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Desai S, Lång P, Näreoja T, Windahl SH, Andersson G. RANKL-dependent osteoclast differentiation and gene expression in bone marrow-derived cells from adult mice is sexually dimorphic. Bone Rep 2023; 19:101697. [PMID: 37485233 PMCID: PMC10359713 DOI: 10.1016/j.bonr.2023.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/22/2023] [Accepted: 06/30/2023] [Indexed: 07/25/2023] Open
Abstract
Sex-specific differences in bone integrity and properties are associated with age as well as the number and activity of cells involved in bone remodeling. The aim of this study was to investigate sex-specific differences in adhesion, proliferation, and differentiation of mouse bone marrow derived cells into osteoclasts. The adherent fraction of bone marrow- derived cells from 12-week-old male and female C57BL/6J mice were assessed for their adhesion, proliferation, and receptor activator of nuclear factor κB (RANKL)-induced differentiation into osteoclasts. Female bone marrow derived macrophages (BMDMs) displayed higher adhesion and proliferation ratio upon macrophage colony stimulating factor (M-CSF) (day 0) and M-CSF + RANKL (day 4) treatment, respectively. On the contrary, male BMDMs differentiated more efficiently into osteoclasts upon RANKL-treatment compared to females (day 5). To further understand these sex-specific differences at the gene expression level, BMDMs treated with M-CSF (day 0) and M-CSF + RANKL (day 4), were assessed for their differential expression of genes through RNA sequencing. M-CSF treatment resulted in 1106 differentially expressed genes, while RANKL-treatment gave 473 differentially expressed genes. Integrin, adhesion, and proliferation-associated genes were elevated in the M-CSF-treated female BMDMs. RANKL-treatment further enhanced the expression of the proliferation- associated genes, and of genes associated with inhibition of osteoclast differentiation in the females, while RANK-signaling-associated genes were upregulated in males. In conclusion, BMDM adhesion, proliferation and differentiation into osteoclasts are sex-specific and may be directed by the PI3K-Akt signaling pathway for proliferation, and the colony stimulating factor 1-receptor and the RANKLsignaling pathway for the differentiation.
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Affiliation(s)
- Suchita Desai
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Pernilla Lång
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Tuomas Näreoja
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
- Department of Life Technologies, University of Turku, Finland
| | - Sara H. Windahl
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Göran Andersson
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
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Robertson EM, Hixon KR, McBride-Gagyi SH, Sell SA. Bioactive impact of manuka honey and bone char incorporated into gelatin and chitosan cryogels in a rat calvarial fracture model. J Biomed Mater Res B Appl Biomater 2023. [PMID: 37243397 DOI: 10.1002/jbm.b.35283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
Bone tissue engineered scaffolds are designed to mimic the natural environment for regeneration when typical healing is inhibited. Autografts are the current gold standard for treatment but are limited by available bone and supplementary surgical sites that broaden complications and comorbidities. Cryogels are an ideal scaffold in bone regeneration due to their mechanical integrity and marcoporous structure that elicits angiogenesis and subsequently new bone tissue formation. To aid in bioactivity and osteoinductivity, manuka honey (MH) and bone char (BC) were added to gelatin and chitosan cryogels (CG). Manuka honey has powerful antimicrobial properties to aid against graft infection, and bone char is composed of 90% hydroxyapatite, a well-studied bioactive material. These additives are natural, abundant, easy to use, and cost effective. CG cryogels incorporated with either BC or MH, and plain CG cryogels were implanted into rat calvarial fracture models for cortical bone regeneration analysis. We found indication of bioactivity with both bone char and manuka honey through the presence of woven bone structure in histology stains and micro computed tomography (microCT) data. Overall, plain CG cryogels supported greater bone regeneration capabilities than the BC or MH incorporated cryogels due to a lack of advanced organized tissue formation and collagen deposition after 8 weeks of implantation; however, future work should explore varying additive concentrations and delivery methods to further assess additive potential.
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Affiliation(s)
- E M Robertson
- Department of Biomedical Engineering, School of Science and Engineering, Saint Louis University, St. Louis, Missouri, USA
| | - K R Hixon
- Department of Biomedical Engineering, School of Science and Engineering, Saint Louis University, St. Louis, Missouri, USA
| | - S H McBride-Gagyi
- Department of Biomedical Engineering, School of Science and Engineering, Saint Louis University, St. Louis, Missouri, USA
| | - S A Sell
- Department of Biomedical Engineering, School of Science and Engineering, Saint Louis University, St. Louis, Missouri, USA
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McColl LF, Chen X, Solga MD, Schlegel K, Haughey SP, Lobo PI, Fread K, Zunder E, Cha R, Park S, Christophel JJ, Cui Q, Dighe AS. BMP-6 promotes type 2 immune response during enhancement of rat mandibular bone defect healing. Front Immunol 2023; 14:1064238. [PMID: 36845161 PMCID: PMC9950738 DOI: 10.3389/fimmu.2023.1064238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 01/31/2023] [Indexed: 02/12/2023] Open
Abstract
Introduction Bone morphogenetic proteins (BMPs) are used as key therapeutic agents for the treatment of difficult fractures. While their effects on osteoprogenitors are known, little is known about their effects on the immune system. Methods We used permutations of BMP-6 (B), vascular endothelial growth factor (V), and Hedgehog signaling pathway activator smoothened agonist (S), to treat a rat mandibular defect and investigated healing outcomes at week 8, in correlation with the cellular landscape of the immune cells in the fracture callus at week 2. Results Maximum recruitment of immune cells to the fracture callus is known to occur at week 2. While the control, S, V, and VS groups remained as nonunions at week 8; all BMP-6 containing groups - B, BV, BS and BVS, showed near-complete to complete healing. This healing pattern was strongly associated with significantly higher ratios of CD4 T (CD45+CD3+CD4+) to putative CD8 T cells (CD45+CD3+CD4-), in groups treated with any permutation of BMP-6. Although, the numbers of putative M1 macrophages (CD45+CD3-CD11b/c+CD38high) were significantly lower in BMP-6 containing groups in comparison with S and VS groups, percentages of putative - Th1 cells or M1 macrophages (CD45+CD4+IFN-γ+) and putative - NK, NKT or cytotoxic CD8T cells (CD45+CD4-IFN-γ+) were similar in control and all treatment groups. Further interrogation revealed that the BMP-6 treatment promoted type 2 immune response by significantly increasing the numbers of CD45+CD3-CD11b/c+CD38low putative M2 macrophages, putative - Th2 cells or M2 macrophages (CD45+CD4+IL-4+) cells and putative - mast cells, eosinophils or basophils (CD45+CD4-IL-4+ cells). CD45- non-haematopoietic fractions of cells which encompass all known osteoprogenitor stem cells populations, were similar in control and treatment groups. Discussion This study uncovers previously unidentified regulatory functions of BMP-6 and shows that BMP-6 enhances fracture healing by not only acting on osteoprogenitor stem cells but also by promoting type 2 immune response.
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Affiliation(s)
- Logan F. McColl
- Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, VA, United States
| | - Xizhao Chen
- Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, VA, United States
| | - Michael D. Solga
- Flow Cytometry Core Facility, University of Virginia, Charlottesville, VA, United States
| | - Kailo Schlegel
- Department of Nephrology, University of Virginia Health System, Charlottesville, VA, United States
| | - Sean P. Haughey
- Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, VA, United States
| | - Peter I. Lobo
- Department of Nephrology, University of Virginia Health System, Charlottesville, VA, United States
| | - Kristen Fread
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Eli Zunder
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Ryan Cha
- Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, VA, United States
| | - Stephen Park
- Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, United States
| | - J. Jared Christophel
- Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, United States
| | - Quanjun Cui
- Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, VA, United States
| | - Abhijit S. Dighe
- Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, VA, United States,*Correspondence: Abhijit S. Dighe,
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Lu H, Xiao L, Wang W, Li X, Ma Y, Zhang Y, Wang X. Fibrinolysis Regulation: A Promising Approach to Promote Osteogenesis. Tissue Eng Part B Rev 2022; 28:1192-1208. [PMID: 35442086 DOI: 10.1089/ten.teb.2021.0222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Soon after bone fracture, the initiation of the coagulation cascade results in the formation of a blood clot, which acts as a natural material to facilitate cell migration and osteogenic differentiation at the fracture site. The existence of hematoma is important in early stage of bone healing, but the persistence of hematoma is considered harmful for bone regeneration. Fibrinolysis is recently regarded as a period of critical transition in angiogenic-osteogenic coupling, it thereby is vital for the complete healing of the bone. Moreover, the enhanced fibrinolysis is proposed to boost bone regeneration through promoting the formation of blood vessels, and fibrinolysis system as well as the products of fibrinolysis also play crucial roles in the bone healing process. Therefore, the purpose of this review is to elucidate the fibrinolysis-derived effects on osteogenesis and summarize the potential approaches-improving bone healing by regulating fibrinolysis, with the purpose to further understand the integral roles of fibrinolysis in bone regeneration and to provide theoretical knowledge for potential fibrinolysis-related osteogenesis strategies. Impact statement Fibrinolysis emerging as a new and viable therapeutic intervention to be contained within osteogenesis strategies, however to now, there have been no review articles which collates the information between fibrinolysis and osteogenesis. This review, therefore, focusses on the effects that fibrinolysis exerts on bone healing, with a purpose to provide theoretical reference to develop new strategies to modulate fibrinolysis to accelerate fibrinolysis thus enhancing bone healing.
