Systemic effects of severe trauma on the function and apoptosis of human skeletal cells

J Bone Joint Surg Br. 2006 Oct;88(10):1394-400. doi: 10.1302/0301-620X.88B10.17139.

Abstract

Systemic factors are believed to be pivotal for the development of heterotopic ossification in severely-injured patients. In this study, cell cultures of putative target cells (human fibroblastic cells, osteoblastic cells (MG-63), and bone-marrow stromal cells (hBM)) were incubated with serum from ten consecutive polytraumatised patients taken from post-traumatic day 1 to day 21 and with serum from 12 healthy control subjects. The serum from the polytraumatised patients significantly stimulated the proliferation of fibroblasts, MG-63 and of hBM cells. The activity of alkaline phosphatase in MG-63 and hBM cells was significantly decreased when exposed to the serum of the severely-injured patient. After three weeks in 3D cell cultures, matrix production and osteogenic gene expression of hBM cells were equal in the patient and control groups. However, the serum from the polytraumatised patients significantly decreased apoptosis of hBM cells compared with the control serum (4.3% vs 19.1%, p = 0.031). Increased proliferation of osteoblastic cells and reduced apoptosis of osteoprogenitors may be responsible for increased osteogenesis in severely-injured patients.

MeSH terms

  • Adult
  • Alkaline Phosphatase / metabolism
  • Apoptosis / physiology*
  • Bone Marrow / pathology
  • Cell Division / physiology
  • Cells, Cultured
  • Connective Tissue Cells / physiology*
  • Extracellular Matrix / pathology
  • Female
  • Fibroblasts / physiology
  • Gene Expression
  • Humans
  • Injury Severity Score
  • Intercellular Signaling Peptides and Proteins / blood
  • Male
  • Middle Aged
  • Ossification, Heterotopic / pathology
  • Ossification, Heterotopic / physiopathology
  • Osteoblasts / physiology
  • Osteogenesis / physiology
  • RNA, Messenger / analysis
  • Reverse Transcriptase Polymerase Chain Reaction / methods
  • Stromal Cells / physiology
  • Wounds and Injuries / blood
  • Wounds and Injuries / pathology
  • Wounds and Injuries / physiopathology*

Substances

  • Intercellular Signaling Peptides and Proteins
  • RNA, Messenger
  • Alkaline Phosphatase