Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, 565-0871, Suita, Japan.
Virchows Arch. 2012 Dec;461(6):705-11. doi: 10.1007/s00428-012-1331-y. Epub 2012 Oct 20.
The reparative reaction including angiogenesis and osteogenesis in human bone after an ischemic event remains unknown. To investigate the reparative reaction in human bone, the distribution of tartrate resistant acid phosphatase (TRAP)-positive cells and the expressions of hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF-2), and CD31 were observed around the fracture site in 101 hips in 100 patients with femoral neck fracture. These 17 men and 83 women had a mean age of 80 years (range, 58-97 years). Of the hips, 17 were Garden stage 3, and 84 were Garden stage 4. The mean duration from fracture to surgery was 6.3 days (range, 1-14 days). Hematoxylin-eosin staining, TRAP staining, and immunohistochemistry using anti-HIF-1α, anti-VEGF anti-FGF-2, and anti-CD31 antibodies were performed for the coronal section of the retrieved whole femoral heads. TRAP-positive cells were detected near the trabecular bone around the fracture site in ten hips (10 %). HIF-1α expression was detected in 41 hips (41 %), mainly in the endothelial cells of the vessels. VEGF showed diffuse cytoplasmic staining of the mononuclear cells in the edematous area in 39 hips (39 %) while FGF-2 was detected in the cytoplasm of mononuclear cells in the bone marrow in 82 hips (82 %). CD31 was expressed in the bone marrow vessels in 35 hips (35 %). There were significant differences in HIF-1α expression relative to the duration between the fracture and the surgery, and in CD31 expression relative to Garden stage. HIF-1α expression was detected around the fracture site in the early period after fracture and CD31 expression was detected more frequently in Garden 3 hips while VEGF and FGF-2 expressions were detected regardless of Garden classification.
在缺血事件后，人体骨骼中的修复反应，包括血管生成和成骨作用，目前仍不清楚。为了研究人体骨骼的修复反应，在 100 例股骨颈骨折患者的 101 髋中，观察了骨折部位周围抗酒石酸酸性磷酸酶（TRAP）阳性细胞的分布以及缺氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）、成纤维细胞生长因子-2（FGF-2）和 CD31 的表达。这些 17 名男性和 83 名女性的平均年龄为 80 岁（58-97 岁）。髋部 17 例为 Garden 3 期，84 例为 Garden 4 期。从骨折到手术的平均时间为 6.3 天（1-14 天）。对回收的整个股骨头的冠状切片进行苏木精-伊红染色、TRAP 染色和免疫组织化学染色，使用抗 HIF-1α、抗 VEGF、抗 FGF-2 和抗 CD31 抗体。在 10 髋（10%）的骨折部位周围小梁骨附近检测到 TRAP 阳性细胞。在 41 髋（41%）中检测到 HIF-1α表达，主要在血管内皮细胞中。VEGF 在 39 髋（39%）中显示出单核细胞在水肿区的弥漫细胞质染色，而 FGF-2 在 82 髋（82%）中在骨髓单核细胞的细胞质中检测到。在 35 髋（35%）中检测到 CD31 在骨髓血管中的表达。HIF-1α表达与骨折与手术之间的时间间隔有关，而 CD31 表达与 Garden 分期有关，差异有统计学意义。在骨折后早期在骨折部位周围检测到 HIF-1α表达，而在 Garden 3 髋中更频繁地检测到 CD31 表达，而 VEGF 和 FGF-2 的表达则不受 Garden 分类的影响。
