Physical Activity and Bone Vascularization: A Way to Explore in Bone Repair Context?

Abstract

Physical activity is widely recognized as a biotherapy by WHO in the fight and prevention of bone diseases such as osteoporosis. It reduces the risk of disabling fractures associated with many comorbidities, and whose repair is a major public health and economic issue. Bone tissue is a dynamic supportive tissue that reshapes itself according to the mechanical stresses to which it is exposed. Physical exercise is recognized as a key factor for bone health. However, the effects of exercise on bone quality depend on exercise protocols, duration, intensity, and frequency. Today, the effects of different exercise modalities on capillary bone vascularization, bone blood flow, and bone angiogenesis remain poorly understood and unclear. As vascularization is an integral part of bone repair process, the analysis of the preventive and/or curative effects of physical exercise is currently very undeveloped. Angiogenesis–osteogenesis coupling may constitute a new way for understanding the role of physical activity, especially in fracturing or in the integration of bone biomaterials. Thus, this review aimed to clarify the link between physical activities, vascularization, and bone repair.

Molecular mechanisms of exercise contributing to tissue regeneration

“…Subsequently, a set of researches have clarified that exercise stimulates angiogenesis during bone defect healing, accelerating bone regeneration as well. 94 , 95 …”

“… 281 , 282 Several studies have revealed that both endurance and resistance exercise increase the expression of VEGF in the brain, heart, skeletal muscle, and bones. 95 , 283 , 284 HIIT training contributed to an overall increase in the expression levels of VEGF and VEGF receptor-2 (VEGFR2) in skeletal muscle of subjects with peripheral myopathy associated with heart failure, promoting muscle capillarization, 285 and differentially expressed genes of the skeletal muscle showed the PI3K/Akt signaling pathway was activated in response to HIIT. 286 Of note, it has been found that the PI3K/Akt axis is not only activated by a range of exerkines mentioned above, but also in response to mechanical stress.…”

“…Subsequently, a set of researches have clarified that exercise stimulates angiogenesis during bone defect healing, accelerating bone regeneration as well. 94,95 Chondral injury is a pathology with high prevalence, reaching as much as 63% of general population and 36% among athletes. 96,97 Despite inappropriate or excessive exercise primarily aggravates joint damage, moderate exercise is recognized to exert a beneficial effect on the healing of osteoarthritis.…”

Role of Traditional Chinese Medicine in Bone Regeneration and Osteoporosis

“…Malfunctioning of vasculature induces bone diseases, skeletal aging, and blood disorders ( Chen et al, 2020 ). Physical activity can improve blood supply and vascularization to an organ, however, the curative/preventive potentials of physical activity on bone repair due to contribution of vascularization due to such activities have not been investigated specifically ( Wazzani et al, 2021 ). The two major components Icaritin and Icariin of Epimedium sagittatum (Yin Yang Huo) also known as Herba Epimedii (HE) have been shown to have prominent effects in vascularization and bone formation.…”

Effects of Exercise or Mechanical Stimulation on Bone Development and Bone Repair

“…Although works investigating the effects of exercise on global vascularization have shown that exercise increases the circulating endothelial progenitor cells and angiogenic factors, specific studies on the response of angiogenesis to physical exercise during osteogenesis in humans are still lacking. New technology that allows for noninvasion monitoring of angiogenesis in patients may provide the necessary clinical data to understand how mechanical loading regulates angiogenesis and osteogenesis [ 62 ].…”