Human osteoblast stimulation by sera from paraplegic patients with heterotopic ossification

Abstract

The pathophysiology of heterotopic periarticular ossification is not understood.Though local agents may be responsible, factors present in the serum may be contributory. Sera from 4 paraplegic patients with heterotopic ossification and 4 'normal' paraplegics were incubated with human osteoblasts in tissue culture and their metabolic acitivy was measured quantitatively. There were significantly greater levels of osteoblast stimulating factors present in the sera of ossifying patients, (p < 0.01). These factors may contribute to the pathogenesis of heterotopic ossification.

Ultrasound in the early diagnosis of heterotopic ossification in patients with spinal injuries

“…[17][18][19] The presence of raised growth hormone levels, osteocalcin, osteoblast stimulating factors such as bone morphogenetic protein etc may have a role in research, but not clinical evaluation. [20][21][22] Early diagnosis is currently difficult. Blood alkaline phosphatase levels rise be fore radiographic changes, but they are relatively nonspecific and are still raised 3 years after the initial event in approximately 55% of patients.…”

Identifying the Cellular Mechanisms Leading to Heterotopic Ossification

“…Current evidence suggests that the formation of ectopic bone in vivo requires three primary conditions: (1) a cell type capable of osteogenic differentiation, (2) the presence of inductive agents, (3) a permissive local environment [23]. However, despite continued efforts to identify the cellular and molecular events leading to HO, the mechanisms of pathogenesis continue to remain elusive.…”

Neurogenic heterotopic ossification in spinal cord injury

“…77,78 Humoral factors Recent work with the serum of traumatic brain injured (TBI) and SCI patients seems to indicate that humoral mechanisms may be involved. 79,80 In the study of Binder, 79 the serum of a TBI patient increased the osteoblast growth factor activity in foetal rats. Kurer et al 80 incubated sera from SCI patients with and without NHO 4 ± 7 months post injury and sera from healthy control subjects with human osteoblasts in tissue culture.…”