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Affiliation(s)
- Haiping Lu
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Lan Xiao
- School of Mechanical, Medical and Process Engineering, Center for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia.,The Australia-China Center for Tissue Engineering and Regenerative Medicine, Kelvin Grove, Brisbane, Queensland, Australia
| | - Weiqun Wang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Xuyan Li
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Yaping Ma
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Yi Zhang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xin Wang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.,School of Mechanical, Medical and Process Engineering, Center for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia.,The Australia-China Center for Tissue Engineering and Regenerative Medicine, Kelvin Grove, Brisbane, Queensland, Australia
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Saunders WB, Dejardin LM, Soltys-Niemann EV, Kaulfus CN, Eichelberger BM, Dobson LK, Weeks BR, Kerwin SC, Gregory CA. Angle-stable interlocking nailing in a canine critical-sized femoral defect model for bone regeneration studies: In pursuit of the principle of the 3R’s. Front Bioeng Biotechnol 2022; 10:921486. [PMID: 36118571 PMCID: PMC9479202 DOI: 10.3389/fbioe.2022.921486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction: Critical-sized long bone defects represent a major therapeutic challenge and current treatment strategies are not without complication. Tissue engineering holds much promise for these debilitating injuries; however, these strategies often fail to successfully translate from rodent studies to the clinical setting. The dog represents a strong model for translational orthopedic studies, however such studies should be optimized in pursuit of the Principle of the 3R’s of animal research (replace, reduce, refine). The objective of this study was to refine a canine critical-sized femoral defect model using an angle-stable interlocking nail (AS-ILN) and reduce total animal numbers by performing imaging, biomechanics, and histology on the same cohort of dogs. Methods: Six skeletally mature hounds underwent a 4 cm mid-diaphyseal femoral ostectomy followed by stabilization with an AS-ILN. Dogs were assigned to autograft (n = 3) or negative control (n = 3) treatment groups. At 6, 12, and 18 weeks, healing was quantified by ordinal radiographic scoring and quantified CT. After euthanasia, femurs from the autograft group were mechanically evaluated using an established torsional loading protocol. Femurs were subsequently assessed histologically. Results: Surgery was performed without complication and the AS-ILN provided appropriate fixation for the duration of the study. Dogs assigned to the autograft group achieved radiographic union by 12 weeks, whereas the negative control group experienced non-union. At 18 weeks, median bone and soft tissue callus volume were 9,001 mm3 (range: 4,939–10,061) for the autograft group and 3,469 mm3 (range: 3,085–3,854) for the negative control group. Median torsional stiffness for the operated, autograft treatment group was 0.19 Nm/° (range: 0.19–1.67) and torque at failure was 12.0 Nm (range: 1.7–14.0). Histologically, callus formation and associated endochondral ossification were identified in the autograft treatment group, whereas fibrovascular tissue occupied the critical-sized defect in negative controls. Conclusion: In a canine critical-sized defect model, the AS-ILN and described outcome measures allowed refinement and reduction consistent with the Principle of the 3R’s of ethical animal research. This model is well-suited for future canine translational bone tissue engineering studies.
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Affiliation(s)
- W. B. Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
- *Correspondence: W. B. Saunders,
| | - L. M. Dejardin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - E. V. Soltys-Niemann
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - C. N. Kaulfus
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - B. M. Eichelberger
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - L. K. Dobson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - B. R. Weeks
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - S. C. Kerwin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, College Station, TX, United States
| | - C. A. Gregory
- Department of Molecular and Cellular Medicine, Institute for Regenerative Medicine, School of Medicine, Texas A & M Health Science Center, College Station, TX, United States
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Bucher CH, Berkmann JC, Burkhardt LM, Paschke C, Schlundt C, Lang A, Wolter A, Damerau A, Geissler S, Volk HD, Duda GN, Schmidt-Bleek K. Local immune cell contributions to fracture healing in aged individuals - A novel role for interleukin 22. Exp Mol Med 2022. [PMID: 36028760 DOI: 10.1038/s12276-022-00834-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 11/08/2022]
Abstract
With increasing age, the risk of bone fractures increases while regenerative capacity decreases. This variation in healing potential appears to be linked to adaptive immunity, but the underlying mechanism is still unknown. This study sheds light on immunoaging/inflammaging, which impacts regenerative processes in aging individuals. In an aged preclinical model system, different levels of immunoaging were analyzed to identify key factors that connect immunoaged/inflammaged conditions with bone formation after long bone fracture. Immunological facets, progenitor cells, the microbiome, and confounders were monitored locally at the injury site and systemically in relation to healing outcomes in 12-month-old mice with distinct individual levels of immunoaging. Bone tissue formation during healing was delayed in the immunoaged group and could be associated with significant changes in cytokine levels. A prolonged and amplified pro-inflammatory reaction was caused by upregulated immune cell activation markers, increased chemokine receptor availability and a lack of inhibitory signaling. In immunoaged mice, interleukin-22 was identified as a core cell signaling protein that played a central role in delayed healing. Therapeutic neutralization of IL-22 reversed this specific immunoaging-related disturbed healing. Immunoaging was found to be an influencing factor of decreased regenerative capacity in aged individuals. Furthermore, a novel therapeutic strategy of neutralizing IL-22 may successfully rejuvenate healing in individuals with advanced immune experiences.
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7
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Fu R, Bertrand D, Wang J, Kavaseri K, Feng Y, Du T, Liu Y, Willie BM, Yang H. In vivo and in silico monitoring bone regeneration during distraction osteogenesis of the mouse femur. Comput Methods Programs Biomed 2022; 216:106679. [PMID: 35139460 DOI: 10.1016/j.cmpb.2022.106679] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/17/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Distraction osteogenesis (DO) is a mechanobiological process of producing new bone by gradual and controlled distraction of the surgically separated bone segments. Mice have been increasingly used to study the role of relevant biological factors in regulating bone regeneration during DO. However, there remains a lack of in silico DO models and related mechano-regulatory tissue differentiation algorithms for mouse bone. This study sought to establish an in silico model based on in vivo experimental data to simulate the bone regeneration process during DO of the mouse femur. METHODS In vivo micro-CT, including time-lapse morphometry was performed to monitor the bone regeneration in the distraction gap. A 2D axisymmetric finite element model, with a geometry originating from the experimental data, was created. Bone regeneration was simulated with a fuzzy logic-based two-stage (distraction and consolidation) mechano-regulatory tissue differentiation algorithm, which was adjusted from that used for fracture healing based on our in vivo experimental data. The predictive potential of the model was further tested with varied distraction frequencies and distraction rates. RESULTS The computational simulations showed similar bone regeneration patterns to those observed in the micro-CT data from the experiment throughout the DO process. This consisted of rapid bone formation during the first 10 days of the consolidation phase, followed by callus reshaping via bone remodeling. In addition, the computational model predicted a faster and more robust bone healing response as the model's distraction frequency was increased, whereas higher or lower distraction rates were not conducive to healing. CONCLUSIONS This in silico model could be used to investigate basic mechanobiological mechanisms involved in bone regeneration or to optimize DO strategies for potential clinical applications.
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Affiliation(s)
- Ruisen Fu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing 100124, China
| | - David Bertrand
- Department of Pediatric Surgery, McGill University, Montreal, Canada; Research Center, Shriners Hospital for Children-Canada, Montreal, Canada
| | - Jianing Wang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing 100124, China
| | - Kyle Kavaseri
- Department of Pediatric Surgery, McGill University, Montreal, Canada; Research Center, Shriners Hospital for Children-Canada, Montreal, Canada
| | - Yili Feng
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing 100124, China
| | - Tianming Du
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing 100124, China
| | - Youjun Liu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing 100124, China
| | - Bettina M Willie
- Department of Pediatric Surgery, McGill University, Montreal, Canada; Research Center, Shriners Hospital for Children-Canada, Montreal, Canada
| | - Haisheng Yang
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing 100124, China.
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Working ZM, Peterson D, Lawson M, O’Hara K, Coghlan R, Provencher MT, Friess DM, Johnstone B, Miclau T, Bahney CS. Collagen X Longitudinal Fracture Biomarker Suggests Staged Fixation in Tibial Plateau Fractures Delays Rate of Endochondral Repair. J Orthop Trauma 2022; 36:S32-S39. [PMID: 35061649 PMCID: PMC10308601 DOI: 10.1097/bot.0000000000002307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To use a novel, validated bioassay to monitor serum concentrations of a breakdown product of collagen X in a prospective longitudinal study of patients sustaining isolated tibial plateau fractures. Collagen X is the hallmark extracellular matrix protein present during conversion of soft, cartilaginous callus to bone during endochondral repair. Previous preclinical and clinical studies demonstrated a distinct peak in collagen X biomarker (CXM) bioassay levels after long bone fractures. SETTING Level 1 academic trauma facility. PATIENTS/PARTICIPANTS Thirty-six patients; isolated tibial plateau fractures. INTERVENTION (3) Closed treatment, ex-fix (temporizing/definitive), and open reduction internal fixation. MAIN OUTCOME MEASUREMENTS Collagen X serum biomarker levels (CXM bioassay). RESULTS Twenty-two men and 14 women (average age: 46.3 y; 22.6-73.4, SD 13.3) enrolled (16 unicondylar and 20 bicondylar fractures). Twenty-five patients (72.2%) were treated operatively, including 12 (33.3%) provisionally or definitively treated by ex-fix. No difference was found in peak CXM values between sexes or age. Patients demonstrated peak expression near 1000 pg/mL (average: male-986.5 pg/mL, SD 369; female-953.2 pg/mL, SD 576). There was no difference in peak CXM by treatment protocol, external fixator use, or fracture severity (Schatzker). Patients treated with external fixation (P = 0.05) or staged open reduction internal fixation (P = 0.046) critically demonstrated delayed peaks. CONCLUSIONS Pilot analysis demonstrates a strong CXM peak after fractures commensurate with previous preclinical and clinical studies, which was delayed with staged fixation. This may represent the consequence of delayed construct loading. Further validation requires larger cohorts and long-term follow-up. Collagen X may provide an opportunity to support prospective interventional studies testing novel orthobiologics or fixation techniques. LEVEL OF EVIDENCE Level II, prospective clinical observational study.
