Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Milano, Italy.
Aging Clin Exp Res. 2011 Apr;23(2 Suppl):65-8.
Many experimental data are available about the positive effect of some molecules on fracture repair, but data on their efficacy in the clinical use in humans are still lacking. Bone Morphogenetic Proteins are currently used in the treatment of delayed unions, but it is necessary to insert them surgically in the fracture site. The only pharmacological factor with clinical data is teriparatide, but more data are needed to confirm its effect on fracture healing in humans, even if experimental data in animals are robust. Data are also available on the effect on bone healing of other molecules used in osteoporosis treatments. Bisphosphonates favour the formation of a bigger callus, mechanically competent, but with a slow rate of remodelling. Estrogens and strontium ranelate have some experimental evidence of stimulating healing process. Robust experimental data are also available on an anti-Sost antibody. Anti-inflammatory drugs have a negative effect on bone healing, interfering with the early phases of inflammation. In conclusion more data, experimental and mainly clinical, are advocated to define whether it is possible to enhance bone healing, even if promising molecules, as teriparatide, are already available.
许多关于某些分子对骨折修复的积极影响的实验数据已经存在，但关于它们在人类临床应用中的疗效的数据仍然缺乏。骨形态发生蛋白目前用于治疗延迟愈合，但需要将其手术插入骨折部位。唯一具有临床数据的药理学因素是特立帕肽，但需要更多的数据来证实其对人类骨折愈合的影响，即使动物实验数据很可靠。其他用于骨质疏松症治疗的分子对骨愈合的影响也有数据。双膦酸盐有利于形成更大的、机械上有能力的，但重塑速度较慢的愈伤组织。雌激素和雷奈酸锶有一些实验证据表明可以刺激愈合过程。一种抗 Sost 抗体也有大量的实验数据。抗炎药对骨愈合有负面影响，干扰炎症的早期阶段。总之，需要更多的数据，包括实验数据和主要的临床数据，来确定是否有可能增强骨愈合，即使已经有特立帕肽等有前途的分子。
