Park Hoon, Lee Dong Hoon, Hwang Jin Ho, Hong Jung Jun, Kim Hyun Woo
*Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu †Division of Orthopaedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
J Pediatr Orthop. 2016 Jan 13. doi: 10.1097/BPO.0000000000000585.
Little is known presently about the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the longitudinal bone growth occurring in the growth plate. We have examined the effects of administration of different types of NSAIDs on the longitudinal growth of the growth plate using a fetal rat metatarsal bone culture model.
Cultured fetal rat metatarsal bones were used to study the effect of nonselective (indomethacin) and selective cyclooxygenase-2 (COX-2, celecoxib) NSAIDs on longitudinal bone growth. The effect of NSAIDs on proliferation and apoptosis of growth plate chondrocytes were analyzed by BrdU incorporation and a TUNEL assay. Prostaglandin E2 (PGE2) production was measured by an ELISA kit. We also examined the effect of exogenous PGE2 on the growth plate.
NSAIDs caused a dose-dependent growth retardation of cultured metatarsal bones. Both nonselective and COX-2 selective NSAIDs inhibit longitudinal bone growth. We found that NSAIDs suppressed the proliferation of chondrocytes and production of PGE2, and increased the apoptosis of chondrocytes. Supplemental PGE2 could not reverse the effects of NSAIDs on the growth plate.
Our data show that NSAIDs induce a dose-dependent growth retardation of cultured rat metatarsal bones. A detailed analysis revealed decreased proliferation and increased apoptosis of chondrocytes in the growth plate, indicating that COX-2 is responsible for PGE2 production in growth plate chondrocytes.
The data from the present study suggest that deleterious effects on the growth plate by chronic NSAIDs use should be considered for children who have chronic inflammatory diseases, such as juvenile rheumatoid arthritis.
目前对于非甾体抗炎药(NSAIDs)对生长板中纵向骨生长的影响知之甚少。我们使用胎鼠跖骨培养模型研究了不同类型NSAIDs给药对生长板纵向生长的影响。
使用培养的胎鼠跖骨研究非选择性(吲哚美辛)和选择性环氧化酶-2(COX-2,塞来昔布)NSAIDs对纵向骨生长的影响。通过BrdU掺入和TUNEL检测分析NSAIDs对生长板软骨细胞增殖和凋亡的影响。用ELISA试剂盒测量前列腺素E2(PGE2)的产生。我们还研究了外源性PGE2对生长板的影响。
NSAIDs导致培养的跖骨出现剂量依赖性生长迟缓。非选择性和COX-2选择性NSAIDs均抑制纵向骨生长。我们发现NSAIDs抑制软骨细胞增殖和PGE2产生,并增加软骨细胞凋亡。补充PGE2不能逆转NSAIDs对生长板的影响。
我们的数据表明,NSAIDs可诱导培养的大鼠跖骨出现剂量依赖性生长迟缓。详细分析显示生长板软骨细胞增殖减少且凋亡增加,表明COX-2负责生长板软骨细胞中PGE2的产生。
本研究数据表明,对于患有慢性炎症性疾病(如幼年类风湿性关节炎)的儿童,应考虑长期使用NSAIDs对生长板的有害影响。