Release of growth factors and the effect of age, sex, and severity of injury after long bone fracture.

Background and purpose The systemic response after fracture is regulated by a complex mechanism involving numerous growth factors. In this study, we analyzed the kinetics of key growth factors following lower-limb long bone fracture. Materials and methods Human serum was isolated from 15 patients su...

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Publicado en:Acta Orthopaedica Vol. 84; no. 1; pp. 65 - 71
Autores principales: Pountos, Ippokratis, Georgouli, Theodora, Henshaw, Karen, Bird, Howard, Giannoudis, Peter V
Formato: research tables/charts Journal Article
Publicado: Medical Journals Sweden AB Feb2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2013
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        10.3109/17453674.2013.765624
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        atl: Release of growth factors and the effect of age, sex, and severity of injury after long bone fracture.
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          Pountos, Ippokratis
          Georgouli, Theodora
          Henshaw, Karen
          Bird, Howard
          Giannoudis, Peter V
        affil: Academic Department of Trauma and Orthopaedics
      sug:
        subj:
          Tibial Fractures Surgery
          Growth Substances Blood
          Femoral Fractures Surgery
          Human
          Descriptive Statistics
          Data Analysis Software
          Biological Markers
          Male
          Female
          Adult
          Middle Age
          Aged
          Control Group
          Analysis of Variance
          Pearson's Correlation Coefficient
          T-Tests
          Mann-Whitney U Test
          Confidence Intervals
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background and purpose The systemic response after fracture is regulated by a complex mechanism involving numerous growth factors. In this study, we analyzed the kinetics of key growth factors following lower-limb long bone fracture. Materials and methods Human serum was isolated from 15 patients suffering from lower-limb long bone fracture (tibia/femur) requiring surgical fixation. The levels of platelet-derived growth factor (PDGF-BB), vascular edothelial growth factor (VEGF), insulin growth factor-I (IGF-I), and transforming growth factor β1 (TGF-β1) were assayed by colorimetric ELISA at different time points during the first week after fracture. 10 healthy volunteers made up the control group of the study. Serum levels of the growth factors measured were compared to age, sex, and injury severity score. Results We found that there was a decline in the levels of PDGF-BB, IGF-I and TGF-β1 during the first 3 days after fracture. However, VEGF levels remained unchanged. The levels of all the growth factors studied then increased, with the highest concentrations noted at day 7 after surgery. No correlation was found between circulating levels of growth factors and age, injury severity score (ISS), blood loss, or fluid administration. Interpretation There are systemic mitogenic and osteogenic signals after fracture. Important growth factors are released into the peripheral circulation, but early after surgery it appears that serum levels of key growth factors fall. By 7 days postoperatively, the levels had increased considerably. Our findings should be considered in cases where autologous serum is used for ex vivo expansion of mesenchymal stem cells. There should be further evaluation of the use of these molecules as biomarkers of bone union.
      pubtype: Academic Journal
      doctype:
        research
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        Journal Article
      ougenre: Article
    language: English
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