Platelet calmodulin levels in adolescent idiopathic scoliosis (AIS): can they predict curve progression and severity?

Abstract

There is no generally accepted scientific theory for the etiology of idiopathic scoliosis. As part of its mission to widen understanding of scoliosis etiology, the International Federated Body on Scoliosis Etiology (IBSE) introduced the electronic focus group (EFG) as a means of increasing debate of extant knowledge on important topics. This has been designated as an on-line Delphi discussion. The text for this EFG was written by Professor Thomas G Lowe MD and drawn from research carried out by himself and his coworkers on platelet calmodulin levels in patients with adolescent idiopathic scoliosis. To explain the relationship of platelet calmodulin levels to scoliosis curve changes in AIS brought about spontaneously, by brace treatment, or surgery Dr Lowe attributes the platelet calmodulin changes to paraspinous muscle activity and suggests that the calmodulin acts as a systemic mediator of tissues having a contractile system (actin and myosin). Controversy includes: 1) the lack of normal data and the large variability in baseline levels of platelet calmodulin, necessitating the use of the AIS subjects as their own controls; 2) calmodulin is not usually used as a marker of platelet activation; 3) whether the platelet calmodulin changes which appear to reflect an abnormality of a portion of the spine are related to local and/or regional changes in muscles, nervous system, or immature vertebrae. What is not controversial is the need for more research on platelets and the immature deforming skeleton in relation to etiology and prognosis.Keywords Scoliosis · Idiopathic · Adolescence · Platelets · Calmodulin This paper provides an edited summary of the second electronic focus group (EFG) of the International Federated Body on Scoliosis Etiology (IBSE). It contains the research of Professor Thomas G Lowe MD and his colleagues on platelet calmodulin levels in adolescent idiopathic scoliosis that was debated via e-mail by IBSE members during the period October 2002-July 2003. The summary (Professor Lowe's statement, comments, questions and answers 1-24) was circulated by e-mail to IBSE members on 22 August 2003 and no further comments were received. Ideas presented in this summary are personal opinions and are not necessarily shared by all those within IBSE. The edited summary of the first EFG of the IBSE and some details about the IBSE have been published [19].

Idiopathic Scoliosis and Pineal Lesions in Australian Children

“…Elevated platelet calmodulin levels are found in children with progressive scoliosis. 64,65 Current controversy focuses on the lack of control data and the large variability of baseline platelet calmodulin levels in idiopathic scoliosis patients. 66 For the purpose of clinical neuromotor assessment of children with idiopathic scoliosis, MRIs of the brain and spinal cord can help in the investigation of abnormalities of proprioception, postural equilibrium control, oculovestibular function, and vibratory sensation.…”

“…64,65 Current controversy focuses on the lack of control data and the large variability of baseline platelet calmodulin levels in idiopathic scoliosis patients. 66 For the purpose of clinical neuromotor assessment of children with idiopathic scoliosis, MRIs of the brain and spinal cord can help in the investigation of abnormalities of proprioception, postural equilibrium control, oculovestibular function, and vibratory sensation. [67][68][69][70][71] Younger children with progressive idiopathic scoliotic curves with and without neuromotor signs are more likely to have brain stem abnormalities such as Arnold-Chiari type-1 malformation, syringomyelia, or cerebellar tonsillar ectopia.…”

Idiopathic scoliosis: Etiological concepts and hypotheses

“…More recently, a study in 55 AIS patients confirmed a direct relationship between higher platelet calmodulin levels and curve progression. Furthermore, curve stabilization by bracing or spine fusion reduced these levels in 82 and 90 % of patients, respectively [31]. In a controlled clinical study, AIS patients were shown to display an asymmetric distribution of calmodulin levels in paraspinal muscle, higher at the convex side and lower at the concave [1].…”

So-Called Idiopathic Scoliosis: Diagnostic Tests: Examples of Children Incorrect Treated: New Therapy by Stretching Exercises and Results

“…5 Rotation movements of the body test-comparison of the left and right rotation movement of the pelvis and shoulders (whole body) in "standing straight position" of the child with feet close together [38][39][40][41][42][43][44][45][46][47][48][49].…”