Marrow changes in paraplegic patients

Minaire, P; Edouard, C.; Arlot, M; Meunier, P

doi:10.1007/bf02405340

Cited by 122 publications

(78 citation statements)

References 5 publications

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“…However, it has been suggested that soft-tissue variation and disproportionate marrow fat fractions 47 may increase DEXA's potential for systematic measurement inaccuracies. Although changes to apparent soft-tissue densities 39,48,49 and marrow constituents are known to occur during the acute/subacute injury phases, FM and BMD did not differentiate FES and CON groups at either subacute or rehabilitation/ recovery points.…”

Section: Effects Of Fat Mass and Lean Mass Upon Bmd Measuresmentioning

confidence: 99%

Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss

Clark

Jelbart

Rischbieth³

et al. 2006

Spinal Cord

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Study design: Controlled, repeat-measures study. Objectives: To determine if functional electrical stimulation (FES) can affect bone atrophy in early spinal cord injury (SCI), and the safety, tolerance and feasibility of this modality in bone loss remediation. Setting: Spinal Injuries Units, Royal Adelaide Hospital and Hampstead Rehabilitation Centre, South Australia. Methods: Patients with acute SCI (ASIA A-D) were allocated to FES (n ¼ 23, 2879 years, C4-T10, 13 Tetra) and control groups (CON, n ¼ 10, 31711 years, C5-T12, four Tetra). The intervention group received discontinuous FES to lower limb muscles (15 min sessions to each leg twice daily, over a 5-day week, for 5 months). Dual energy X-ray absorptiometry (DEXA) measured total body bone mineral density (tbBMD), hip, spine BMD and fat mass (FM) within 3 weeks, and 3 and 6 months postinjury. Results: FES and CON groups' tbBMD differed significantly at 3 months postinjury (Po0.01), but not thereafter. Other DEXA measures (hip, spine BMD, FM) did not differ between groups at any time. No adverse events were identified. Conclusion: Electrically stimulated muscle activation was elicited, and tetanic effects were reproducible; however, there were no convincing trends to suggest that FES can play a clinically relevant role in osteoporosis prevention (or subsequent fracture risk) in the recently injured patient. The lack of an osteogenic response in paralysed extremities to electrically evoked exercise during subacute and rehabilitation/recovery phases cannot be fully explained, and may warrant further evaluation.Spinal Cord (2007) 45, 78-85.

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Section: Effects Of Fat Mass and Lean Mass Upon Bmd Measuresmentioning

confidence: 99%

Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss

Clark

Jelbart

Rischbieth³

et al. 2006

Spinal Cord

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“…Recent studies have also demonstrated an increase in neutrophils, natural killer cells, and lymphocytes and a decrease in monocytes in patients subjected to 60 days of bed rest (38). Finally, bone marrow adipocytes increase in patients with spinal cord injury (58) and after long-term bed-rest (91).…”

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confidence: 96%

Effects of hibernation on bone marrow transcriptome in thirteen-lined ground squirrels