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Affiliation(s)
- Zachary M. Working
- Department of Orthopaedics & Rehabilitation, Oregon Health and Science University, Portland, OR
| | - Danielle Peterson
- Department of Orthopaedics & Rehabilitation, Oregon Health and Science University, Portland, OR
| | - Michelle Lawson
- Department of Orthopaedics & Rehabilitation, Oregon Health and Science University, Portland, OR
| | | | | | | | - Darin M. Friess
- Department of Orthopaedics & Rehabilitation, Oregon Health and Science University, Portland, OR
| | - Brian Johnstone
- Department of Orthopaedics & Rehabilitation, Oregon Health and Science University, Portland, OR
- Portland Shriners Hospital, Portland, OR
| | - Theodore Miclau
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, University of California at San Francisco, San Francisco, CA
| | - Chelsea S. Bahney
- Steadman Philippon Research Institute, Vail, CO
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, University of California at San Francisco, San Francisco, CA
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Haffner-Luntzer M, Fischer V, Ignatius A. Differences in Fracture Healing Between Female and Male C57BL/6J Mice. Front Physiol 2021; 12:712494. [PMID: 34434120 PMCID: PMC8381649 DOI: 10.3389/fphys.2021.712494] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background Mice are increasingly used in fracture healing research because of the opportunity to use transgenic animals. While both, male and female mice are employed, there is no consensus in the literature whether fracture healing differs between both sexes. Therefore, the aim of the present study was to analyze diaphyseal fracture healing in female and male C57BL/6J mice, a commonly used mouse strain in bone research. Methods For that purpose, 12-week-old Female (17–20 g) and Male mice (22–26 g) received a standardized femur midshaft osteotomy stabilized by an external fixator. Mice were euthanized 10 and 21 days after fracture and bone healing was analyzed by biomechanical testing, μCT, histology, immunohistochemistry and qPCR. Results Ten days after fracture, Male mice displayed significantly more cartilage but less fibrous tissue in the fracture callus compared to Female mice, whereas the amount of bone did not differ. At day 21, Male mice showed a significantly larger fracture callus compared to Female mice. The relative amount of bone in the fracture callus did not significantly differ between both sexes, whereas its tissue mineral density was significantly higher in Male mice on day 21, indicating more mature bone and slightly more rapid fracture healing. These results were confirmed by a significantly greater absolute bending stiffness of the fractured femurs of Male mice on day 21. On the molecular level, Male mice displayed increased active β-catenin expression in the fracture callus, whereas estrogen receptor α (ERα) expression was lower. Conclusion These results suggest that Male mice display more rapid fracture healing with more prominent cartilaginous callus formation. This might be due to the higher weight of Male mice, resulting in increased mechanical loading of the fracture. Furthermore, Male mice displayed significantly greater activation of osteoanabolic Wnt/β-catenin signaling, which might also contribute to more rapid bone regeneration.
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Affiliation(s)
- Melanie Haffner-Luntzer
- Institute of Orthopaedic Research and Biomechanics, University Medical Centre Ulm, Ulm, Germany
| | - Verena Fischer
- Institute of Orthopaedic Research and Biomechanics, University Medical Centre Ulm, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopaedic Research and Biomechanics, University Medical Centre Ulm, Ulm, Germany
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10
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Working ZM, Morris ER, Chang JC, Coghlan RF, Johnstone B, Miclau T, Horton WA, Bahney CS. A quantitative serum biomarker of circulating collagen X effectively correlates with endochondral fracture healing. J Orthop Res 2021; 39:53-62. [PMID: 32533783 DOI: 10.1002/jor.24776] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 02/04/2023]
Abstract
Currently, there are no standardized methods for quantitatively measuring fracture repair. Physicians rely on subjective physical examinations and qualitative evaluation of radiographs to detect mineralized tissue. Since most fractures heal indirectly through a cartilage intermediate, these tools are limited in their diagnostic utility of early repair. Prior to converting to the bone, cartilage undergoes hypertrophic maturation, characterized by the deposition of a provisional collagen X matrix. The objective of this study was to characterize the kinetics of a novel collagen X biomarker relative to other biological measurements of fracture healing using a murine model of endochondral fracture repair in which a closed, mid-shaft tibia fracture was created using the classic drop-weight technique. Serum was collected 5 to 42 days post-fracture in male and female mice and compared to uninjured controls (n = 8-12). Collagen X in the serum was quantified using a recently validated ELISA-based bioassay ("Cxm")1 and compared to genetic and histological markers of fracture healing and inflammation. We found the Cxm biomarker reliably increased from baseline to a statistically unique peak 14 days post-fracture that then resolved to pre-fracture levels by 3 weeks following injury. The shape and timing of the Cxm curve followed the genetic and histological expression of collagen X but did not show a strong correlation with local inflammatory states. Assessment of fracture healing progress is crucial to making correct and timely clinical decisions for patients. This Cxm bioassay represents a minimally invasive, inexpensive technique that could provide reliable information on the biology of the fracture to significantly improve clinical care.
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Affiliation(s)
- Zachary M Working
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital (ZSFG), University of California, San Francisco (UCSF), San Francisco, California
- Orthopaedics and Rehabilitation, Oregon Health & Science University (OHSU), Portland, Oregon
| | - Elizabeth R Morris
- Center for Regenerative Sports Medicine, Steadman Philippon Research Institute (SPRI), Vail, Colorado
| | - Jiun Chiun Chang
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital (ZSFG), University of California, San Francisco (UCSF), San Francisco, California
| | - Ryan F Coghlan
- Shriners Hospitals for Children, Research Center, Portland, Oregon
| | - Brian Johnstone
- Orthopaedics and Rehabilitation, Oregon Health & Science University (OHSU), Portland, Oregon
| | - Theodore Miclau
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital (ZSFG), University of California, San Francisco (UCSF), San Francisco, California
| | - William A Horton
- Shriners Hospitals for Children, Research Center, Portland, Oregon
| | - Chelsea S Bahney
- Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital (ZSFG), University of California, San Francisco (UCSF), San Francisco, California
- Center for Regenerative Sports Medicine, Steadman Philippon Research Institute (SPRI), Vail, Colorado
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11
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Perier-Metz C, Duda GN, Checa S. Mechano-Biological Computer Model of Scaffold-Supported Bone Regeneration: Effect of Bone Graft and Scaffold Structure on Large Bone Defect Tissue Patterning. Front Bioeng Biotechnol 2020; 8:585799. [PMID: 33262976 PMCID: PMC7686036 DOI: 10.3389/fbioe.2020.585799] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/05/2020] [Indexed: 12/04/2022] Open
Abstract
Large segmental bone defects represent a clinical challenge for which current treatment procedures have many drawbacks. 3D-printed scaffolds may help to support healing, but their design process relies mainly on trial and error due to a lack of understanding of which scaffold features support bone regeneration. The aim of this study was to investigate whether existing mechano-biological rules of bone regeneration can also explain scaffold-supported bone defect healing. In addition, we examined the distinct roles of bone grafting and scaffold structure on the regeneration process. To that end, scaffold-surface guided migration and tissue deposition as well as bone graft stimulatory effects were included in an in silico model and predictions were compared to in vivo data. We found graft osteoconductive properties and scaffold-surface guided extracellular matrix deposition to be essential features driving bone defect filling in a 3D-printed honeycomb titanium structure. This knowledge paves the way for the design of more effective 3D scaffold structures and their pre-clinical optimization, prior to their application in scaffold-based bone defect regeneration.
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Affiliation(s)
- Camille Perier-Metz
- Julius Wolff Institute, Charité-Universitätsmedizin, Berlin, Germany.,MINES ParisTech - PSL Research University (Paris Sciences & Lettres), Paris, France
| | - Georg N Duda
- Julius Wolff Institute, Charité-Universitätsmedizin, Berlin, Germany.,Berlin Institute of Health (BIH) Center for Regenerative Therapies, Charité-Universitätsmedizin, Berlin, Germany
| | - Sara Checa
- Julius Wolff Institute, Charité-Universitätsmedizin, Berlin, Germany
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12
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Garske DS, Schmidt-Bleek K, Ellinghaus A, Dienelt A, Gu L, Mooney DJ, Duda GN, Cipitria A. Alginate Hydrogels for In Vivo Bone Regeneration: The Immune Competence of the Animal Model Matters. Tissue Eng Part A 2020; 26:852-862. [DOI: 10.1089/ten.tea.2019.0310] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Daniela S. Garske
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
| | - Katharina Schmidt-Bleek
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Agnes Ellinghaus
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Anke Dienelt
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Luo Gu
- School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
- Department of Materials Science and Engineering, Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, Maryland, USA
| | - David J. Mooney
- School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Georg N. Duda
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Amaia Cipitria
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité–Universitätsmedizin Berlin, Berlin, Germany
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13
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Godino Izquierdo M. Osteogenic in vitro training of bone marrow mesenquimal cells for application in segmentary bone resections. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020. [DOI: 10.1016/j.recote.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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14
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Godino Izquierdo M. Osteogenic in vitro training of bone marrow mesenquimal cells for application in segmentary bone resections. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 64:236-243. [PMID: 32473814 DOI: 10.1016/j.recot.2020.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 02/18/2020] [Accepted: 04/09/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To achieve bone continuity in an experimental model of segmental resection of femur bone by applying a treatment with committed to osteogenic bone linage mesenchymal stem cells. MATERIAL AND METHOD Bone marrow mesenchymal stem cells, obtained from syngeneic Wistar murine, were committed into osteogenic lineage and embedded within a hydroxipatite block. They were implanted in an experimentally created diaphyseal femur resection model. The diaphysis was synthetized with a 1.5mm thick plate. In order to calculate binomial distributions, we stablished one experimental and 3 control groups of 8 elements each: Group I, filling the gap with allograft; group ii, filling with a hydroxyapatite block without cells; group iii, filling with the hydroxyapatite block embedded with committed cells, and group iv, with the hydroxyapatite embedded with osteoinduced cells in a 3 dimensions TRAP culture. Descriptive analysis was performed by frequency distribution and Fisher statistic test. Level of statistical significance was considered at P<.05. RESULTS Group I presented good bone consolidation and no plate breakage. Group II showed fibrous but non-bone tissue, with rupture of all plates. Group III showed bone tissue in all cases, but the plates broke in all of them, while in group iv bone consolidation was achieve without any plate rupture. CONCLUSION Cell therapy with mesenchymal stem cells, trained in a 3 dimensions cell culture, produces bone tissue and ensures the permanence of the mechanical stabilization performed in a segmental resection model. LIMITATIONS A study with a larger sample size is necessary before planning the human inference.
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Affiliation(s)
- M Godino Izquierdo
- Servicio de Traumatología y Ortopedia, Hospital Costa del Sol, Marbella, Málaga, España.
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15
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Onishi T, Shimizu T, Akahane M, Okuda A, Kira T, Omokawa S, Tanaka Y. Robust method to create a standardized and reproducible atrophic non-union model in a rat femur. J Orthop 2020; 21:223-227. [PMID: 32273661 DOI: 10.1016/j.jor.2020.03.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/24/2020] [Indexed: 11/18/2022] Open
Abstract
Objective No evidence exists about which biological approach is more reliable for creating non-union model. We investigated how to create a reproducible atrophic non-union model in a rat femur. Methods We compared three groups: simple osteotomy (group A), partial periosteum cauterization (group B), and extensive periosteum and bone marrow resection (group C). Results All samples in group C demonstrated atrophic non-union in radiological, histological, and biomechanical analyses, however half of the samples in group B showed fracture healing at week 16. Conclusion Extensive resection of periosteum and bone marrow is important for a reproducible atrophic non-union model in a rat femur.
