Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative Approach
In this clinical trial, we investigated if biochemical bone turnover markers (BTM) changed according to the progression of bone healing induced by autologous expanded MSC combined with a biphasic calcium phosphate in patients with delayed union or nonunion of long bone fractures. Bone formation mark...
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doaj-8f1d2634f1f043f4ae2fc0d09e13d6ce2020-11-24T22:11:21ZengHindawi LimitedStem Cells International1687-966X1687-96782017-01-01201710.1155/2017/36740453674045Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative ApproachDonatella Granchi0Enrique Gómez-Barrena1Markus Rojewski2Philippe Rosset3Pierre Layrolle4Benedetta Spazzoli5Davide Maria Donati6Gabriela Ciapetti7Orthopedic Pathophysiology and Regenerative Medicine Unit, Rizzoli Orthopedic Institute, Bologna, ItalyHospital La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, SpainInstitute for Clinical Transfusion Medicine and Immunogenetic Ulm (IKT Ulm), Ulm, GermanyService of Orthopaedic Surgery and Traumatology, CHRU, Tours, FranceInserm U957, Laboratoire de Physiopathologie de la Résorption Osseuse et Thérapie des Tumeurs Osseuses Primitives (LPRO), University of Nantes, Nantes, FranceIII Orthopedic and Traumatology Clinic, Rizzoli Orthopedic Institute, Bologna, ItalyIII Orthopedic and Traumatology Clinic, Rizzoli Orthopedic Institute, Bologna, ItalyOrthopedic Pathophysiology and Regenerative Medicine Unit, Rizzoli Orthopedic Institute, Bologna, ItalyIn this clinical trial, we investigated if biochemical bone turnover markers (BTM) changed according to the progression of bone healing induced by autologous expanded MSC combined with a biphasic calcium phosphate in patients with delayed union or nonunion of long bone fractures. Bone formation markers, bone resorption markers, and osteoclast regulatory proteins were measured by enzymatic immunoassay before surgery and after 6, 12, and 24 weeks. A satisfactory bone healing was obtained in 23 out of 24 patients. Nine subjects reached a good consolidation already at 12 weeks, and they were considered as the “early consolidation” group. We found that bone-specific alkaline phosphatase (BAP), C-terminal propeptide of type I procollagen (PICP), and beta crosslaps collagen (CTX) changed after the regenerative treatment, BAP and CTX correlated to the imaging results collected at 12 and 24 weeks, and BAP variation along the healing course differed in patients who had an “early consolidation.” A remarkable decrease in BAP and PICP was observed at all time points in a single patient who experienced a treatment failure, but the predictive value of BTM changes cannot be determined. Our findings suggest that BTM are promising tools for monitoring cell therapy efficacy in bone nonunions, but studies with larger patient numbers are required to confirm these preliminary results.http://dx.doi.org/10.1155/2017/3674045 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Donatella Granchi Enrique Gómez-Barrena Markus Rojewski Philippe Rosset Pierre Layrolle Benedetta Spazzoli Davide Maria Donati Gabriela Ciapetti |
spellingShingle |
Donatella Granchi Enrique Gómez-Barrena Markus Rojewski Philippe Rosset Pierre Layrolle Benedetta Spazzoli Davide Maria Donati Gabriela Ciapetti Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative Approach Stem Cells International |
author_facet |
Donatella Granchi Enrique Gómez-Barrena Markus Rojewski Philippe Rosset Pierre Layrolle Benedetta Spazzoli Davide Maria Donati Gabriela Ciapetti |
author_sort |
Donatella Granchi |
title |
Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative Approach |
title_short |
Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative Approach |
title_full |
Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative Approach |
title_fullStr |
Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative Approach |
title_full_unstemmed |
Changes of Bone Turnover Markers in Long Bone Nonunions Treated with a Regenerative Approach |
title_sort |
changes of bone turnover markers in long bone nonunions treated with a regenerative approach |
publisher |
Hindawi Limited |
series |
Stem Cells International |
issn |
1687-966X 1687-9678 |
publishDate |
2017-01-01 |
description |
In this clinical trial, we investigated if biochemical bone turnover markers (BTM) changed according to the progression of bone healing induced by autologous expanded MSC combined with a biphasic calcium phosphate in patients with delayed union or nonunion of long bone fractures. Bone formation markers, bone resorption markers, and osteoclast regulatory proteins were measured by enzymatic immunoassay before surgery and after 6, 12, and 24 weeks. A satisfactory bone healing was obtained in 23 out of 24 patients. Nine subjects reached a good consolidation already at 12 weeks, and they were considered as the “early consolidation” group. We found that bone-specific alkaline phosphatase (BAP), C-terminal propeptide of type I procollagen (PICP), and beta crosslaps collagen (CTX) changed after the regenerative treatment, BAP and CTX correlated to the imaging results collected at 12 and 24 weeks, and BAP variation along the healing course differed in patients who had an “early consolidation.” A remarkable decrease in BAP and PICP was observed at all time points in a single patient who experienced a treatment failure, but the predictive value of BTM changes cannot be determined. Our findings suggest that BTM are promising tools for monitoring cell therapy efficacy in bone nonunions, but studies with larger patient numbers are required to confirm these preliminary results. |
url |
http://dx.doi.org/10.1155/2017/3674045 |
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