Repair of Critical Calvarias Defects With Systemic Epimedium sagittatum Extract

Abstract

It is well established in reconstructive surgery the repair of great bone defects is a difficult goal to be achieved. The aim of this study was to evaluate the influence of an extract rich in icariin on bone neoformation in critically sized defects in rat calvaria. Under continual saline irrigation, a circular bone defect was created in 40 rat calvarias with an 8-mm diameter trephine drill. Animals were randomly divided into a test group that received an Epimedium sagittatum extract (containing 5.8 mg/mL of icariin) and a control group that received an equal volume of saline solution. Substances were administered daily through a feeding tube until euthanasia. After 7, 14, 21, and 42 days, 5 animals from each group were euthanized. Calvaria defect samples were fixed in 10% formalin for 48 hours, X-rayed, and histologically processed. In the test group, there was a significant reduction in the bone defect area on X-ray images and an increase in new bone area in all of the experimental periods in the test group. At 42 days, the bone in the test group also exhibited a significant reduction in osteocyte (P = 0.002) and osteoclast density (P = 0.041). The authors conclude that administration of systemic Epimedium extracts containing high concentrations of icariin can induce bone neoformation and reduce osteocyte and osteoclast densities, thereby altering the normal deposition and remodeling patterns that are present in critically sized bone defects.

Plant Extracts in the Bone Repair Process: A Systematic Review

“…The most analyzed parameters among the 31 papers found in this review were radiological analyses (80.64%, n = 25) [21–31, 33, 34, 36, 39, 41–50], followed by immunological and histopathological markers (70.97%, n = 22) [23–28, 30–37, 39–44, 47, 48]. These analyses demonstrated mainly osteoblastic proliferation, angiogenesis, and increased formation of the bone matrix with fracture closure and bone callus formation.…”

“…Only 25.81% ( n = 8) [22, 32, 37, 38, 42, 46, 48, 49] reported whether the fracture had complete, partial, or absent closure. Other analyses related to bone strength, tensile strength, and expression of inflammatory genes that stimulate bone formation and osteogenic differentiation were performed in 38.71% ( n = 12) of the studies [20, 23, 24, 28, 33, 36, 40–42, 44, 45, 47] (Figure 2).…”

“…As for the secondary metabolites found in the phytochemical description of the studies, we observed that 32.26% were flavonoids, indicating the positive action of this compound on the bone repair. The role of flavonoids in skin repair is already known, but recent studies have demonstrated the action of this compound also in bone repair [23, 29, 30, 36, 40, 41, 43, 45]. Another important fact to be informed in works with phytotherapics is the knowledge about the extraction techniques as well as the solvents used, since they can determine the isolation of a biologically active compound, directing the research [87].…”

Growth Dynamic of Allogeneic and Autogenous Bone Grafts in a Vertical Model

“…A conventional light microscope (Olympus ® CH2, Olympus Optical Co. Ltd. Japan) was used to assess the histological sections with a final magnification of 400X. Histomorphometric analysis was adapted from a previous study (17). Briefly, four histological sections were randomly and blindly selected from each animal and group.…”

Osteoprotective Medicinal Plants - Part 1 (A Human Clinical Evidence-Based Review)

“…Animal studies. E. sagittatum extract produced a significant reduction in the bone defect area on X-ray images and bone neoformation in rats with critical calvarias defects (Burim et al, 2016).…”