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Affiliation(s)
- Tadanobu Onishi
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
| | - Takamasa Shimizu
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
| | - Manabu Akahane
- Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, Kashihara, Nara, 634-8521, Japan
| | - Akinori Okuda
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
| | - Tsutomu Kira
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
| | - Shohei Omokawa
- Department of Hand Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
| | - Yasuhito Tanaka
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan
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16
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Jirkof P, Durst M, Klopfleisch R, Palme R, Thöne-Reineke C, Buttgereit F, Schmidt-Bleek K, Lang A. Administration of Tramadol or Buprenorphine via the drinking water for post-operative analgesia in a mouse-osteotomy model. Sci Rep 2019; 9:10749. [PMID: 31341225 DOI: 10.1038/s41598-019-47186-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/11/2019] [Indexed: 12/17/2022] Open
Abstract
Adequate analgesia is essential whenever pain might occur in animal experiments. Unfortunately, the selection of suitable analgesics for mice in bone-linked models is limited. Here, we evaluated two analgesics – Tramadol [0.1 mg/ml (Tlow) vs. 1 mg/ml (Thigh)] and Buprenorphine (Bup; 0.009 mg/ml) – after a pre-surgical injection of Buprenorphine, in a mouse-osteotomy model. The aim of this study was to verify the efficacy of these opioids in alleviating pain-related behaviors, to provide evidence for adequate dosages and to examine potential side effects. High concentrations of Tramadol affected water intake, drinking frequency, food intake and body weight negatively in the first 2–3 days post-osteotomy, while home cage activity was comparable between all groups. General wellbeing parameters were strongly influenced by anesthesia and analgesics. Model-specific pain parameters did not indicate more effective pain relief at high concentrations of Tramadol. In addition, ex vivo high-resolution micro computed tomography (µCT) analysis and histology analyzing bone healing outcomes showed no differences between analgesic groups with respect to newly formed mineralized bone, cartilage and vessels. Our results show that high concentrations of Tramadol do not improve pain relief compared to low dosage Tramadol and Buprenorphine, but rather negatively affect animal wellbeing.
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17
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Meeson R, Moazen M, Sanghani-Kerai A, Osagie-Clouard L, Coathup M, Blunn G. The influence of gap size on the development of fracture union with a micro external fixator. J Mech Behav Biomed Mater 2019; 99:161-168. [PMID: 31357063 PMCID: PMC6715773 DOI: 10.1016/j.jmbbm.2019.07.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/31/2019] [Accepted: 07/18/2019] [Indexed: 02/02/2023]
Abstract
Increasingly, the rat femoral fracture model is being used for preclinical investigations of fracture healing, however, the effect of gap size and its influence on mechanobiology is not well understood. We aimed to evaluate the influence of osteotomy gap on osteotomy healing between the previously published extremes of guaranteed union (0.5 mm) and non-union (3 mm) using this model. A femoral osteotomy in 12–14 week old female Wistar rats was stabilised with a micro fixator (titanium blocks, carbon fiber bars) with an osteotomy gap of 1.0 mm (n = 5), 1.5 mm (n = 7), 2.0 mm (n = 6). After five weeks, the left femur was retrieved. The osteotomy gap was scanned using X-ray microtomography and then histologically evaluated. The radiographic union rate (complete mineralised bone bridging across the osteotomy) was three times higher for the 1.0 mm than the 2.0 mm gap. The 1.0 mm gap had the largest callus (0.069μm3) and bone volume (0.035μm3). Callus and bone volume were approximately 50% smaller within the 2.0 mm gap. Using cadaveric rat femurs stabilised with the external fixator, day 0 mechanical assessment of construct stiffness was calculated on materials testing machine displacement vs load output. The construct stiffness for the 1.0, 1.5 and 2.0 mm gaps was 32.6 ± 5.4, 32.5 ± 2.4, and 32.4 ± 8.3 N/mm (p = 0.779). Interfragmentary strain (IFS) was calculated using the change in osteotomy gap displacement as measured using microstrain miniature differential reluctance transducer spanning the osteotomy gap. Increasing the gap size significantly reduced the IFS (p = 0.013). The mean ‘day 0’ IFS for the 1.0, 1.5 and 2.0 mm gaps were 11.2 ± 1.3, 8.4 ± 1.5 and 6.1 ± 1.2% respectively. A 1.5 mm gap resulted in a delayed fracture healing by 5 weeks and may represent a useful test environment for fracture healing therapy. Increasing gap size did not affect construct stiffness, but did reduce the ‘day 0’ IFS, with a doubling of non-union and halving of bone volume measured between 1.0 and 2.0 mm gaps.
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Affiliation(s)
- Richard Meeson
- Division of Surgery, University College London, Stanmore, UK; Royal Veterinary College, Hertfordshire, UK.
| | - Mehran Moazen
- Division of Surgery, University College London, Stanmore, UK; Mechanical Engineering, University College London, UK
| | | | | | - Melanie Coathup
- Division of Surgery, University College London, Stanmore, UK; University of Central Florida, USA
| | - Gordon Blunn
- Division of Surgery, University College London, Stanmore, UK; University of Portsmouth, Portsmouth, UK
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18
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Mangum LH, Avila JJ, Hurtgen BJ, Lofgren AL, Wenke JC. Burn and thoracic trauma alters fracture healing, systemic inflammation, and leukocyte kinetics in a rat model of polytrauma. J Orthop Surg Res 2019; 14:58. [PMID: 30782193 DOI: 10.1186/s13018-019-1082-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/31/2019] [Indexed: 01/31/2023] Open
Abstract
Background Singular traumatic insults, such as bone fracture, typically initiate an appropriate immune response necessary to restore the host to pre-insult homeostasis with limited damage to self. However, multiple concurrent insults, such as a combination of fracture, blunt force trauma, and burns (polytrauma), are clinically perceived to result in abnormal immune response leading to inadequate healing and resolution. To investigate this phenomenon, we created a model rat model of polytrauma. Methods To investigate relationship between polytrauma and delayed healing, we created a novel model of polytrauma in a rat which encompassed a 3-mm osteotomy, blunt chest trauma, and full-thickness scald burn. Healing outcomes were determined at 5 weeks where the degree of bone formation at the osteotomy site of polytrauma animals was compared to osteotomy only animals (OST). Results We observed significant differences in the bone volume fraction between polytrauma and OST animals indicating that polytrauma negatively effects wound healing. Polytrauma animals also displayed a significant decrease in their ability to return to pre-injury weight compared to osteotomy animals. Polytrauma animals also exhibited significantly altered gene expression in osteogenic pathways as well as the innate and adaptive immune response. Perturbed inflammation was observed in the polytrauma group compared to the osteotomy group as evidenced by significantly altered white blood cell (WBC) profiles and significantly elevated plasma high-mobility group box 1 protein (HMGB1) at 6 and 24 h post-trauma. Conversely, polytrauma animals exhibited significantly lower concentrations of plasma TNF-alpha (TNF-α) and interleukin 6 (IL-6) at 72 h post-injury compared to OST. Conclusions Following polytrauma with burn injury, the local and systemic immune response is divergent from the immune response following a less severe singular injury (osteotomy). This altered immune response that follows was associated with a reduced capacity for wound healing. Electronic supplementary material The online version of this article (10.1186/s13018-019-1082-4) contains supplementary material, which is available to authorized users.
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19
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Petersen A, Princ A, Korus G, Ellinghaus A, Leemhuis H, Herrera A, Klaumünzer A, Schreivogel S, Woloszyk A, Schmidt-Bleek K, Geissler S, Heschel I, Duda GN. A biomaterial with a channel-like pore architecture induces endochondral healing of bone defects. Nat Commun 2018; 9:4430. [PMID: 30361486 PMCID: PMC6202397 DOI: 10.1038/s41467-018-06504-7] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/30/2018] [Indexed: 12/22/2022] Open
Abstract
Biomaterials developed to treat bone defects have classically focused on bone healing via direct, intramembranous ossification. In contrast, most bones in our body develop from a cartilage template via a second pathway called endochondral ossification. The unsolved clinical challenge to regenerate large bone defects has brought endochondral ossification into discussion as an alternative approach for bone healing. However, a biomaterial strategy for the regeneration of large bone defects via endochondral ossification is missing. Here we report on a biomaterial with a channel-like pore architecture to control cell recruitment and tissue patterning in the early phase of healing. In consequence of extracellular matrix alignment, CD146+ progenitor cell accumulation and restrained vascularization, a highly organized endochondral ossification process is induced in rats. Our findings demonstrate that a pure biomaterial approach has the potential to recapitulate a developmental bone growth process for bone healing. This might motivate future strategies for biomaterial-based tissue regeneration.
