Seebeck P, Bail H J, Exner C, Schell H, Michel R, Amthauer H, Bragulla H, Duda G N
Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Free and Humboldt-University of BerlinAugustenburger Platz 1, Germany.
Bone. 2005 Nov;37(5):669-77. doi: 10.1016/j.bone.2005.06.008. Epub 2005 Aug 25.
Serological parameters of bone and fibrous tissue turnover were demonstrated to monitor the course of fracture healing. The aim of this study was to evaluate the correlation between the serological parameter levels during fracture healing and callus development in a standardised ovine model of fracture healing. Two years old female sheep received a standardised 3 mm tibial bone defect stabilised by an external fixator. The serological levels of the C-terminal propeptide of procollagen type I (PICP), bone specific alkaline phosphatase (bALP), total alkaline phosphatase (tALP), osteocalcin, tartrate-resistant acid phosphatase (TRAP), calcium, phosphate and the N-terminal peptide of procollagen type III (PIIINP) were observed over a 9-week healing period. The course of fracture healing was monitored radiographically, and the callus composition was evaluated histologically at 2, 3, 6 and 9 weeks post-surgery. The serological results were compared with an untreated control group. Additionally, the maximum values during healing were compared with juvenile values to gauge the level of the serological response. The histological and radiographical results demonstrated callus formation without complications. All serological parameters showed broad inter-individual variations, and the response to the standardised fracture scenario was strongly individual. Maximum values during fracture healing did not reach the juvenile levels. The fractured as well as the control animals showed significant changes in the parameter levels. No correlations were observed between the histological course of healing and the course of bone formation markers whilst the TRAP level was reduced during bony callus formation. The PIIINP level increased when the amount of soft callus tissue decreased during healing. The observed bone formation markers were not suitable as general markers to detect the course of fracture healing, whilst PIIINP was able to reflect soft callus degradation.
骨与纤维组织转换的血清学参数被证实可用于监测骨折愈合过程。本研究的目的是在标准化的绵羊骨折愈合模型中，评估骨折愈合过程中血清学参数水平与骨痂形成之间的相关性。两岁雌性绵羊接受标准化的3毫米胫骨骨缺损，并通过外固定器进行固定。在9周的愈合期内，观察血清中I型前胶原C末端前肽（PICP）、骨特异性碱性磷酸酶（bALP）、总碱性磷酸酶（tALP）、骨钙素、抗酒石酸酸性磷酸酶（TRAP）、钙、磷以及III型前胶原N末端肽（PIIINP）的水平。通过X线摄影监测骨折愈合过程，并在术后2、3、6和9周对骨痂成分进行组织学评估。将血清学结果与未治疗的对照组进行比较。此外，将愈合过程中的最大值与幼年值进行比较，以评估血清学反应水平。组织学和X线摄影结果显示骨痂形成且无并发症。所有血清学参数均显示出个体间的广泛差异，对标准化骨折情况的反应具有很强的个体性。骨折愈合过程中的最大值未达到幼年水平。骨折动物和对照动物的参数水平均有显著变化。在骨痂形成过程中，未观察到愈合的组织学过程与骨形成标志物的过程之间存在相关性，而TRAP水平在骨痂形成期间降低。在愈合过程中，当软骨痂组织量减少时，PIIINP水平升高。观察到的骨形成标志物不适用于作为检测骨折愈合过程的通用标志物，而PIIINP能够反映软骨痂的降解情况。
