Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan.
Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
BMJ Open Diabetes Res Care. 2020 Dec;8(2). doi: 10.1136/bmjdrc-2019-001129.
Diabetes mellitus (DM) negatively affects fracture repair by inhibiting endochondral ossification, chondrogenesis, callus formation, and angiogenesis. We previously reported that transcutaneous CO application accelerates fracture repair by promoting endochondral ossification and angiogenesis. The present study aimed to determine whether CO treatment would promote fracture repair in cases with type I DM.
A closed femoral shaft fracture was induced in female rats with streptozotocin-induced type I DM. CO treatment was performed five times a week for the CO group. Sham treatment, where CO was replaced with air, was performed for the control group. Radiographic, histologic, genetic, and biomechanical measurements were taken at several time points.
Radiographic assessment demonstrated that fracture repair was induced in the CO group. Histologically, accelerated endochondral ossification and capillary formation were observed in the CO group. Immunohistochemical assessment indicated that early postfracture proliferation of chondrocytes in callus was enhanced in the CO group. Genetic assessment results suggested that cartilage and bone formation, angiogenesis, and vasodilation were upregulated in the CO group. Biomechanical assessment revealed enhanced mechanical strength in the CO group.
Our findings suggest that CO treatment accelerates fracture repair in type I DM rats. CO treatment could be an effective strategy for delayed fracture repair due to DM.
糖尿病(DM)通过抑制软骨内骨化、软骨生成、骨痂形成和血管生成,对骨折修复产生负面影响。我们之前的研究报告表明,经皮 CO 应用通过促进软骨内骨化和血管生成来加速骨折修复。本研究旨在确定 CO 治疗是否会促进 I 型糖尿病患者的骨折修复。
通过链脲佐菌素诱导的 I 型糖尿病诱导雌性大鼠闭合性股骨干骨折。CO 组每周进行 5 次 CO 治疗。对照组进行假处理,用空气代替 CO。在多个时间点进行影像学、组织学、遗传学和生物力学测量。
影像学评估表明 CO 组诱导了骨折修复。组织学观察到 CO 组加速了软骨内骨化和毛细血管形成。免疫组织化学评估表明 CO 组骨痂中软骨细胞的早期增殖增强。遗传评估结果表明 CO 组软骨和骨形成、血管生成和血管扩张上调。生物力学评估显示 CO 组机械强度增强。
我们的研究结果表明,CO 治疗可加速 I 型糖尿病大鼠的骨折修复。CO 治疗可能是治疗因 DM 导致的延迟性骨折修复的有效策略。