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Affiliation(s)
- A Petersen
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - A Princ
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - G Korus
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Ellinghaus
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - H Leemhuis
- Matricel GmbH, Kaiserstrasse 100, 52134, Herzogenrath, Germany
| | - A Herrera
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Klaumünzer
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Schreivogel
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Woloszyk
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Orthopaedic Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr, 78229, San Antonio, TX, USA
| | - K Schmidt-Bleek
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Geissler
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - I Heschel
- Matricel GmbH, Kaiserstrasse 100, 52134, Herzogenrath, Germany
| | - G N Duda
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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20
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Schwarz C, Ott CE, Wulsten D, Brauer E, Schreivogel S, Petersen A, Hassanein K, Roewer L, Schmidt T, Willie BM, Duda GN. The Interaction of BMP2-Induced Defect Healing in Rat and Fixator Stiffness Modulates Matrix Alignment and Contraction. JBMR Plus 2018; 2:174-186. [PMID: 30283901 PMCID: PMC6124159 DOI: 10.1002/jbm4.10031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/14/2017] [Accepted: 12/27/2017] [Indexed: 12/15/2022] Open
Abstract
Successful fracture healing requires a tight interplay between mechanical and biological cues. In vitro studies illustrated that mechanical loading modulates bone morphogenetic protein (BMP) signaling. However, in the early phases of large bone defect regeneration in vivo, the underlying mechanisms leading to this mechanosensation remained unknown. We investigated the interaction of BMP2 stimulation and mechanical boundary conditions in a rat critical‐sized femoral defect model (5 mm) stabilized with three distinctly different external fixator stiffness. Defects were treated with 5 μg rhBMP2 loaded on an absorbable collagen sponge. Early matrix alignment was monitored by second‐harmonic generation imaging. Bony bridging of defects and successive healing was monitored by histology at day 7 and day 14 as well as in vivo microCT at days 10, 21, and 42 post‐operation. Femora harvested at day 42 were characterized mechanically assessing torsional load to failure ex vivo. At tissue level, differences between groups were visible at day 14 with manifest bone formation in the microCT. Histologically, we observed prolonged chondrogenesis upon flexible fixation, whereas osteogenesis started earlier after rigid and semirigid fixation. At later time points, there was a boost of bone tissue formation upon flexible fixation, whereas other groups already displayed signs of tissue maturation. Based on gene expression profiling, we analyzed the mechanobiological interplay. Already at day 3, these analyses revealed differences in expression pattern, specifically of genes involved in extracellular matrix formation. Gene regulation correlating with fixator stiffness was pronounced at day 7 comprising genes related to immunological processes and cellular contraction. The influence of loading on matrix contraction was further investigated and confirmed in a 3D bioreactor. Taken together, we demonstrate an early onset of mechanical conditions influencing BMP2‐induced defect healing and shed light on gene regulatory networks associated with extracellular matrix organization and contraction that seemed to directly impact healing outcomes. © 2018 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
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Affiliation(s)
- Carolin Schwarz
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT) Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Claus-Eric Ott
- Institute for Medical Genetics and Human Genetics Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany.,Research Group Development and Disease Max Planck Institute for Molecular Genetics Berlin Germany
| | - Dag Wulsten
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Erik Brauer
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Sophie Schreivogel
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Ansgar Petersen
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT) Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Kerstin Hassanein
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Linda Roewer
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Tanja Schmidt
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT) Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | - Bettina M Willie
- Research Center Shriners Hospitals for Children-Canada Department of Pediatric Surgery McGill University Montreal Canada
| | - Georg N Duda
- Julius Wolff Institute and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT) Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health Berlin Germany
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Thorpe AA, Freeman C, Farthing P, Callaghan J, Hatton PV, Brook IM, Sammon C, Le Maitre CL. In vivo safety and efficacy testing of a thermally triggered injectable hydrogel scaffold for bone regeneration and augmentation in a rat model. Oncotarget 2018; 9:18277-18295. [PMID: 29719605 PMCID: PMC5915072 DOI: 10.18632/oncotarget.24813] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/27/2018] [Indexed: 12/29/2022] Open
Abstract
Bone loss resulting from degenerative diseases and trauma is a significant clinical burden which is likely to grow exponentially with the aging population. In a number of conditions where pre-formed materials are clinically inappropriate an injectable bone forming hydrogel could be beneficial. The development of an injectable hydrogel to stimulate bone repair and regeneration would have broad clinical impact and economic benefit in a variety of orthopedic clinical applications. We have previously reported the development of a Laponite® crosslinked pNIPAM-co-DMAc (L-pNIPAM-co-DMAc) hydrogel delivery system, loaded with hydroxyapatite nanoparticles (HAPna), which was capable of inducing osteogenic differentiation of mesenchymal stem cells (MSCs) without the need for additional growth factors in vitro. However to enable progression towards clinical acceptability, biocompatibility and efficacy of the L-pNIPAM-co-DMAc hydrogel to induce bone repair in vivo must be determined. Biocompatibility was evaluated by subcutaneous implantation for 6 weeks in rats, and efficacy to augment bone repair was evaluated within a rat femur defect model for 4 weeks. No inflammatory reactions, organ toxicity or systemic toxicity were observed. In young male rats where hydrogel was injected, defect healing was less effective than sham operated controls when rat MSCs were incorporated. Enhanced bone healing was observed however, in aged exbreeder female rats where acellular hydrogel was injected, with increased deposition of collagen type I and Runx2. Integration of the hydrogel with surrounding bone was observed without the need for delivered MSCs; native cell infiltration was also seen and bone formation was observed within all hydrogel systems investigated. This hydrogel can be delivered directly into the target site, is biocompatible, promotes increased bone formation and facilitates migration of cells to promote integration with surrounding bone, for safe and efficacious bone repair.
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Affiliation(s)
- Abbey A Thorpe
- Biomolecular Sciences Research Centre, Sheffield Hallam University, S1 1WB, UK
| | | | - Paula Farthing
- School of Clinical Dentistry, University of Sheffield, S10 2TA, UK
| | - Jill Callaghan
- School of Clinical Dentistry, University of Sheffield, S10 2TA, UK
| | - Paul V Hatton
- School of Clinical Dentistry, University of Sheffield, S10 2TA, UK
| | - Ian M Brook
- School of Clinical Dentistry, University of Sheffield, S10 2TA, UK
| | - Chris Sammon
- Materials and Engineering Research Institute, Sheffield Hallam University, S1 1WB, UK
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23
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Binsalah MA, Ramalingam S, Alkindi M, Nooh N, Al-Hezaimi K. Guided Bone Regeneration of Femoral Segmental Defects using Equine Bone Graft: An In-Vivo Micro-Computed Tomographic Study in Rats. J INVEST SURG 2018; 32:456-466. [DOI: 10.1080/08941939.2018.1441343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Mohammed Awadh Binsalah
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sundar Ramalingam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alkindi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nasser Nooh
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Al-Hezaimi
- American Board of Periodontology & Endodontics, Riyadh Elm University, Riyadh, Saudi Arabia
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24
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Abstract
Fracture healing is a complex regeneration process which produces new bone tissue without scar formation. However, fracture healing disorders occur in approximately 10% of human patients and cause severe pain and reduced quality of life. Recently, the development of more standardized, sophisticated and commercially available osteosynthesis techniques reflecting clinical approaches has increased the use of small rodents such as rats and mice in bone healing research dramatically. Nevertheless, there is no standard for pain assessment, especially in these species, and consequently limited information regarding the welfare aspects of osteotomy models. Moreover, the selection of analgesics is restricted for osteotomy models since non-steroidal anti-inflammatory drugs (NSAIDs) are known to affect the initial, inflammatory phase of bone healing. Therefore, opioids such as buprenorphine and tramadol are often used. However, dosage data in the literature are varied. Within this review, we clarify the background of osteotomy models, explain the current status and challenges of animal welfare assessment, and provide an example score sheet including model specific parameters. Furthermore, we summarize current refinement options and present a brief outlook on further 3R research.
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Affiliation(s)
- Annemarie Lang
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin, Berlin, Germany .,Berlin Brandenburg School for Regenerative Therapies, Charité-Universitätsmedizin, Berlin, Germany.,German Rheumatism Research Centre Berlin, Berlin, Germany
| | - Anja Schulz
- German Rheumatism Research Centre Berlin, Berlin, Germany
| | - Agnes Ellinghaus
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin, Berlin, Germany
| | - Katharina Schmidt-Bleek
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin, Berlin, Germany.,Berlin Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin, Berlin, Germany
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25
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Cipitria A, Boettcher K, Schoenhals S, Garske DS, Schmidt-Bleek K, Ellinghaus A, Dienelt A, Peters A, Mehta M, Madl CM, Huebsch N, Mooney DJ, Duda GN. In-situ tissue regeneration through SDF-1α driven cell recruitment and stiffness-mediated bone regeneration in a critical-sized segmental femoral defect. Acta Biomater 2017; 60:50-63. [PMID: 28739546 DOI: 10.1016/j.actbio.2017.07.032] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/23/2017] [Accepted: 07/20/2017] [Indexed: 12/28/2022]
Abstract
In-situ tissue regeneration aims to utilize the body's endogenous healing capacity through the recruitment of host stem or progenitor cells to an injury site. Stromal cell-derived factor-1α (SDF-1α) is widely discussed as a potent chemoattractant. Here we use a cell-free biomaterial-based approach to (i) deliver SDF-1α for the recruitment of endogenous bone marrow-derived stromal cells (BMSC) into a critical-sized segmental femoral defect in rats and to (ii) induce hydrogel stiffness-mediated osteogenic differentiation in-vivo. Ionically crosslinked alginate hydrogels with a stiffness optimized for osteogenic differentiation were used. Fast-degrading porogens were incorporated to impart a macroporous architecture that facilitates host cell invasion. Endogenous cell recruitment to the defect site was successfully triggered through the controlled release of SDF-1α. A trend for increased bone volume fraction (BV/TV) and a significantly higher bone mineral density (BMD) were observed for gels loaded with SDF-1α, compared to empty gels at two weeks. A trend was also observed, albeit not statistically significant, towards matrix stiffness influencing BV/TV and BMD at two weeks. However, over a six week time-frame, these effects were insufficient for bone bridging of a segmental femoral defect. While mechanical cues combined with ex-vivo cell encapsulation have been shown to have an effect in the regeneration of less demanding in-vivo models, such as cranial defects of nude rats, they are not sufficient for a SDF-1α mediated in-situ regeneration approach in segmental femoral defects of immunocompetent rats, suggesting that additional osteogenic cues may also be required. STATEMENT OF SIGNIFICANCE Stromal cell-derived factor-1α (SDF-1α) is a chemoattractant used to recruit host cells for tissue regeneration. The concept that matrix stiffness can direct mesenchymal stromal cell (MSC) differentiation into various lineages was described a decade ago using in-vitro experiments. Recently, alginate hydrogels with an optimized stiffness and ex-vivo encapsulated MSCs were shown to have an effect in the regeneration of skull defects of nude rats. Here, we apply this material system, loaded with SDF-1α and without encapsulated MSCs, to (i) recruit endogenous cells and (ii) induce stiffness-mediated osteogenic differentiation in-vivo, using as model system a load-bearing femoral defect in immunocompetent rats. While a cell-free approach is of great interest from a translational perspective, the current limitations are described.
