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. 2020 Sep;22(3):2521-2527.
doi: 10.3892/mmr.2020.11320. Epub 2020 Jul 9.

Influence of reaming intramedullary nailing on MSC population after surgical treatment of patients with long bone fracture

Ioannis Sperelakis  1 , Eliza Tsitoura  2 , Chara Koutoulaki  2 , Semeli Mastrodimou  2 , Theodoros H Tosounidis  1 , Demetrios A Spandidos  3 , Katerina M Antoniou  2 , George Kontakis  1
Affiliations

Influence of reaming intramedullary nailing on MSC population after surgical treatment of patients with long bone fracture

Ioannis Sperelakis et al. Mol Med Rep. 2020 Sep.

Abstract

Reamed intramedullary nailing (RIN) is a surgical method of choice for treatment of diaphyseal fractures. This procedure affects the biological environment of bone tissue locally and systemically. This study investigated the influence of RIN on mesenchymal stem cells (MSCs) in patients with long bone fractures. The axis of C-X-C motif chemokine receptor 4 (CXCR4)/stromal cell-derived factor 1 (SDF‑1) was selected since it is considered as major pathway for MSC homing and migration. Iliac crest bone marrow (IC‑BM) samples and blood samples were collected at two different time points. One sample was collected before the RIN (BN) and the other immediately after RIN (AN). BM‑MSCs were cultured and RT‑qPCR was performed for CXCR4 mRNA levels and ELISA for the SDF‑1 sera levels. The experimental study revealed that there was a correlation between the increase of SDF‑1 levels in peripheral blood and a decrease in the levels of CXCR4 in MSCs in the IC‑BM following RIN. The levels of SDF‑1 showed a significant increase in the sera of patients after RIN. In conclusion, the present study is the first providing evidence of the effects of RIN on MSC population via the CXCR4/SDF‑1 axis. The levels of serum SDF‑1 factor were elevated after RIN while increased levels of SDF‑1 in peripheral blood were inversely correlated with the mRNA levels of CXCR4 on BM‑MSCs after RIN. Therefore, this study contributes to enlighten the systematic effects of RIN on the population of MSCs at a cellular level.

Keywords: reaming intramedullary nailing; long bone fracture; mesenchymal stem cells; SdF-1; cXcr4.

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Figures

Figure 1.
Figure 1.
DT of BN and AN samples are similar. DT of MSCs prior to and following RIN procedure according to each patient, calculated as described in methods. DT, doubling time; RIN, reamed intramedullary nailing; BN, before RIN; AN, after RIN.
Figure 2.
Figure 2.
SDF-1 increases in the serum of patients following RIN. (A) Mean levels of SDF-1 measured by ELISA in sera of patients prior to and following RIN procedure. (B) Comparison of serum SDF-1 levels per patient. (*P<0.05, paired t-test). SDF-1, stromal cell-derived factor 1; RIN, reamed intramedullary nailing; BN, before the RIN; AN, after RIN.
Figure 3.
Figure 3.
Change of CXCR4 mRNA following RIN. (A) CXCR4 mRNA levels in patients following RIN relative to baseline levels (BN). (B) CXCR4 mRNA levels between IN and AN samples relative to baseline levels (BN). CXCR4, C-X-C motif chemokine receptor 4; RIN, reamed intramedullary nailing; BN, before RIN; AN, after RIN; IN, intramedullary nailing.
Figure 4.
Figure 4.
Inverse correlation of serum SDF-1 and MSC CXCR4 changes following RIN. Scatter plot of changes in CXCR4 mRNA levels relative to changes in SDF-1 serum protein levels (Pearson r and P-value). SDF-1, stromal cell-derived factor 1; MSCs, mesenchymal stem cells; CXCR4, C-X-C motif chemokine receptor 4; RIN, reamed intramedullary nailing.
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References

    1. Zelle BA, Boni G. Safe surgical technique: Intramedullary nail fixation of tibial shaft fractures. Patient Saf Surg. 2015;9:40. doi: 10.1186/s13037-015-0086-1. - DOI - PMC - PubMed
    1. Hansen ST, Winquist RA. Closed intramedullary nailing of the femur. Küntscher technique with reaming. Clin Orthop Relat Res. 1979;138:56–61. - PubMed
    1. Brookes M. Blood supply of long bones. BMJ. 1963;2:1064–1065. doi: 10.1136/bmj.2.5364.1064-b. - DOI - PMC - PubMed
    1. Cuthbertson EM, Siris E, Gilfillan RS. The femoral diaphyseal medullary venous system as a venous collateral channel in the dog. J Bone Joint Surg Am. 1965;47:965–974. doi: 10.2106/00004623-196547050-00006. - DOI - PubMed
    1. Pape HC, Giannoudis P. The biological and physiological effects of intramedullary reaming. J Bone Joint Surg Br. 2007;89:1421–1426. doi: 10.1302/0301-620X.89B11.19570. - DOI - PubMed