1. A Pronounced Inflammatory Activity Characterizes the Early Fracture Healing Phase in Immunologically Restricted Patients.
- Author
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Hoff P, Gaber T, Strehl C, Jakstadt M, Hoff H, Schmidt-Bleek K, Lang A, Röhner E, Huscher D, Matziolis G, Burmester GR, Schmidmaier G, Perka C, Duda GN, and Buttgereit F
- Subjects
- Angiogenesis Inducing Agents metabolism, Bone Marrow immunology, Bone Marrow metabolism, Bone Marrow pathology, Case-Control Studies, Cytokines metabolism, Female, Fractures, Bone immunology, Fractures, Bone pathology, Hematoma immunology, Hematoma pathology, Hematopoietic Stem Cells immunology, Hematopoietic Stem Cells metabolism, Humans, Inflammation metabolism, Inflammation pathology, Inflammation Mediators metabolism, Leukocytes immunology, Leukocytes metabolism, Leukocytes pathology, Male, Neovascularization, Physiologic, Phenotype, Fracture Healing immunology, Immunocompromised Host, Inflammation immunology
- Abstract
Immunologically restricted patients such as those with autoimmune diseases or malignancies often suffer from delayed or insufficient fracture healing. In human fracture hematomas and the surrounding bone marrow obtained from immunologically restricted patients, we analyzed the initial inflammatory phase on cellular and humoral level via flow cytometry and multiplex suspension array. Compared with controls, we demonstrated higher numbers of immune cells like monocytes/macrophages, natural killer T (NKT) cells, and activated T helper cells within the fracture hematomas and/or the surrounding bone marrow. Also, several pro-inflammatory cytokines such as Interleukin (IL)-6 and Tumor necrosis factor α (TNFα), chemokines (e.g., Eotaxin and RANTES), pro-angiogenic factors (e.g., IL-8 and Macrophage migration inhibitory factor: MIF), and regulatory cytokines (e.g., IL-10) were found at higher levels within the fracture hematomas and/or the surrounding bone marrow of immunologically restricted patients when compared to controls. We conclude here that the inflammatory activity on cellular and humoral levels at fracture sites of immunologically restricted patients considerably exceeds that of control patients. The initial inflammatory phase profoundly differs between these patient groups and is probably one of the reasons for prolonged or insufficient fracture healing often occurring within immunologically restricted patients.
- Published
- 2017
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