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Affiliation(s)
- Amaia Cipitria
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
| | - Kathrin Boettcher
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Sophia Schoenhals
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Daniela S Garske
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Katharina Schmidt-Bleek
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Agnes Ellinghaus
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Anke Dienelt
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Anja Peters
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Manav Mehta
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Christopher M Madl
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Nathaniel Huebsch
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - David J Mooney
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Georg N Duda
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
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26
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Ishida W, Elder BD, Holmes C, Lo SFL, Witham TF. Variables Affecting Fusion Rates in the Rat Posterolateral Spinal Fusion Model with Autogenic/Allogenic Bone Grafts: A Meta-analysis. Ann Biomed Eng 2016; 44:3186-3201. [PMID: 27473706 DOI: 10.1007/s10439-016-1701-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/21/2016] [Indexed: 01/14/2023]
Abstract
The rat posterolateral spinal fusion model with autogenic/allogenic bone graft (rat PFABG) has been increasingly utilized as an experimental model to assess the efficacy of novel fusion treatments. The objective of this study was to investigate the reliability of the rat PFABG model and examine the effects of different variables on spinal fusion. A web-based literature search from January, 1970 to September, 2015, yielded 26 studies, which included 40 rat PFABG control groups and 449 rats. Data regarding age, weight, sex, and strain of rats, graft volume, graft type, decorticated levels, surgical approach, institution, the number of control rats, fusion rate, methods of fusion assessment, and timing of fusion assessment were collected and analyzed. The primary outcome variable of interest was fusion rate, as evaluated by manual palpation. Fusion rates varied widely, from 0 to 96%. The calculated overall fusion rate was 46.1% with an I 2 value of 62.4, which indicated moderate heterogeneity. Weight >300 g, age >14 weeks, male rat, Sprague-Dawley strain, and autogenic coccyx grafts increased fusion rates with statistical significance. Additionally, an assessment time-point ≥8 weeks had a trend towards statistical significance (p = 0.070). Multi-regression analysis demonstrated that timing of assessment and age as continuous variables, as well as sex as a categorical variable, can predict the fusion rate with R 2 = 0.82. In an inter-institution reliability analysis, the pooled overall fusion rate was 50.0% [44.8, 55.3%], with statistically significant differences among fusion outcomes at different institutions (p < 0.001 and I 2 of 72.2). Due to the heterogeneity of fusion outcomes, the reliability of the rat PFABG model was relatively limited. However, selection of adequate variables can optimize its use as a control group in studies evaluating the efficacy of novel fusion therapies.
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Affiliation(s)
- Wataru Ishida
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, 1800 Orleans St., Room 6007, Baltimore, MD, 21287, USA
| | - Benjamin D Elder
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, 1800 Orleans St., Room 6007, Baltimore, MD, 21287, USA.
| | - Christina Holmes
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, 1800 Orleans St., Room 6007, Baltimore, MD, 21287, USA
| | - Sheng-Fu L Lo
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, 1800 Orleans St., Room 6007, Baltimore, MD, 21287, USA
| | - Timothy F Witham
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, 1800 Orleans St., Room 6007, Baltimore, MD, 21287, USA
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Schmidt-Bleek K, Willie BM, Schwabe P, Seemann P, Duda GN. BMPs in bone regeneration: Less is more effective, a paradigm-shift. Cytokine Growth Factor Rev 2016; 27:141-8. [PMID: 26678813 DOI: 10.1016/j.cytogfr.2015.11.006] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 11/13/2015] [Indexed: 11/20/2022]
Abstract
Worldwide, the clinical application of BMP2 (bone morphogenetic protein 2) has helped an increasing number of patients achieve bone regeneration in a clinical area lacking simple solutions for difficult bone healing situations. In this review, the historical aspects and current critical clinical issues are summarized and positioned against new research findings on efficacy and function of BMP2. Knowledge concerning how the dose of this growth factor as well as its interaction with mechanical loading influences the efficacy of bone regeneration, might open possible future strategies in cases where bony bridging is unachievable so far. In conclusion, it is apparent that there is a substantial need for continued basic research to unravel the details of its function and the underlying signaling pathways involved, to make BMP2 even more relevant and safe in daily clinical use, even though this growth factor has been known for more than 125 years.
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28
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Kampschulte M, Krombach GA, Richards DC, Sender J, Lips KS, Thormann U, El Khassawna T, Ray S, Alt V, Langheinrich AC. Neovascularization of osteoporotic metaphyseal bone defects: A morphometric micro-CT study. Microvasc Res 2015; 105:7-14. [PMID: 26522284 DOI: 10.1016/j.mvr.2015.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Neovascularization is essential for bone regeneration in fractures. This study aimed to investigate the microvascular morphology and distribution in the non-injured femur and the neovascularization of the metaphyseal critical size defect in a small animal model of osteoporosis. MATERIALS AND METHODS Female rats (n=7) were ovariectomized (OVX) and received a multideficiency diet. Three months after OVX, a 5mm wedge shaped critical size defect was cut at the distal femoral metaphysis and stabilized with a T-shaped mini-plate. After six weeks, the animals were euthanized, and femora were removed and decalcified for micro-CT measurement of fracture neovascularization. RESULTS No fracture healing was observed along the critical size defects. In the non-injured bone, micro-vessel distribution showed a specific pattern, thereby enabling a differentiation between epi-, meta- and diaphysis. Micro-CT based morphometry revealed a significant reduction of the vascular volume fraction as well as the vascular thickness (p<0.001) in the critical size defect compared to the intact contralateral femur. Blood volume related vascular surface (vascular surface/volume) increased significantly (p<0.001). Connectivity density and tissue volume related vascular surface (vascular surface density) did not change significantly. CONCLUSIONS Micro-CT based vascular morphometry demonstrated differences between epi-, meta- and diaphysis in the non-injured bone as well as differences between the critical size defect and the non-injured metaphysis. As angiogenesis is a crucial prerequisite that precedes osteogenesis, our results may influence further evaluation of osteoconductive or osteogenic biomaterials in this small animal model of osteoporosis.
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Affiliation(s)
- Marian Kampschulte
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Germany; Laboratory of Experimental Radiology, Justus Liebig University Giessen, Germany.
| | - Gabriele A Krombach
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Germany; Laboratory of Experimental Radiology, Justus Liebig University Giessen, Germany
| | - Dana C Richards
- Laboratory of Experimental Radiology, Justus Liebig University Giessen, Germany
| | - Jonas Sender
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Germany; Laboratory of Experimental Radiology, Justus Liebig University Giessen, Germany
| | - Katrin S Lips
- Laboratory of Experimental Trauma Surgery, Justus Liebig University Giessen, Germany
| | - Ulrich Thormann
- Laboratory of Experimental Trauma Surgery, Justus Liebig University Giessen, Germany; Department of Trauma Surgery, University Hospital Giessen, Germany
| | - Thaqif El Khassawna
- Laboratory of Experimental Trauma Surgery, Justus Liebig University Giessen, Germany
| | - Seemun Ray
- Laboratory of Experimental Trauma Surgery, Justus Liebig University Giessen, Germany
| | - Volker Alt
- Laboratory of Experimental Trauma Surgery, Justus Liebig University Giessen, Germany; Department of Trauma Surgery, University Hospital Giessen, Germany
| | - Alexander C Langheinrich
- Laboratory of Experimental Radiology, Justus Liebig University Giessen, Germany; Department of Diagnostic and Interventional Radiology, BG Trauma Hospital Frankfurt/Main, Germany
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Bilgili F, Balci HI, Karaytug K, Sariyilmaz K, Atalar AC, Bozdag E, Tuna M, Bilgic B, Gurler N. Can Normal Fracture Healing Be Achieved When the Implant Is Retained on the Basis of Infection? An Experimental Animal Model. Clin Orthop Relat Res 2015; 473:3190-6. [PMID: 25981711 PMCID: PMC4562922 DOI: 10.1007/s11999-015-4331-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Infection after open fractures is a common complication. Treatment options for infections developed after intramedullary nailing surgery remain a topic of controversy. We therefore used a rat fracture model to evaluate the effects of infection on osseous union when the implant was maintained. QUESTIONS/PURPOSES In a rat model, (1) does infection alter callus strength; (2) does infection alter the radiographic appearance of callus; and (3) does infection alter the histological properties of callus? METHODS An open femoral fracture was created and fixed with an intramedullary Kirschner wire in 72 adult male Sprague-Dawley rats, which were divided into two study groups. In the infection group, the fracture site was contaminated with Staphylococcus aureus (36 animals), whereas in the control group, there was no bacterial contamination (36 animals). No antibiotics were used either for prophylaxis or for treatment. We performed biomechanical (maximum torque causing failure and stiffness), radiographic (Lane and Sandhu scoring for callus formation), and histologic (scoring for callus maturity) assessments at 3 and 6 weeks. The number of bacteria colonies on the femur, wire, and soft tissue inside knee were compared to validate that we successfully created an infection model. The number of bacteria colonies in the soft tissue inside the knee was higher in the infection group after 6 weeks than after the third week, demonstrating the presence of locally aggressive infection. RESULTS Infection decreased callus strength at 6 weeks. Torque to failure (299.07 ± 65.53 Nmm versus 107.20 ± 88.81, mean difference with 95% confidence interval, 192 [43-340]; p = 0.007) and stiffness at 6 weeks (11.28 ± 2.67 Nmm versus 2.03 ± 1.68, mean difference with 95% confidence interval, 9 [3-16]; p = 0.004) both were greater in the control group than in the group with infection. Radiographic analysis at 6 weeks demonstrated the fracture line was less distinct (Lane and Sandhu score of 2-3) in the infection group and complete union was observed (Lane and Sandhu score of 3-4) in the control group (p = 0.001). Semiquantitative histology scores were not different between the noninfected controls and the rats with infection (score 10 versus 9). CONCLUSIONS Retaining an implant in the presence of an underlying infection without antibiotic treatment leads to weaker callus and impedes callus maturation compared with noninfected controls in a rat model. Future studies might evaluate whether antibiotic treatment would modify this result. CLINICAL RELEVANCE This model sets the stage for further investigations that might study the influence of different interventions on fracture healing in implant-associated osteomyelitis. Future observational studies might also evaluate the histological properties of callus in patients with osteomyelitis.
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Affiliation(s)
- Fuat Bilgili
- Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Fatih/Capa, Istanbul, 34093, Turkey,
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Degenkolbe E, Schwarz C, Ott CE, König J, Schmidt-Bleek K, Ellinghaus A, Schmidt T, Lienau J, Plöger F, Mundlos S, Duda GN, Willie BM, Seemann P. Improved bone defect healing by a superagonistic GDF5 variant derived from a patient with multiple synostoses syndrome. Bone 2015; 73:111-9. [PMID: 25543012 DOI: 10.1016/j.bone.2014.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/16/2014] [Accepted: 12/17/2014] [Indexed: 11/20/2022]
Abstract
Multiple synostoses syndrome 2 (SYNS2) is a rare genetic disease characterized by multiple fusions of the joints of the extremities, like phalangeal joints, carpal and tarsal joints or the knee and elbows. SYNS2 is caused by point mutations in the Growth and Differentiation Factor 5 (GDF5), which plays an essential role during skeletal development and regeneration. We selected one of the SYNS2-causing GDF5 mutations, p.N445T, which is known to destabilize the interaction with the Bone Morphogenetic Protein (BMP) antagonist NOGGIN (NOG), in order to generate the superagonistic GDF5 variant GDF5(N445T). In this study, we tested its capacity to support regeneration in a rat critical-sized defect model in vivo. MicroCT and histological analyses indicate that GDF5(N445T)-treated defects show faster and more efficient healing compared to GDF5 wild type (GDF5(wt))-treated defects. Microarray-based gene expression and quantitative PCR analyses from callus tissue point to a specific acceleration of the early phases of bone healing, comprising the inflammation and chondrogenesis phase. These results support the concept that disease-deduced growth factor variants are promising lead structures for novel therapeutics with improved clinical activities.
