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132. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

28.04. - 01.05.2015, München

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Tnf-alpha and osteoclastogenesis is upregulated in human scaphoid non-unions in comparison to cancellous bone from the distal radius

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  • Björn Behr - BG Universitätsklinikum Bergmannsheil Bochum, Klinik für Plastische Chirurgie, Bochum, Deutschland
  • Carmen Döbele - BGU Ludwigshafen, Klinik für Plastische Chirurgie, Ludwigshafen, Deutschland
  • Matthias Schulte - BGU Ludwigshafen, Klinik für Plastische Chirurgie, Ludwigshafen, Deutschland
  • Christoph Wallner - BG Universitätsklinikum Bergmannsheil Bochum, Klinik für Plastische Chirurgie, Bochum, Deutschland
  • Adrien Daigeler - BG Universitätsklinikum Bergmannsheil Bochum, Klinik für Plastische Chirurgie, Bochum, Deutschland
  • Ulrich Kneser - BGU Ludwigshafen, Klinik für Plastische Chirurgie, Ludwigshafen, Deutschland
  • Marcus Lehnhardt - BG Universitätsklinikum Bergmannsheil Bochum, Klinik für Plastische Chirurgie, Bochum, Deutschland
  • Jessica Schira - BG Universitätsklinikum Bergmannsheil Bochum, Klinik für Plastische Chirurgie, Bochum, Deutschland

Deutsche Gesellschaft für Chirurgie. 132. Kongress der Deutschen Gesellschaft für Chirurgie. München, 28.04.-01.05.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15dgch624

doi: 10.3205/15dgch624, urn:nbn:de:0183-15dgch6248

Published: April 24, 2015

© 2015 Behr et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Introduction: The scaphoid bone has the highest prevalence for non-union in the human body. Even with adequate treatment, bone regeneration does not occur in many instances. Although this condition is well described, the molecular pathology of scaphoid non-unions is still poorly defined.

Material and methods: In this project, gene expression of osteogenic, inflammatory and angiogenic growth and transcription factors was analyzed in human scaphoid non-unions and compared to adjacent autologous cancellous bone from the distal radius in 72 patients. In addition, histology and immunohistochemistry was performed.

Results: Our data show a significant upregulation of TNF-a, RANKL and WNT5a in scaphoid non-unions, indicating chronic inflammation and increased osteoclast activity. Interestingly, TNF-a was highly upregulated in all samples (mean: 9.7 fold upregulation, SEM: 10.5). In addition, markers for acute inflammation such as IL-1β or IFN-γ were not detectable in neither tissue. With respect to genes related to osteogenesis, alkaline phosphatase was significantly upregulated in scaphoid non-unions. No differences were detectable for other osteogenic genes such as RUNX-2 or BMP-2. To our surprise, we did not find differences in angiogenesis between the scaphoid non-unions and control bone. TRAP staining and immunohistochemistry data confirmed these observations.

Conclusion: Summarized, our data show a dramatic upregulation of TNF-a and genes involved in osteoclastogenesis in scaphoid non-unions. These data can increase our understanding for the reduced bone regeneration capacity present in scaphoid non-unions and may translate into the identification of new therapeutic targets in order to avoid secondary damages and prevent occurrence of non-unions to scaphoid bones.