Evidence for a humoral mechanism for enhanced osteogenesis after head injury.

Bidner, S M; Rubins, I M; Desjardins, Johanne; Zukor, David J.; Goltzman, David

doi:10.2106/00004623-199072080-00004

Cited by 128 publications

(102 citation statements)

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“…Studies suggest the rate of ectopic bone formation in combat-related injuries is substantially higher than prior estimates reported in civilian trauma populations [16,39]. Despite several studies investigating systemic factors and the in vitro measurement of osteoblastic activity of cells from heterotopic bone [2,27,45], the biological mechanisms responsible for HO as a result of traumatic injury have not been defined.…”

Section: Introductionmentioning

confidence: 93%

Osteogenic Gene Expression Correlates With Development of Heterotopic Ossification in War Wounds

Evans

Potter

Brown

et al. 2013

Clin Orthop Relat Res

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Background Heterotopic ossification (HO) is a frequent complication of modern wartime extremity injuries. The biological mechanisms responsible for the development of HO in traumatic wounds remain elusive. Question/purposes The aims of our study were to (1) characterize the expression profile of osteogenesis-related gene transcripts in traumatic war wounds in which HO developed; and (2) determine whether expression at the mRNA level correlated with functional protein expression and HO formation. Methods Biopsy specimens from 54 high-energy penetrating extremity wounds obtained at the initial and final surgical débridements were evaluated. The levels of selected osteogenic-related gene transcripts from RNA extracts were assessed by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. As a result of its key role in osteogenesis, the concentration of BMP-2 in the effluent of 29 wounds also was determined. Conclusions Important differences exist in the osteogenic gene expression profile of wounds in which HO developed compared with wounds in which it did not develop. The upregulation of multiple osteogenesis-related gene transcripts indicates the presence of a proosteogenic environment necessary for ectopic bone formation in traumatic wounds.

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Section: Introductionmentioning

confidence: 93%

Osteogenic Gene Expression Correlates With Development of Heterotopic Ossification in War Wounds

Evans

Potter

Brown

et al. 2013

Clin Orthop Relat Res

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“…77,78 Humoral factors Recent work with the serum of traumatic brain injured (TBI) and SCI patients seems to indicate that humoral mechanisms may be involved. 79,80 In the study of Binder, 79 the serum of a TBI patient increased the osteoblast growth factor activity in foetal rats. Kurer et al 80 incubated sera from SCI patients with and without NHO 4 ± 7 months post injury and sera from healthy control subjects with human osteoblasts in tissue culture.…”

Section: Pathophysiologymentioning

confidence: 99%

Neurogenic heterotopic ossification in spinal cord injury

2002

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Neurogenic heterotopic ossi®cation (NHO) is a frequent complication in spinal cord injury (SCI) that is often di cult to treat. This review emphasizes the incidence, risk factors and clinical signs of NHO in SCI patients. Although the exact pathophysiology underlying NHO in neurologic patients is not yet understood, di erent pathogenic mechanisms have been proposed in the literature. A selection of the most important theories will be given and discussed. Moreover the di erent diagnostic, therapeutic, and preventive methods currently used in NHO management after SCI will be reviewed.

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“…During subsequent decades, a series of studies were carried out to attempt to identify the mechanism responsible for this phenomenon. Bidner et al (2) provided clear evidence that patients with TBI possess a humoral mechanism for enhanced fracture healing and that TBI is associated with an increased amount of certain stimulating factors found in serum. Calcitonin gene-related peptide (CGRP) is among these factors and may induce enhanced osteogenesis in patients with TBI.…”

Section: Introductionmentioning

confidence: 99%

Increased levels of calcitonin gene-related peptide in serum accelerate fracture healing following traumatic brain injury

Song

Zhang

et al. 2011

Mol Med Report

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Abstract. The mechanisms responsible for the phenomenon of an accelerated speed of fracture healing in patients with traumatic brain injury (TBI) remain unclear. The present study was performed to test the hypothesis that TBI causes changes in calcitonin gene-related peptide (CGRP) levels in sera that enhance fracture healing. A standard closed femoral fracture was produced in rats, which were subjected to additional closed head trauma. The fracture healing was assessed 4 and 8 weeks later using micro-CT. Sera, brain tissues and muscles surrounding the fracture sites collected at 24, 48, 72 and 168 h after injury were used to detect the expression of CGRP using ELISA, immunohistochemistry and RT-PCR. Micro-CT demonstrated that fracture healing and mineralization in the TBI-fracture group occurred earlier compared to the fracture-only group. ELISA analysis revealed a high concentration of CGRP in the TBI-fracture group (P<0.05), and immunohistochemistry assay and RT-PCR analysis revealed a significant increase in CGRP in the brain and muscle of the TBI-fracture group at 168 h after fracture (P<0.001). Our results indicate that the mechanism for the enhancement of fracture-healing secondary to traumatic brain injury is correlated to the high levels of CGRP, which may be released from the brain tissue into the serum.

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Evidence for a humoral mechanism for enhanced osteogenesis after head injury.

Cited by 128 publications

References 0 publications

Osteogenic Gene Expression Correlates With Development of Heterotopic Ossification in War Wounds

Osteogenic Gene Expression Correlates With Development of Heterotopic Ossification in War Wounds

Neurogenic heterotopic ossification in spinal cord injury

Increased levels of calcitonin gene-related peptide in serum accelerate fracture healing following traumatic brain injury

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