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Affiliation(s)
- Elisa Degenkolbe
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Carolin Schwarz
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Claus-Eric Ott
- Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Research Group Development and Disease, Max Planck Institute for Molecular Genetics, 14195 Berlin, Germany
| | - Jana König
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Katharina Schmidt-Bleek
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Agnes Ellinghaus
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Tanja Schmidt
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Jasmin Lienau
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | | | - Stefan Mundlos
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Research Group Development and Disease, Max Planck Institute for Molecular Genetics, 14195 Berlin, Germany
| | - Georg N Duda
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Bettina M Willie
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Petra Seemann
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Research Group Development and Disease, Max Planck Institute for Molecular Genetics, 14195 Berlin, Germany.
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Abstract
UNLABELLED PURPOSE/AIMS OF THE STUDY: Bone's hierarchical structure can be visualized using a variety of methods. Many techniques, such as light and electron microscopy generate two-dimensional (2D) images, while micro-computed tomography (µCT) allows a direct representation of the three-dimensional (3D) structure. In addition, different methods provide complementary structural information, such as the arrangement of organic or inorganic compounds. The overall aim of the present study is to answer bone research questions by linking information of different 2D and 3D imaging techniques. A great challenge in combining different methods arises from the fact that they usually reflect different characteristics of the real structure. MATERIALS AND METHODS We investigated bone during healing by means of µCT and a couple of 2D methods. Backscattered electron images were used to qualitatively evaluate the tissue's calcium content and served as a position map for other experimental data. Nanoindentation and X-ray scattering experiments were performed to visualize mechanical and structural properties. RESULTS We present an approach for the registration of 2D data in a 3D µCT reference frame, where scanning electron microscopies serve as a methodic link. Backscattered electron images are perfectly suited for registration into µCT reference frames, since both show structures based on the same physical principles. We introduce specific registration tools that have been developed to perform the registration process in a semi-automatic way. CONCLUSIONS By applying this routine, we were able to exactly locate structural information (e.g. mineral particle properties) in the 3D bone volume. In bone healing studies this will help to better understand basic formation, remodeling and mineralization processes.
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Affiliation(s)
- Rebecca M Hoerth
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces , Potsdam , Germany
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Neffe AT, Pierce BF, Tronci G, Ma N, Pittermann E, Gebauer T, Frank O, Schossig M, Xu X, Willie BM, Forner M, Ellinghaus A, Lienau J, Duda GN, Lendlein A. One step creation of multifunctional 3D architectured hydrogels inducing bone regeneration. Adv Mater 2015; 27:1738-1744. [PMID: 25601165 DOI: 10.1002/adma.201404787] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/15/2014] [Indexed: 06/04/2023]
Abstract
Structured hydrogels showing form stability and elastic properties individually tailorable on different length scales are accessible in a one-step process. They support cell adhesion and differentiation and display growing pore size during degradation. In vivo experiments demonstrate their efficacy in biomaterial-induced bone regeneration, not requiring addition of cells or growth factors.
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Affiliation(s)
- Axel T Neffe
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Kantstrasse 55, 14513, Teltow, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Augustenburger Platz 1, 13533 Berlin and Kantstr. 55, 14513, Teltow, Germany
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Wehner T, Steiner M, Ignatius A, Claes L. Prediction of the time course of callus stiffness as a function of mechanical parameters in experimental rat fracture healing studies--a numerical study. PLoS One 2014; 9:e115695. [PMID: 25532060 DOI: 10.1371/journal.pone.0115695] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 11/26/2014] [Indexed: 11/19/2022] Open
Abstract
Numerous experimental fracture healing studies are performed on rats, in which different experimental, mechanical parameters are applied, thereby prohibiting direct comparison between each other. Numerical fracture healing simulation models are able to predict courses of fracture healing and offer support for pre-planning animal experiments and for post-hoc comparison between outcomes of different in vivo studies. The aims of this study are to adapt a pre-existing fracture healing simulation algorithm for sheep and humans to the rat, to corroborate it using the data of numerous different rat experiments, and to provide healing predictions for future rat experiments. First, material properties of different tissue types involved were adjusted by comparing experimentally measured callus stiffness to respective simulated values obtained in three finite element (FE) models. This yielded values for Young's moduli of cortical bone, woven bone, cartilage, and connective tissue of 15,750 MPa, 1,000 MPa, 5 MPa, and 1 MPa, respectively. Next, thresholds in the underlying mechanoregulatory tissue differentiation rules were calibrated by modifying model parameters so that predicted fracture callus stiffness matched experimental data from a study that used rigid and flexible fixators. This resulted in strain thresholds at higher magnitudes than in models for sheep and humans. The resulting numerical model was then used to simulate numerous fracture healing scenarios from literature, showing a considerable mismatch in only 6 of 21 cases. Based on this corroborated model, a fit curve function was derived which predicts the increase of callus stiffness dependent on bodyweight, fixation stiffness, and fracture gap size. By mathematically predicting the time course of the healing process prior to the animal studies, the data presented in this work provides support for planning new fracture healing experiments in rats. Furthermore, it allows one to transfer and compare new in vivo findings to previously performed studies with differing mechanical parameters.
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Sato K, Watanabe Y, Harada N, Abe S, Matsushita T, Yamanaka K, Kaneko T, Sakai Y. Establishment of Reproducible, Critical-Sized, Femoral Segmental Bone Defects in Rats. Tissue Eng Part C Methods 2014; 20:1037-41. [DOI: 10.1089/ten.tec.2013.0612] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Kenji Sato
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshinobu Watanabe
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Noriko Harada
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Satoshi Abe
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Takashi Matsushita
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Katsuyuki Yamanaka
- Research and Development Department, GC Corporation, Itabashi, Tokyo, Japan
| | - Tadashi Kaneko
- Research and Development Department, GC Corporation, Itabashi, Tokyo, Japan
| | - Yuhiro Sakai
- Research and Development Department, GC Corporation, Itabashi, Tokyo, Japan
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Hoerth RM, Seidt BM, Shah M, Schwarz C, Willie BM, Duda GN, Fratzl P, Wagermaier W. Mechanical and structural properties of bone in non-critical and critical healing in rat. Acta Biomater 2014; 10:4009-19. [PMID: 24929204 DOI: 10.1016/j.actbio.2014.06.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 05/19/2014] [Accepted: 06/03/2014] [Indexed: 02/06/2023]
Abstract
A fracture in bone results in a dramatic change of mechanical loading conditions at the site of injury. Usually, bone injuries heal normally but with increasing fracture gaps, healing is retarded, eventually leading to non-unions. The clinical situation of these two processes with different outcomes is well described. However, the exact relation between the mechanical environment and characteristics of the tissues at all levels of structural hierarchy remains unclear. Here we studied the differences in material formation of non-critical (1mm) and critical (5mm gap) healing. We employed a rat osteotomy model to explore bone material structure depending upon the different mechanical conditions. In both cases, primary bone formation was followed by secondary bone deposition with mineral particle sizes changing from on average short and thick to long and thin particles. Bony bridging occurred at first in the endosteal callus and the nanostructure and microstructure developed towards cortical ordered material organization. In contrast, in critical healing, instead of bridging, a marrow cavity closure was formed endosteal, exhibiting tissue structure oriented along the curvature and a periosteal callus with less mature material structure. The two healing processes separated between 4 and 6 weeks post-osteotomy. The outcome of healing was determined by the varied geometrical conditions in critical and non-critical healing, inducing completely different mechanical situations.
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Affiliation(s)
- Rebecca M Hoerth
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Research Campus Golm, 14424 Potsdam, Germany; Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Britta M Seidt
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Research Campus Golm, 14424 Potsdam, Germany
| | - Miheer Shah
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Research Campus Golm, 14424 Potsdam, Germany
| | - Carolin Schwarz
- Berlin-Brandenburg School for Regenerative Therapies (BSRT), Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany; Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Bettina M Willie
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute & Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Peter Fratzl
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Research Campus Golm, 14424 Potsdam, Germany
| | - Wolfgang Wagermaier
- Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Research Campus Golm, 14424 Potsdam, Germany.
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Harada N, Watanabe Y, Sato K, Abe S, Yamanaka K, Sakai Y, Kaneko T, Matsushita T. Bone regeneration in a massive rat femur defect through endochondral ossification achieved with chondrogenically differentiated MSCs in a degradable scaffold. Biomaterials. 2014;35:7800-7810. [PMID: 24952976 DOI: 10.1016/j.biomaterials.2014.05.052] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 05/20/2014] [Indexed: 12/20/2022]
Abstract
Mesenchymal stem cells (MSCs) are multipotent cells capable of proliferating and differentiating into several lineages. In regenerative medicine, their potential as a resource for tissue-replacement therapy is receiving much attention. However, transplanting MSCs to repair larger bone defects in animal models has so far proved disappointing. Here we report on the healing of both critical-sized (5 mm) and massive (15 mm) full-thickness femur defects in rats by implanting a uniquely fabricated PLGA scaffold seeded with MSCs pre-differentiated in vitro into cartilage-forming chondrocytes (MSC-DCs). This strategy closely mimics endochondral ossification, the process by which long bones develop in nature. It is thought that because the transplanted MSC-DCs induced natural bone formation, the defect size was not critical to the outcome. Crucially, after 8 weeks the mean biomechanical strength of femora with the massive 15 mm implant reached 75% that of a normal rat femur, while in the case of 5 mm implants there was no significant difference. Successful healing was also highly reproducible, with bone union occurring in all treated animals examined radiologically 8 or 16 weeks after surgery.
