Does long-term ischemia affect the oxidant status during fracture healing?

Cetinus, Ercan; Kılınç, Metin; Üzel, Murat; İnanç, Fatma; Kurutaş, Ergül Belge; Bilgic, Erkal; Karaoguz, Ahmet

doi:10.1007/s00402-005-0825-3

Cited by 21 publications

(17 citation statements)

References 22 publications

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“…As in some other clinical trials (Prasad et al 2003), the levels of NO were found to be high especially on the postfracture 7th and 14th days in the present study. These fi ndings show that NO production increases in an signifi cant amount in the 2nd and 3rd weeks of fracture, when the most intense oxidative stress occurs (Gokturk et al 1995;Prasad et al 2003;Petrovich et al 2004;Yeler et al 2005;Cetinus et al 2005). The extreme production of NO may cause peroxynitrite-related tissue damage and a consequent disturbance of fracture healing, especially at the 2nd and 3rd weeks following the fracture.…”

Section: Discussionmentioning

confidence: 94%

“…Ischemia-reperfusion mechanisms may cause an oxidative stress injury in a fractured extremity. Some studies indicate that oxidative stress occurred especially on the 7th and 14th days after the fracture (Gokturk et al 1995;Prasad et al 2003;Petrovich et al 2004;Yeler et al 2005;Cetinus et al 2005). The common idea in those studies is as follows: the fi rst few days of fracture healing is the ischemia period and no oxidative stress injury occurs during this time.…”

Section: Discussionmentioning

confidence: 99%

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Time-Dependent Changes in Serum Nitric Oxide Levels after Long Bone Fracture

Keskin

Kızıltunç

2007

Tohoku J. Exp. Med.

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Nitric oxide (NO) is a free radical of physiological signifi cance. The changes in the production of NO during the fracture healing process are not well known. This clinical prospective study was planned to determine these changes in patients with fractured long bone(s), who underwent surgery in the 3rd week after fracture. The patients were divided into two groups: 20 patients with an isolated femoral fracture and 20 patients with multiple fractures, including a femoral fracture. Venous blood was drawn from the healthy volunteers (n = 20) once, and from the patients seven times during 21 days after fracture. NO level was measured as nitrite in each serum sample. The serum NO levels at all measurements of the patients were signifi cantly higher than those of the control subjects. The timedependent changes in the NO levels were similar in both patient groups. The serum NO levels were highest in the fi rst 6 hrs, and then decreased to the lowest level on the 3rd day. Subsequently, there was an increasing trend on the 5th, 7th and 14th days. At all times of the measurements, the NO levels were higher in patients with multiple fractures than in those with the femoral fracture, with the signifi cant difference observed at the 6 hrs and on the 7th day. The NO levels were decreased on the 21st day after surgery. The present study suggests that NO production may be increased in considerable amounts during the fi rst 2 weeks of fracture healing, particularly in the fi rst 6 hrs.human; bone; fracture; blood; nitric oxide © 2007 Tohoku University Medical PressNitric oxide (NO) is a physiological free radical, synthesized from the amino acid L-arginine by the 3 NO synthase (NOS) isoforms; neuronal NOS (nNOS), endothelial NOS (eNOS) and inducible NOS (iNOS). It functions in vascular regulation, host immune defense, neurotransmission, and other systems. While some diseases, like vascular dysfunctions, impair NO production, some diseases, like septic schock, cerebral infarction, diabetes mellitus and neurodegenerative disorders, augment NO production (Mori and Gotoh 2004). It is not clear how NO affects bone cells. Some studies show that NO has a biphasic effect on bone cell activity. It has been stated that moderate concentrations of NO produced by eNOS in the bone is necessary for normal osteoblast growth and fracture healing (Ralston 1997;Corbett et al. 1999). However, it was suggested that high concentrations of NO produced by cytokine-induced iNOS activity may inhibit the

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Time-Dependent Changes in Serum Nitric Oxide Levels after Long Bone Fracture

Keskin

Kızıltunç

2007

Tohoku J. Exp. Med.

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“…So they consider that fracture causes oxidative stress like IR injury, and endogenous antioxidant defense systems may be insufficient to overcome the increased oxidative stress during the first month of fracture healing. Cetinus et al [33] reported that oxidative stress occurring from fracture was increased in callus bone tissue by applying IR. In our study; MDA and PCO levels showing oxidative stress was increased in bone tissue significantly after IR.…”

Section: Discussionmentioning

confidence: 98%

Effect of Preconditioned Hyperbaric Oxygen and Ozone on Ischemia-Reperfusion Induced Tourniquet in Skeletal Bone of Rats

Koca

Yurttaş

Bïlgïç

et al. 2010

Journal of Surgical Research

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“…The increased levels of oxidative enzymes during the Table 4 The descriptive data of the mean values, standard deviations and p values related to kidney histopathology for each group. healing processes can explain the delay of healing observed in the DEXT and MEL groups because free oxygen radicals are known to impair bone healing [46][47][48]. However, NSAIDs affect the bone fracture healing process through the inhibition of both COX and PGs.…”

Section: Discussionmentioning

confidence: 99%