Fracture healing and bone repair: an update

Abstract

Bone healing represents a physiological process of repair and restoration of function. Recent advances in a variety of medical disciplines have enabled scientists and clinicians to characterise this phenomenon at the molecular level. A number of molecular mediators and cells interact utilising different pathways. Despite the involvement of many local and systemic factors failure of the naturally occurring mechanisms can occur leading to either delayed union or non-union. This review article is focused on the recent understanding of the mechanisms governing the bone repair process.

The Effect of HU308/TGF-β3 Combination on Wound healing, Cell Proliferation and Protein Secretion of MG-63 Osteoblast Monolayers

“…It has also been indicated that unlike the role of TGF-βI and II in inducing scar formation, TGF-β3 was shown to reduce scarring and promote better collagen organization in vivo [6]. There is limited research regarding the use of TGF-β isomers in bone cell engineering [7,8] and healing compared to other cell types such as keratinocytes [9,10]. The rationale for combining CB2 selective agonist with transforming growth factor-beta 3 arises from the idea that the cannabinoids that target CB2 receptor mainly act down-stream through the MAP Kinase pathway which are a link between membrane-bound receptors and the terminal changes of gene expression.…”

Benign and Malignant Cardiac and Mediastinal Masses in Children

“…Extensive remodeling of the newly formed bone follows these four concurrent processes and facilitates restoration of the full biomechanical integrity of the bone. A number of investigators have commented on the similarities between the repair process and embryonic bone formation [1,2,3]. Indeed, a number of specific events characteristic of embryonic bone formation are reiterated in fracture healing.…”

“…The major growth factors present in the fracture site are TGF-ß1, TGF-ß2, BMP-2, BMP-3, BMP-4, and BMP-7 (OP-1), PDGF, and acidic and basic FGF-1 and FGF-2, VEGF and insulin-like growth factor (IGF) [5,7,18,20]. Given the well described roles of these factors in embryonic bone development and in vitro effects on bone cells, these molecules are likely to be important regulators of fracture repair [3,6]. Of note, the signaling pathways utilized by these molecules can be categorized into distinct groups: dependent on receptor tyrosine kinases (FGFs, PDGF, VEGFs and IGF) and dependent on serine-threonine kinase receptors (TGF-ßs and BMPs) (Fig.…”

How to use BMP-2 for clinical applications? A review on pros and cons of existing delivery strategies

“…Long bone fractures are reported to occur in the western world at an incidence rate of 300-400 cases per 100,000 individuals per year [2,3] and heal in most cases without surgical intervention within 20 weeks [4]. The needs for a progressive union of bone fractures have been identified and defined as a so-called diamond shaped concept comprising the parameters: adequate cellular environment, sufficient growth factors, bone matrix and mechanical stability.…”