rates of musculoskeletal injuries and diseases, and their inevitable consequences, impose a huge financial burden on individuals and healthcare systems worldwide.
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Affiliation(s)
- Saber Ghadakzadeh
- Experimental Surgery, Department of Surgery, Faculty of Medicine, McGill University, Montreal, Canada.,Division of Orthopaedic Surgery, Shriners Hospital for Children, McGill University, Montreal, Canada
| | - Mina Mekhail
- Division of Orthopaedic Surgery, Shriners Hospital for Children, McGill University, Montreal, Canada
| | - Ahmed Aoude
- Division of Orthopaedic Surgery, Shriners Hospital for Children, McGill University, Montreal, Canada
| | - Reggie Hamdy
- Experimental Surgery, Department of Surgery, Faculty of Medicine, McGill University, Montreal, Canada.,Division of Orthopaedic Surgery, Shriners Hospital for Children, McGill University, Montreal, Canada
| | - Maryam Tabrizian
- Department of Biomedical Engineering, McGill University, Montreal, Canada
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Balmayor ER, van Griensven M. Gene therapy for bone engineering. Front Bioeng Biotechnol 2015; 3:9. [PMID: 25699253 PMCID: PMC4313589 DOI: 10.3389/fbioe.2015.00009] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 01/14/2015] [Indexed: 11/13/2022] Open
Abstract
Bone has an intrinsic healing capacity that may be exceeded when the fracture gap is too big or unstable. In that moment, osteogenic measures need to be taken by physicians. It is important to combine cells, scaffolds and growth factors, and the correct mechanical conditions. Growth factors are clinically administered as recombinant proteins. They are, however, expensive and needed in high supraphysiological doses. Moreover, their half-life is short when administered to the fracture. Therefore, gene therapy may be an alternative. Cells can constantly produce the protein of interest in the correct folding, with the physiological glycosylation and in the needed amounts. Genes can be delivered in vivo or ex vivo by viral or non-viral methods. Adenovirus is mostly used. For the non-viral methods, hydrogels and recently sonoporation seem to be promising means. This review will give an overview of recent advancements in gene therapy approaches for bone regeneration strategies.
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Affiliation(s)
- Elizabeth Rosado Balmayor
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich , Munich , Germany ; Institute for Advanced Science, Technical University Munich , Garching , Germany
| | - Martijn van Griensven
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich , Munich , Germany
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Kuroda R, Matsumoto T, Kawakami Y, Fukui T, Mifune Y, Kurosaka M. Clinical impact of circulating CD34-positive cells on bone regeneration and healing. TISSUE ENGINEERING PART B-REVIEWS 2014; 20:190-9. [PMID: 24372338 DOI: 10.1089/ten.teb.2013.0511] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Failures in fracture healing after conventional autologous and allogenic bone grafting are mainly due to poor vascularization. To meet the clinical demand, recent attentions in the regeneration and repair of bone have been focused on the use of stem cells such as bone marrow mesenchymal stem cells and circulating skeletal stem cells. Circulating stem cells are currently paid a lot of attention due to their ease of clinical setting and high potential for osteogenesis and angiogenesis. In this report, we focus on the first proof-of-principle experiments demonstrating the collaborative characteristics of circulating CD34(+) cells, known as endothelial and hematopoietic progenitor cell-rich population, which are capable to differentiate into both endothelial cells and osteoblasts. Transplantation of circulating CD34(+) cells provides a favorable environment for fracture healing via angiogenesis/vasculogenesis and osteogenesis, finally leading to functional recovery from fracture. Based on a series of basic studies, we performed a phase 1/2 clinical trial of autologous CD34(+) cell transplantation in patients with tibial or femoral nonunions and reported the safety and efficacy of this novel therapy. In this review, the current concepts and strategies in circulating CD34(+) cell-based therapy and its potential applications for bone repair will be highlighted.
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Affiliation(s)
- Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine , Kobe, Japan
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