Heller Justin B, Gabbay Joubin S, Wasson Kristy, Mitchell Scott, Heller Misha M, Zuk Patricia, Bradley James P
Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles.
Plast Reconstr Surg. 2007 Jun;119(7):2037-2045. doi: 10.1097/01.prs.0000260589.75706.19.
Current theory on normal cranial suture fusion entrusts the dura with the regulatory role. Studies suggest that the dura responds to stress with changes in gene expression. Noggin (bone morphogenetic protein inhibitor) expression is decreased in normal (rat and mouse) cranial suture fusion, but its role in craniosynostosis and the response to stress has not been studied.
Posterior frontal (fusing) and sagittal (patent) rat cranial sutures were held static, oscillated, or distracted for 10 days in an organ culture microdistraction device beginning at 5 days of age (n = 30 sutures, or 10 sutures per group). The percentage of fusion equaled the score received for bony closure. Noggin, Runx2, and alkaline phosphatase expression was localized by immunohistochemistry for all groups.
Both the posterior frontal and sagittal sutures demonstrated a significant (p < 0.05) increase in fusion percentage with oscillation relative to the static control. Noggin was not expressed in the fusing posterior frontal suture but was expressed in the normally patent sagittal suture. Conversely, Runx2 was expressed in the posterior frontal suture but not in the sagittal suture. However, when a mechanical stress was applied, both the posterior frontal and sagittal sutures expressed Runx2 but not Noggin, as in the static fusing suture.
The application of mechanical stress to cranial sutures results in fusion of both the posterior frontal suture and the normally patent sagittal suture. Runx2 is expressed but Noggin is not expressed. Thus, mechanical stress influences sutural fusion and may play a role in craniosynostosis.
目前关于正常颅缝融合的理论认为硬脑膜具有调节作用。研究表明,硬脑膜会随着基因表达的变化对应激做出反应。在正常(大鼠和小鼠)颅缝融合过程中,骨形态发生蛋白抑制因子Noggin的表达会降低,但其在颅缝早闭及对应激反应中的作用尚未得到研究。
从5日龄开始,将大鼠的额后(融合中)和矢状(未融合)颅缝在器官培养微牵张装置中分别保持静止、振荡或牵张10天(n = 30条颅缝,即每组10条颅缝)。融合百分比等于骨闭合所获得的分数。通过免疫组织化学对所有组的Noggin、Runx2和碱性磷酸酶表达进行定位。
相对于静态对照组,额后颅缝和矢状颅缝在振荡时融合百分比均显著增加(p < 0.05)。Noggin在融合中的额后颅缝中未表达,但在正常未融合的矢状颅缝中表达。相反,Runx2在额后颅缝中表达,但在矢状颅缝中不表达。然而,当施加机械应力时,额后颅缝和矢状颅缝均表达Runx2但不表达Noggin,这与静态融合颅缝的情况相同。
对颅缝施加机械应力会导致额后颅缝和正常未融合的矢状颅缝均发生融合。Runx2表达,但Noggin不表达。因此,机械应力会影响颅缝融合,并可能在颅缝早闭中发挥作用。