Cooper

Sell

Fahrenkrog

et al. 2016

Physiological Genomics

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M. Effects of hibernation on bone marrow transcriptome in thirteen-lined ground squirrels. Physiol Genomics 48: 513-525, 2016. First published May 20, 2016 doi:10.1152/physiolgenomics.00120.2015.-Mammalian hibernators adapt to prolonged periods of immobility, hypometabolism, hypothermia, and oxidative stress, each capable of reducing bone marrow activity. In this study bone marrow transcriptomes were compared among thirteen-lined ground squirrels collected in July, winter torpor, and winter interbout arousal (IBA). The results were consistent with a suppression of acquired immune responses, and a shift to innate immune responses during hibernation through higher complement expression. Consistent with the increase in adipocytes found in bone marrow of hibernators, expression of genes associated with white adipose tissue are higher during hibernation. Genes that should strengthen the bone by increasing extracellular matrix were higher during hibernation, especially the collagen genes. Finally, expression of heat shock proteins were lower, and cold-response genes were higher, during hibernation. No differential expression of hematopoietic genes involved in erythrocyte or megakaryocyte production was observed. This global view of the changes in the bone marrow transcriptome over both short term (torpor vs. IBA) and long term (torpor vs. July) hypothermia can explain several observations made about circulating blood cells and the structure and strength of the bone during hibernation. erythrocyte; leukocyte; megakaryocyte; osteoblast; adipose BONE MARROW IS A COMPLEX ORGAN consisting of many different cell types and stem cell pools. These cells express both unique and common sets of genes and likely influence each other's activities. Hematopoietic stem cells can differentiate into lymphoid progenitor cells that produce natural killer cells and lymphocytes, or into myeloid progenitor cells that give rise to erythrocytes, the remaining leukocytes, and megakaryocytes. Megakaryocytes in turn shed anucleated platelets involved in blood clotting and inflammation. Bone marrow resident mesenchymal stem cells can differentiate to produce resident bone cells including osteoblasts, adipocytes, and chondrocytes (64). Osteoblasts can terminally differentiate into osteocytes and are involved in maintaining bone strength and extracellular matrix production. Bone marrow adipose composition is affected by age, diet, and disease states. Bone marrow may also contain skeletal muscle and hepatocyte stem cell pools. Because of the rapid rate of mitosis by multiple resident stem cell pools, bone marrow is sensitive to damage by radiation and chemotherapy, leaving patients immunocompromised and anemic (25). Bone mineral density and collagen are decreased by prolonged disuse such as bed rest or immobilization (45,86). Recent studies have also demonstrated an increase in neutrophils, natural killer cells, and lymphocytes and a decrease in monocytes in patients subjected to 60 days of bed rest (38). Finally, bone marrow adipocytes increase in ...

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“…Since BM is less di erentiated than trabecular bone surface-derived OB, the presence in our culture of various relative quantities of BM and OB could explain the di erence in our results according to the groups. Paralytic patients have been shown to have less red bone marrow, related to a lower BMC, BMD and TBV, 9 in their trabecular bone than that of the control model. However, this hypothesis does not explain the di erence between spastic and¯accid patients.…”

Section: Discussionmentioning

confidence: 97%

“…2 Although the physiopathological mechanism behind osteopenia is not really the same, paralytic patients with spinal cord injuries (SCI) also show a loss of bone in areas located below the lesion caused by an early increase of bone remodeling. 6 ± 8 This osteoporo-sis is also characterized by lower bone mineral content (BMC), bone mineral density (BMD), decreased trabecular bone volume (TBV) 9 and an increased osteoclastic resorption surface. 6 These changes are accompanied by changes in the biochemical markers.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of the in vitro characteristics of osteoblasts from paralytic and non-paralytic children

et al. 2000

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Study design: Cerebral palsy is known to provoke a high loss of bone in children and adults. The potential interest of human osteoblastic cell culture for assessing the osteoblastic function in metabolic bone disorders has been demonstrated by many previous studies. Few studies have attempted to evaluate the capacities of osteoblasts isolated from immobilized or normal bones by in vitro culture methods. Moreover, a few teams did make the distinction between young spastic and¯accid patients. Objectives: We attempted to characterize mature osteoblasts (OB) and bone marrow-stromal cells (BM) originating from 56 immobile and normal children. Spastic and¯accid patients formed the paralytic group. Setting: France. Methods: Osteoblasts and bone marrow cells were isolated from iliac crests obtained during pelvic osteotomies of young control and paralytic patients. The in vitro viability, proliferation and di erentiation parameters of the cells from paralytic patients were compared with those of cells coming from normal controls. Results: No signi®cant di erences in the cell proliferation parameters were observed between the two groups. Only initial cell viability before inoculation was lower for the paralytic group, compared to the control group. On the other hand, contrary to expectations, we found that fresh and thawed OB cells from¯accid patients synthesized more osteocalcin and more collagen respectively than those of the spastic and control groups. Opposite results were obtained from BM cultures. Conclusion: A negative feedback mechanism by systemic or local factors, which is not conserved in vitro but controls the in vivo osteocalcin and collagen synthesis of¯accid paralytic OB cells, is hypothesized. Because these¯accid patients are known to have a high fat/lean mass, we suggest that leptin may be the potential regulating factor implicated in the hypothesized negative feedback mechanism. Spinal Cord (2000) 38, 622 ± 629

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Marrow changes in paraplegic patients

Cited by 122 publications

References 5 publications

Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss

Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss

Effects of hibernation on bone marrow transcriptome in thirteen-lined ground squirrels

Comparative study of the in vitro characteristics of osteoblasts from paralytic and non-paralytic children

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