Bone marrow aspirates contain connective tissue progenitor cells which can proliferate to form cell colonies that express connective tissue phenotypes. The number of osteogenic connective tissue progenitor cells can be estimated by counting colonies that express alkaline phosphatase, an early marker of osteoblastic differentiation. Because tobacco use is associated with decreased bone mass and fracture nonunion, we tested the hypothesis that current or previous tobacco use is an independent determinant of marrow cellularity or prevalence of osteogenic connective tissue progenitor cells among marrow-derived cells. Marrow aspirates were obtained from the anterior iliac crest of 62 patients who were grouped as never smoked, past smokers, or current smokers. The number of nucleated cells per aspirate was determined. Cells were cultured for 6 days in osteogenic media. The prevalence of osteogenic connective tissue progenitor cells was determined by counting colony forming units. The area of each colony was assessed using quantitative image analysis. Cellularity of bone marrow was found to decrease with age. We observed no relationship between smoking status and marrow cellularity, colony prevalence, or colony area. This suggests that tobacco use is not associated with a change in prevalence of osteogenic connective tissue progenitor cells in bone marrow, or their intrinsic biologic capacity to undergo early osteoblastic differentiation.
Level of evidence: Diagnostic Study, Level I (testing of previously developed diagnostic criteria on consecutive patients--with universally applied reference "gold" standard). See the Guidelines for Authors for a complete description of levels of evidence.