Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, Indiana, USA.
Division of Nephrology, School of Medicine, Indiana University, Indianapolis, Indiana, USA.
J Orthop Res. 2023 May;41(5):1060-1069. doi: 10.1002/jor.25452. Epub 2022 Oct 17.
Nonunion describes bone fractures that fail to heal, resulting in the fracture callus failing to fully ossify or, in atrophic cases, not forming altogether. Fracture healing is regulated, in part, by the balance of proinflammatory and anti-inflammatory processes occurring within the bone marrow and surface cell populations. We sought to further understand the role of osteoimmunology (i.e., study of the close relationship between the immune system and bone) by examining immune cell gene expression via single-cell RNA sequencing of intramedullary canal tissue obtained from human patients with femoral nonunions. Intramedullary canal tissue samples obtained by reaming were collected at the time of surgical repair for femur fracture nonunion (n = 5) or from native bone controls when harvesting autologous bone graft (n = 4). Cells within the samples were isolated and analyzed using the Chromium Single-Cell System (10x Genomics Inc.) and Illumina sequencers. Twenty-three distinct cell clusters were identified, with higher cell proportions in the nonunion samples for monocytes and CD14 + dendritic cells (DCs), and lower proportions of T cells, myelocytes, and promyelocytes in nonunion samples. Gene expression differences were identified in each of the cell clusters from cell types associated with osteoimmunology, including CD14 + DC, monocytes, T cells, promyelocytes, and myelocytes. These results provide human-derived gene profiles that can further our understanding of pathways that may be a cause or a consequence of nonunion, providing the clinical rationale to focus on specific components of osteoimmunology. Clinical significance: The novel single-cell approach may lead to clinically relevant diagnostic biomarkers during earlier stages of nonunion development and/or investigation into therapeutic options.
非愈合描述了骨折未能愈合,导致骨折痂未能完全骨化,或者在萎缩性病例中根本没有形成。骨折愈合受炎症前和抗炎过程平衡的部分调节,这些过程发生在骨髓和表面细胞群中。我们试图通过检查骨髓腔内组织的免疫细胞基因表达,进一步了解骨免疫学(即研究免疫系统和骨骼之间的密切关系)的作用,这些组织是从患有股骨非愈合的人类患者的骨髓腔内获得的。通过扩髓获得的骨髓腔内组织样本在股骨骨折非愈合的手术修复时(n=5)或从自体骨移植物采集时的天然骨对照中(n=4)收集。使用 Chromium Single-Cell System(10x Genomics Inc.)和 Illumina 测序仪对样本中的细胞进行分离和分析。鉴定出 23 个不同的细胞簇,非愈合样本中的单核细胞和 CD14+树突状细胞(DC)的细胞比例较高,而非愈合样本中的 T 细胞、髓细胞和早幼粒细胞的比例较低。在与骨免疫学相关的细胞类型的每个细胞簇中都鉴定出基因表达差异,包括 CD14+DC、单核细胞、T 细胞、早幼粒细胞和髓细胞。这些结果提供了人类衍生的基因谱,可以进一步了解可能是骨折不愈合的原因或后果的途径,为关注骨免疫学的特定成分提供了临床依据。临床意义:新的单细胞方法可能会在非愈合发展的早期阶段提供临床相关的诊断生物标志物,以及对治疗选择的研究。
Ont Health Technol Assess Ser. 2005
J Bone Joint Surg Am. 2006-9
Nihon Geka Hokan. 1998-3-1
BMC Musculoskelet Disord. 2018-12-21
J Funct Biomater. 2025-6-11
J Orthop Translat. 2025-2-4
J Clin Invest. 2024-11-7
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2024-8-25
Bioengineering (Basel). 2024-5-22
Curr Osteoporos Rep. 2024-6
Pharmacol Rev. 2021-4
Medicine (Baltimore). 2019-8