Qi Guobin, Jiang Zengxin, Niu Jialin, Jiang Chang, Zhang Jian, Pei Jia, Wang Xiao, An Senbo, Yu Tao, Wang Xiuhui, Zhang Yueqi, Ma Tianle, Zhang Xiaotian, Yuan Guangyin, Wang Zhe
Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai, 200233, China.
National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai, 200240, China.
Mater Today Bio. 2024 Sep 3;28:101227. doi: 10.1016/j.mtbio.2024.101227. eCollection 2024 Oct.
Osteoporotic fractures have become a common public health problem and are usually accompanied by chronic pain. Mg and Mg-based alloys are considered the next-generation orthopedic implants for their excellent osteogenic inductivity, biocompatibility, and biodegradability. However, Mg-based alloy can initiate aberrant activation of osteoclasts and modulate sensory innervation into bone callus resulting in postoperative pain at the sequential stage of osteoporotic fracture healing. Its mechanism is going to be investigated. Strontium hydrogen phosphate (SrHPO) coating to delay the Mg-based alloy degradation, can reduce the osteoclast formation and inhibit the growth of sensory nerves into bone callus, dorsal root ganglion hyperexcitability, and pain hypersensitivity at the early stage. Liquid chromatography-mass spectrometry (LC-MS) metabolomics analysis of bone marrow-derived macrophages (BMMs) treated with SrHPO-coated Mg alloy extracts shows the potential effect of increased metabolite levels of AICAR (an activator of the AMPK pathway). We demonstrate a possible modulated secretion of AICAR and osteoclast differentiation from BMMs, which inhibits sensory innervation and postoperative pain through the AMPK/mTORc1/S6K pathway. Importantly, supplementing with AICAR in Mg-activated osteoclasts attenuates postoperative pain. These results suggest that Mg-induced postoperative pain is related to the osteoclastogenesis and sensory innervation at the early stage in the osteoporotic fractures and the SrHPO coating on Mg-based alloys can reduce the pain by upregulating AICAR secretion from BMMs or preosteoclasts.
骨质疏松性骨折已成为一个常见的公共卫生问题,通常伴有慢性疼痛。镁及镁基合金因其出色的成骨诱导性、生物相容性和生物降解性而被视为下一代骨科植入物。然而,镁基合金可引发破骨细胞的异常激活,并调节感觉神经向骨痂的神经支配,从而在骨质疏松性骨折愈合的后续阶段导致术后疼痛。其机制有待研究。磷酸氢锶(SrHPO)涂层可延缓镁基合金的降解,能减少破骨细胞的形成,并在早期抑制感觉神经向骨痂的生长、背根神经节的过度兴奋和疼痛超敏反应。对用SrHPO涂层镁合金提取物处理的骨髓来源巨噬细胞(BMMs)进行液相色谱-质谱(LC-MS)代谢组学分析,显示出AICAR(AMPK途径的激活剂)代谢物水平升高的潜在作用。我们证明了BMMs可能调节AICAR的分泌和破骨细胞分化,通过AMPK/mTORc1/S6K途径抑制感觉神经支配和术后疼痛。重要的是,在镁激活的破骨细胞中补充AICAR可减轻术后疼痛。这些结果表明,镁诱导的术后疼痛与骨质疏松性骨折早期的破骨细胞生成和感觉神经支配有关,镁基合金上的SrHPO涂层可通过上调BMMs或前破骨细胞的AICAR分泌来减轻疼痛。