Postoperative radiation therapy after hip replacement in high-risk patients for development of heterotopic bone formation

Hashem, Rania; Tänzer, Michael; Rene, N.; Evans, Michael D.; Souhami, Luís

doi:10.1016/j.canrad.2010.10.003

Cited by 11 publications

(6 citation statements)

References 21 publications

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“…There are currently no local or systemic therapies that effectively treat HO, and surgical approaches have had limited efficacy [3], [4]. Radiation therapy is effective when it is delivered to prevent HO, but it is not beneficial once HO is formed [5]. Thus, a new therapy aimed at preventing and/or regressing HO would have enormous health benefits for a wide variety of patients.…”

Section: Introductionmentioning

confidence: 99%

An Inducible, Ligand-Independent Receptor Activator of NF-κB Gene to Control Osteoclast Differentiation from Monocytic Precursors

Rementer

Buranaphatthana

et al. 2013

PLoS ONE

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Osteoclasts are bone-resorbing cells that are critical for the normal formation and maintenance of teeth and skeleton. Osteoclast deficiency can contribute to heterotopic ossification (HO), a pathology that is particularly detrimental to the mechanical functions of joints, valves and blood vessels. On the other hand, osteoclast over-activity is a major cause of osteoporosis. A reliable method for controlled generation of osteoclasts would be useful as a potential autologous cell therapy for HO, as well as high-throughput drug screening for anti-osteoporotic drugs. In this report, we describe the development of a cell engineering approach to control monocytic precursor cell differentiation to osteoclasts. Oligomerization of receptor activator of nuclear factor κB (RANK) is known to be essential for osteoclast differentiation from monocyte/macrophage precursors. We engineered a murine monocytic cell line, RAW264.7 to express a fusion protein comprising the intracellular RANK signaling domain and FK506-derived dimerization domains that bind to a small molecule chemical inducer of dimerization (CID). Virally infected cells expressing this fusion protein were treated with CID and dose-dependent induction of tartrate-resistant acid phosphatase activity, as well as multinucleated osteoclast formation were observed. Furthermore, NF-κB signaling was upregulated in a CID-dependent fashion, demonstrating effective RANK intracellular signaling. Functionally CID-induced osteoclasts had robust mineral resorptive activity in both two-dimensional and three-dimensional in vitro resorption assays. In addition, the CID-induced osteoclasts have the same life span as native RANKL-induced osteoclasts. Most importantly and crucially, the engineered cells differentiated into osteoclasts that were resistant to the potent osteoclast inhibitor, osteoprotegerin. Taken together, these studies are the first to describe a method for inducible control of monocytic precursor differentiation to osteoclasts that may be useful for future development of an engineered autologous cell therapy as well as high-throughput drug testing systems to treat diseases of osteoclast over-activity that are independent of osteoprotegerin.

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Section: Introductionmentioning

confidence: 99%

An Inducible, Ligand-Independent Receptor Activator of NF-κB Gene to Control Osteoclast Differentiation from Monocytic Precursors

Rementer

Buranaphatthana

et al. 2013

PLoS ONE

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“…Radiation exposure of skeletal tissues can lead to bone loss and therefore is relevant to astronauts 1 2 3 4 5 6 7 8 9 , cancer patients undergoing radiotherapy 10 11 12 13 , radiation workers and victims of nuclear accidents 14 15 16 . Reduced bone density (osteopenia) and osteoporosis, are major health conditions affecting millions of people across the world, and osteoporotic patients are increasing with an aging population 17 .…”

mentioning

confidence: 99%

Dried plum diet protects from bone loss caused by ionizing radiation

Schreurs

Shirazi‐Fard

Shahnazari

et al. 2016

Sci Rep

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Bone loss caused by ionizing radiation is a potential health concern for radiotherapy patients, radiation workers and astronauts. In animal studies, exposure to ionizing radiation increases oxidative damage in skeletal tissues, and results in an imbalance in bone remodeling initiated by increased bone-resorbing osteoclasts. Therefore, we evaluated various candidate interventions with antioxidant or anti-inflammatory activities (antioxidant cocktail, dihydrolipoic acid, ibuprofen, dried plum) both for their ability to blunt the expression of resorption-related genes in marrow cells after irradiation with either gamma rays (photons, 2 Gy) or simulated space radiation (protons and heavy ions, 1 Gy) and to prevent bone loss. Dried plum was most effective in reducing the expression of genes related to bone resorption (Nfe2l2, Rankl, Mcp1, Opg, TNF-α) and also preventing later cancellous bone decrements caused by irradiation with either photons or heavy ions. Thus, dietary supplementation with DP may prevent the skeletal effects of radiation exposures either in space or on Earth.

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“…Hashem et al recruited 47 patients at high risk of HO, including patients with AS, and treated all of them with post-arthroplasty radiotherapy. They showed statistically low rates of HO [ 47 ]. In a larger study of eighty-six hips treated with pre-operative radiation as prophylaxis against HO, utilising varying doses of radiation, the rate of HO was low suggesting that this was an effective measure.…”

Section: Peri-operative Considerationsmentioning

confidence: 99%

A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome

Putnis¹,

Wartemberg²,

Khan³

et al. 2015

TOORTHJ

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Ankylosing spondylitis is a spondyloarthropathy affecting the sacro-iliac joints with subsequent progression to the spine and the hip joints. The hip joints are affected by synovitis, enthesial inflammation, involvement of medullary bone, progressive degeneration and secondary osteoarthritis. Clinical presentation is usually in the form of pain and stiffness progressing to disabling fixed flexion contractures and in some instances, complete ankylosis. Hip arthroplasty should be considered for hip pain, postural and functional disability, or pain in adjacent joints due to hip stiffness. We conducted a literature review to determine peri-operative considerations and outcome in ankylosing spondylitis patients undergoing hip arthroplasty. In this review, we have discussed pre-operative surgical planning, thromboprophylaxis, anaesthetic considerations and heterotopic ossification. Outcomes of arthroplasty include range of movement, pain relief, survivorship and complications.

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Postoperative radiation therapy after hip replacement in high-risk patients for development of heterotopic bone formation

Cited by 11 publications

References 21 publications

An Inducible, Ligand-Independent Receptor Activator of NF-κB Gene to Control Osteoclast Differentiation from Monocytic Precursors

An Inducible, Ligand-Independent Receptor Activator of NF-κB Gene to Control Osteoclast Differentiation from Monocytic Precursors

Dried plum diet protects from bone loss caused by ionizing radiation

A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome

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