2017
DOI: 10.3390/ijms18030583
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A Pronounced Inflammatory Activity Characterizes the Early Fracture Healing Phase in Immunologically Restricted Patients

Abstract: Abstract:Immunologically restricted patients such as those with autoimmune diseases or malignancies often suffer from delayed or insufficient fracture healing. In human fracture hematomas and the surrounding bone marrow obtained from immunologically restricted patients, we analyzed the initial inflammatory phase on cellular and humoral level via flow cytometry and multiplex suspension array. Compared with controls, we demonstrated higher numbers of immune cells like monocytes/macrophages, natural killer T (NKT… Show more

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Cited by 46 publications
(48 citation statements)
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“…While pain and limited range of motion are frequently seen in isolated trauma (4,5), previous clinical and experimental studies linked multiple trauma to significantly longer fracture healing times and higher incidences of non-unions in comparison to isolated fractures (7)(8)(9). Overwhelming local and systemic inflammatory responses with an associated negative influence on downstream processes of bone repair are a potential pathomechanism for this impaired fracture healing (10)(11)(12)(13). Despite knowledge about the connectivity between the systemic and local inflammatory responses, information on the impact of trauma severity on systemic and local immunologic interactions and responses is scarce (14).…”
Section: Introductionmentioning
confidence: 99%
“…While pain and limited range of motion are frequently seen in isolated trauma (4,5), previous clinical and experimental studies linked multiple trauma to significantly longer fracture healing times and higher incidences of non-unions in comparison to isolated fractures (7)(8)(9). Overwhelming local and systemic inflammatory responses with an associated negative influence on downstream processes of bone repair are a potential pathomechanism for this impaired fracture healing (10)(11)(12)(13). Despite knowledge about the connectivity between the systemic and local inflammatory responses, information on the impact of trauma severity on systemic and local immunologic interactions and responses is scarce (14).…”
Section: Introductionmentioning
confidence: 99%
“…Similar to our data, increased IL1-beta, IL6 and IL8 (protein levels) were detected early in hematoma [35] while we did not see a clear increase in IL10, IL1R or VEGF early (although at mRNA levels rather than protein). In hematoma (72 h of fracture) from patients with autoimmune conditions, exaggerated expression of the same factor was also reported [36] as well as increased in transcript for osteopontin/SPP1 and HIF1 [37]. This is different in humans, with a massive reduction in ANGPT1 over the overall period studied (0-15 days), while ANGPT2 did not show variation (similar levels to heathy bone).…”
Section: Discussionmentioning
confidence: 76%
“…No cartilage remains; 28 days: remodeling phase. Histological samples stained with Movat Pentachrome: bone = yellow; bone marrow =purple; cartilage = blue-green, muscle = orange; connective tissue = light blue [2,4,6,15,[34][35][36][37][38][39][40][41][42][43]. Periost has been carefully elevated from the bone and was stained with hematoxylin eosin.…”
Section: Resultsmentioning
confidence: 99%