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5. Elevated transforming growth factor-beta 1 (TGF-β1) levels in human fracture healing.

Author

Sarahrudi K, Thomas A, Mousavi M, Kaiser G, Köttstorfer J, Kecht M, Hajdu S, Aharinejad S, Sarahrudi, Kambiz, Thomas, Anita, Mousavi, Mehdi, Kaiser, Georg, Köttstorfer, Julia, Kecht, Mathias, Hajdu, S, and Aharinejad, S

Abstract

Introduction: Transforming growth factor-beta 1(TGF-β1) is a regulatory protein, involved in bone fracture healing. Circulating TGF-β1 levels have been reported to be a predictor of delayed bone healing and non-union, suggesting active relationship between tissue and circulating TGF-β1 in fracture healing. The purpose of this study was to analyse TGF-β1 local and serum concentrations in fracture healing to further contribute to the understanding of molecular regulation of fracture healing.Patients and Methods: Serum samples of 113 patients with long bone fractures were collected over a period of 6 months following a standardised time schedule. TGF-β1 serum concentrations were measured using ELISA. Patients were assigned to 2 groups: Group 1 contained 103 patients with physiological healing. Group 2 contained 10 patients with impaired healing. Patients in both groups were matched. One patient of the group 2 had to be excluded because of missing match partner. In addition, fracture haematoma from 11 patients of group 1 was obtained to analyse local TGF-β1 concentrations. 33 volunteers donated serum which served as control.Results: TGF-β1 serum concentrations increased during the early healing period and were significantly higher in patients with physiological healing compared to controls (P=0.04). Thereafter, it decreased continuously between weeks 2 and 8 and fell again after week 8. TGF-β1 serum concentrations in patients with physiological healing were significantly higher at week 24 compared to controls (P=0.05). In non-unions, serum concentrations differed significantly from those of controls at week 6 (P=0.01). No significant difference in between patients with physiological and impaired fracture healing was observed. Fracture haematoma contained significantly higher TGF-β1 concentrations than peripheral serum of the patients (P=0.017).Conclusion: Elevated levels of TGF-β1 in haematoma and in serum after bone fracture especially during the entire healing process indicate its importance for fracture healing. [ABSTRACT FROM AUTHOR]

Published
2011
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6. Growth factor release in extra- and intramedullary osteosynthesis following tibial fracture

Author

A. Krumböck, Thomas Heinz, Anita Thomas, Vilmos Vécsei, Seyedhossein Aharinejad, Kambiz Sarahrudi, University of Zurich, and Sarahrudi, K

Subjects
Adult, Male, Vascular Endothelial Growth Factor A, medicine.medical_specialty, Time Factors, medicine.medical_treatment, 610 Medicine & health, Bone healing, law.invention, Intramedullary rod, Transforming Growth Factor beta1, chemistry.chemical_compound, Fixation (surgical), Fracture Fixation, Internal, Young Adult, 2732 Orthopedics and Sports Medicine, law, medicine, Humans, Tibial fracture, Tibia, 10266 Clinic for Reconstructive Surgery, General Environmental Science, Aged, Aged, 80 and over, Fracture Healing, Analysis of Variance, Osteosynthesis, business.industry, Growth factor, Macrophage Colony-Stimulating Factor, Middle Aged, Surgery, Fracture Fixation, Intramedullary, Vascular endothelial growth factor, Tibial Fractures, Treatment Outcome, chemistry, General Earth and Planetary Sciences, Female, 2711 Emergency Medicine, business, Bone Plates
Abstract

Introduction Recent studies indicate alterations of local and systemic growth factor level during fracture healing. As a result, osteogenic and angiogenic growth factors allow us to monitor fracture healing on a molecular level. We hypothesised that closed intramedullary (IM) reaming and nail fixation, in contrast to open reduction and internal plate fixation (ORIF), could exert an effect on the cellular elements present in the intramedullary canal, leading to increased release of mediators. The purpose of the study was to investigate whether different osteosynthesis techniques influence the released quantity of cytokines. Patients and methods A total of 34 patients with tibia fractures treated with IM fixation and 19 patients treated with ORIF were included in the study. In addition to clinical and radiological examination, serum concentrations of transforming growth factor beta 1(TGF-β1), macrophage-colony stimulating factor (M-CSF) and vascular endothelial growth factor (VEGF), were analysed at 1, 2, 4, 6, 8, 12, and 24 weeks after surgery. Results Expression of TGF-β1 and M-CSF was increased during the first 2 weeks of fracture healing in patients treated with the IM fixation technique compared with those treated by ORIF. After 24 weeks, M-CSF levels in patients with IM fixation were clearly higher. Conversely, VEGF levels were higher during the first 2 weeks of fracture healing in patients treated by ORIF compared with IM fixation. However, these results were not significant. Conclusion Our results show that 1 week after surgery neither reamed IM fixation nor ORIF of the tibia could increase the expression of VEGF, M-CSF and TGF-β1 in its favour.

Published
2010

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