Age-Related Features of Bone Regeneration (Literature Review)

Abstract

The number of elderly people is constantly increasing all over the world. They are most often the patients who need orthopedic surgeries like arthroplasty, osteosynthesis and others. It is knownthat the process of bone regeneration depends on the patient’s age. However, certain characteristics of bone regeneration process depend on the age remain unclear, which is important for developingthe best strategies for treatment of elderly patients. Objective. Тo identify age-related features of bone regeneration and to establish possible ways of influencing them in order to optimize the boneregeneration in elderly patients. Methods. Literature search was performed in the PubMed database. Inclusion criteria were original experimental and clinical studies in English. The search depth is accepted for 20 years. Results. It has been experimentally and clinically shown that bone tissue regeneration slows down with age, which is more pronounced in women. According to scientific information, this involves two signaling pathways — Notch and Wnt/β-Catenin, the activity of which is suppressed with age. However, the regulation of regeneration is a cascade of signaling pathwaysand macromolecules. The expression of growth factors after fracture changes at older age compared to a younger one. In particular,a decrease in the expression of TGFβ-1 was clinically revealed. In addition, in older patients after fracture, an increase in macrophage colony-stimulating factor and VEGF was recorded. It has been experimentally established that a combination of a slowdownin bone tissue regeneration with a decrease in the content of Indian Hedgehog, Sonic Hedgehog, BMP-2, 4, -7 proteins and MMP-9 in bone callus has been established. Among the ways to overcome the delayed bone regeneration in elderly patients can be the use of modern technologies of cell and gene therapy, inhibitors of macrophages, biologically active factors at certain stages of bone regeneration. For cell therapy, it is important to take into account the age of the cell donor because of the high probability of functional disorders in cells from older donors.

Osteogenic and Protective Effects of Erucic Acid and Erucic Acid-Induced Exosomes against Fine Dust

“…Osteogenesis is important for the bone regeneration associated with age-related bone diseases [19]. Changes in the expression of various genes occurs during the osteogenic stages of mesenchymal differentiation.…”