Thein vitroandin vivoeffects of nicotine on bone, bone cells and fracture repair

Abstract

The review suggests that nicotine has effects on osteoneogenesis, osseointegration and steady-state skeletal bone in animal in vivo models, as well as effects on all 'bone cells', via several mechanisms in both animal and human cell in vitro studies. The effect of nicotine is dose-dependent, with higher concentrations having predominantly negative effects, whereas at low concentrations a stimulatory effect is seen. Stimulatory effects on certain cells may indicate a possible, limited therapeutic role; advice regarding smoking cessation perioperatively should remain due to the other harmful components of cigarette smoke, but there may be scope for allowing the use of nicotine patches instead of complete abstention. Further research into clinical outcomes is required before the exact response of bone and fracture repair in humans to nicotine is known.

A review of lifestyle, smoking and other modifiable risk factors for osteoporotic fractures

“…Such mechanisms include direct and indirect cellular effects on bone cells involving all skeletal sites. 21 …”

“…21 The actions may be receptor-mediated via a nicotinic acetylcholine receptor. Low levels of nicotine upregulate osteocalcin, type I collagen and alkaline phosphatase gene expression.…”

Sirt3–MnSOD axis represses nicotine-induced mitochondrial oxidative stress and mtDNA damage in osteoblasts

“…In vivo studies have demonstrated that tobacco smoking is a major risk factor for osteoporosis [1,2]. Nicotine, one of the main compounds in cigarette, influences the biological activity, proliferation, and differentiation of osteoblasts [3][4][5]. In addition, nicotine can also suppress the osteoblast differentiation from human mesenchymal stem cell (MSC) [6].…”

The effects of subcutaneous injection of nicotine on osseointegration of machined and anodized implants in rabbits

“…These differences can be explained by the interaction between growth/hormone factors and rougher surface topography that favor cellular differentiation and mineralization. This beneficial effect of rough surfaces in osseointegration has been confirmed by experimental and clinical studies 14,20,22 . In addition, low concentrations of nicotine showed a stimulatory effect on cell replication, especially at low concentrations (0.025 µM), it had a significant stimulatory effect on fibroblast proliferation 22 as well as in human osteoblast-like cells 23 , which could explain the higher torque necessary to remove the implants in nicotine than in control group found in the present study.…”