Lončar Stephie R, Halcrow Siân E, Swales Diana
Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Scotland, United Kingdom.
Department of Anatomy, University of Otago, New Zealand.
Forensic Sci Int Synerg. 2023 Mar 17;6:100326. doi: 10.1016/j.fsisyn.2023.100326. eCollection 2023.
Understanding factors that affect bone response to trauma is integral to forensic skeletal analysis. It is essential in forensic anthropology to identify if impaired fracture healing impacts assessment of post-traumatic time intervals and whether a correction factor is required. This paper presents a synthetic review of the intersection of the literature on the immune system, bone biology, and osteoimmunological research to present a novel model of interactions that may affect fracture healing under autoimmune conditions. Results suggest that autoimmunity likely impacts fracture healing, the pathogenesis however, is under researched, but likely multifactorial. With autoimmune diseases being relatively common, significant clinical history should be incorporated when assessing skeletal remains. Future research includes the true natural healing rate of bone; effect of autoimmunity on this rate; variation of healing with different autoimmune diseases; and if necessary, development of a correction factor on the natural healing rate to account for impairment in autoimmunity.
了解影响骨骼对创伤反应的因素对于法医骨骼分析至关重要。在法医人类学中,确定骨折愈合受损是否会影响创伤后时间间隔的评估以及是否需要校正因子至关重要。本文对免疫系统、骨生物学和骨免疫学研究的文献交叉点进行了综合综述,以提出一种可能影响自身免疫条件下骨折愈合的相互作用新模型。结果表明,自身免疫可能会影响骨折愈合,然而其发病机制研究较少,但可能是多因素的。由于自身免疫性疾病相对常见,在评估骨骼遗骸时应纳入重要的临床病史。未来的研究包括骨骼的真实自然愈合率;自身免疫对该率的影响;不同自身免疫性疾病愈合情况的差异;以及如有必要,开发一个基于自然愈合率的校正因子,以考虑自身免疫中的损伤情况。