Bone Vascularization in Normal and Disease Conditions

Abstract

Bone vasculature is essential for many processes, such as skeletal development and growth, bone modeling and remodeling, and healing processes. Endothelium is an integral part of bone tissue, expressing a physiological paracrine function via growth factors and chemokines release, and interacting with several cellular lines. Alterations of the complex biochemical interactions between vasculature and bone cells may lead to various clinical manifestations. Two different types of pathologies result: a defect or an excess of bone vasculature or endothelium metabolism. Starting from the molecular basis of the interactions between endothelial and bone cells, the Authors present an overview of the recent acquisitions in the physiopathology of the most important clinical patterns, and the modern therapeutic strategies for their treatments.

Epidemiology of fractures in type 2 diabetes

“…For example, retinopathy is a marker of microvascular damage. Vasculature of the bone and bone marrow is essential to bone health [87,88] although the effects of diabetes have not been studied. As another example, higher levels of advanced glycation endproducts (AGEs) in bone collagen are hypothesized to increase bone fragility.…”

Blood vessel formation and function in bone

“…Vascular cells have also been shown to be part of the niche that controls the maintenance and differentiation of hematopoietic stem cells (HSCs) that reside in bone marrow (Ugarte and Forsberg, 2013). Notably, angiogenesis also plays a major role in bone fracture healing and repair (Beamer et al, 2010), and changes in the local vasculature are also associated with the progression of numerous diseases affecting bone, such as osteoporosis, osteonecrosis, rheumatoid arthritis, bone cancer and metastasis (Carulli et al, 2013).…”

A steroid-induced bilateral avascular necrosis of the femoral head in an underage patient affected by multiple sclerosis

“…Pulsed corticosteroid doses are generally effective for relapses in MS (1-3): however, they are not free from complications, as ANFH (2,4,5,(7)(8)(9). As reported in few cases in literature, adult MS patients affected by ANFH after intravenous corticosteroids often require a surgical procedure (6,8,9) have conducted surgeons to propose a hip arthroplasty, even in young subjects (9,10).…”

“…The intravenous administration is not free from complications (5,6). Frequently, an avascular necrosis of bones may occur due to several mechanisms not yet cleared (5)(6)(7). Femoral heads represent a specific target as reported recently in adult patients even with a bilateral involvement (2,8).…”