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Histing T, Klein M, Stieger A, Stenger D, Steck R, Matthys R, Holstein JH, Garcia P, Pohlemann T, Menger MD. A new model to analyze metaphyseal bone healing in mice. J Surg Res 2012; 178:715-21. [DOI: 10.1016/j.jss.2012.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 04/02/2012] [Accepted: 04/04/2012] [Indexed: 11/25/2022]
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Savaridas T, Wallace RJ, Muir AY, Salter DM, Simpson AHRW. The development of a novel model of direct fracture healing in the rat. Bone Joint Res 2012; 1:289-96. [PMID: 23610660 PMCID: PMC3626205 DOI: 10.1302/2046-3758.111.2000087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 10/04/2012] [Indexed: 11/22/2022] Open
Abstract
Objectives Small animal models of fracture repair primarily investigate
indirect fracture healing via external callus formation. We present
the first described rat model of direct fracture healing. Methods A rat tibial osteotomy was created and fixed with compression
plating similar to that used in patients. The procedure was evaluated
in 15 cadaver rats and then in vivo in ten Sprague-Dawley
rats. Controls had osteotomies stabilised with a uniaxial external
fixator that used the same surgical approach and relied on the same
number and diameter of screw holes in bone. Results Fracture healing occurred without evidence of external callus
on plain radiographs. At six weeks after fracture fixation, the
mean stress at failure in a four-point bending test was 24.65 N/mm2 (sd 6.15).
Histology revealed ‘cutting-cones’ traversing the fracture site.
In controls where a uniaxial external fixator was used, bone healing
occurred via external callus formation. Conclusions A simple, reproducible model of direct fracture healing in rat
tibia that mimics clinical practice has been developed for use in
future studies of direct fracture healing.
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Affiliation(s)
- T Savaridas
- Northern Deanery Orthopaedic Training Programme, Waterfront 4, Goldcrest Way, Newburn Riverside, Newcastle Upon Tyne NE15 8NY, UK
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Schwarz C, Wulsten D, Ellinghaus A, Lienau J, Willie BM, Duda GN. Mechanical load modulates the stimulatory effect of BMP2 in a rat nonunion model. Tissue Eng Part A 2012; 19:247-54. [PMID: 22861354 DOI: 10.1089/ten.tea.2012.0265] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Local application of bone morphogenetic proteins (BMPs) at the fracture site is known to stimulate bone regeneration. However, recent studies illustrate that the BMP-initiated mineralization may be enhanced by additional mechanical stimulation. Therefore, bone healing was monitored in vivo in order to investigate the effect of mechanical loading on the initiation and maturation of mineralization after cytokine treatment. We hypothesized that the mechanical stimulation would further enhance the efficacy of BMP2 treatment. METHOD Female Sprague-Dawley rats underwent a 5-mm defect, stabilized with an external fixator. Type I collagen scaffolds containing 50 μg of BMP2 diluted in a solvent or solvent only were placed into the defects. The BMP2-treated specimens and control specimens were then each divided into two groups: one that underwent mechanical loading and a nonloaded group. In vivo loading began immediately after surgery and continued once per week for the entire 6-week experimental period. For all groups, the newly formed callus tissue was quantitatively evaluated first by in vivo microcomputed tomography at 2, 4, and 6 weeks and further by histologic or histomorphometric analysis at 6 weeks postoperation. RESULTS Mechanical stimulation with BMP2 treatment significantly enhanced mineralized tissue volume and mineral content at 2 weeks. Histological analysis demonstrated a significantly greater area of fibrous connective tissue including bone marrow in the stimulated group, suggesting reconstitution of the endosteal canal and more advanced bone remodeling present in the mechanical loaded group. Both groups receiving BMP2 underwent massive bone formation, achieving bony bridging after only 2 weeks, while both control groups, receiving solvent only, revealed a persisting nonunion, filled with fibrous connective tissue, prolapsed muscle tissue, and a sealed medullary canal at week 6. CONCLUSION Mechanical loading further enhanced the efficacy of BMP2 application evidenced by increased mineralized tissue volume and mineralization at the stage of bony callus bridging. These data suggest that already a minimal amount of mechanical stimulation through load bearing or exercise may be a promising adjunct stimulus to enhance the efficacy of cytokine treatment in segmental defects. Further studies are required to elucidate the mechanistic interplay between mechanical and biological stimuli.
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Affiliation(s)
- Carolin Schwarz
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
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40
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Mehta M, Schmidt-Bleek K, Duda GN, Mooney DJ. Biomaterial delivery of morphogens to mimic the natural healing cascade in bone. Adv Drug Deliv Rev 2012; 64:1257-76. [PMID: 22626978 PMCID: PMC3425736 DOI: 10.1016/j.addr.2012.05.006] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 05/01/2012] [Accepted: 05/03/2012] [Indexed: 12/20/2022]
Abstract
Complications in treatment of large bone defects using bone grafting still remain. Our understanding of the endogenous bone regeneration cascade has inspired the exploration of a wide variety of growth factors (GFs) in an effort to mimic the natural signaling that controls bone healing. Biomaterial-based delivery of single exogenous GFs has shown therapeutic efficacy, and this likely relates to its ability to recruit and promote replication of cells involved in tissue development and the healing process. However, as the natural bone healing cascade involves the action of multiple factors, each acting in a specific spatiotemporal pattern, strategies aiming to mimic the critical aspects of this process will likely benefit from the usage of multiple therapeutic agents. This article reviews the current status of approaches to deliver single GFs, as well as ongoing efforts to develop sophisticated delivery platforms to deliver multiple lineage-directing morphogens (multiple GFs) during bone healing.
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Affiliation(s)
- Manav Mehta
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02139, USA
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Meszaros LB, Usas A, Cooper GM, Huard J. Effect of host sex and sex hormones on muscle-derived stem cell-mediated bone formation and defect healing. Tissue Eng Part A 2012; 18:1751-9. [PMID: 22712541 DOI: 10.1089/ten.tea.2011.0448] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Muscle-derived stem cells (MDSCs) are known to exhibit sexual dimorphism, by donor sex, of osteogenic, chondrogenic, and myogenic differentiation potential in vitro. Moreover, host sex differences in the myogenic capacity of MDSCs in vivo are also observed. This study investigated the role of host sex and host sex hormones in MDSC-mediated bone formation and healing. Using unaltered male, castrated male, unaltered female, and ovariectomized female mice, both MDSC-mediated ectopic bone formation and cranial defect healing were examined. Male hosts, whether unaltered or castrated, form significantly larger volumes of MDSC-mediated ectopic bone than female hosts (either unaltered or ovariectomized), and no differences in ectopic bone volume were found between hosts of the same sex. In a cranial defect healing model, similar results were found-unaltered and castrated male hosts display larger volumes of bone formed when compared with unaltered and ovariectomized female hosts. However, in this healing model, some volume differences were found between hosts of the same sex. In both models, these differences were attributed to varying rates of endochondral bone formation in male and female hosts.
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Affiliation(s)
- Laura B Meszaros
- Stem Cell Research Center, Department of Orthopaedic Surgery and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
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Ferreira ML, Silva PC, Alvarez Silva LH, Bonfim DC, Conilho Macedo Müller LC, Espósito CC, Schanaider A. Heterologous mesenchymal stem cells successfully treat femoral pseudarthrosis in rats. J Transl Med 2012; 10:51. [PMID: 22429995 PMCID: PMC3334676 DOI: 10.1186/1479-5876-10-51] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 03/20/2012] [Indexed: 01/14/2023] Open
Abstract
Background This study evaluated the effectiveness of treating pseudarthrosis in rats by using bone marrow cell suspensions or cultures of bone marrow mesenchymal stromal cells Methods Thirty-eight specific pathogen-free (SPF) animals were randomly assigned to four groups: Group 1, Control, without surgical intervention; Group 2 (Placebo), experimental model of femoral pseudarthrosis treated only with saline solution; Group 3, experimental model of femoral pseudarthrosis treated with heterologous bone marrow cells suspension; Group 4, experimental model of femoral pseudarthrosis treated with cultures of heterologous mesenchymal stromal cells from bone marrow. When pseudarthrosis was confirmed by simple radiological studies, digital radiography and histopathology after a 120-day postoperative period, Groups 2, 3 and 4 were treated as above. At 30, 60 and 90 days after the treatment, all animals were evaluated by simple radiological studies, and at the end of the experiment, the animals were assessed by computed axial tomography and anatomopathological and histomorphometric examinations. Results Injected cells were detected in the areas affected by pseudarthrosis using scintigraphy within the first 24 hours after their administration. After 60 days, the animals of Group 3 showed callus formation while the animals of Group 4 presented periosteal reaction and had some consolidated areas. In contrast, Group 2 showed a predominance of fibro-osteoid tissue. After 90 days, bone consolidation and remodeling was observed in all animals from Group 3 whereas animals from Group 4 exhibited partial consolidation and those ones from Group 2 persisted with pseudarthrosis. Conclusion The treatment with heterologous bone marrow cells suspension proved to be effective in the treatment of pseudarthrosis whereas cultures of heterologous bone marrow mesenchymal stromal cells did not show the same potential to aid bone healing.
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Affiliation(s)
- Manoel Luiz Ferreira
- Post-graduate Program in Surgical Sciences, Department of Surgery, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Histing T, Stenger D, Kuntz S, Scheuer C, Tami A, Garcia P, Holstein JH, Klein M, Pohlemann T, Menger MD. Increased osteoblast and osteoclast activity in female senescence-accelerated, osteoporotic SAMP6 mice during fracture healing. J Surg Res 2011; 175:271-7. [PMID: 21571305 DOI: 10.1016/j.jss.2011.03.052] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 03/04/2011] [Accepted: 03/18/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Previous studies have shown that fracture healing depends on gender and that in females, ovariectomy-induced osteoporosis impairs the healing process. There is no information, however, whether the alteration of fracture healing in osteoporosis also depends on gender. MATERIALS AND METHODS Therefore, we herein studied fracture healing in female and male senescence-accelerated osteoporotic mice, strain P6 (SAMP6), including biomechanical, histomorphometric, and protein biochemical analysis. RESULTS Bending stiffness was reduced in male and female SAMP6 mice compared with senescence-resistant strain 1 (SAMR1) controls. This was associated with elevated serum concentrations of tartrate-resistent acid phosphatase form 5b (TRAP) in both female and male SAMP6 mice. Callus size, however, was significantly larger in female SAMP6 mice compared with male SAMP6 mice and female SAMR1 controls. This indicates a delayed remodeling process in female SAMP6 mice. The delay of callus remodeling in female SAMP6 mice was associated with a significantly higher osteoprotegerin (OPG) callus tissue expression and increased serum concentrations of osteocalcin (OC) and deoxypyridinoline (DPD), indicating elevated osteoblast and osteoclast activities. CONCLUSION The present study shows that remodeling during fracture healing in female, but not in male, SAMP6 mice is delayed, most probably due to an increased osteoblast and osteoclast activity.
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Affiliation(s)
- Tina Histing
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany.
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