Different mechanisms of spinal fusion using equine bone protein extract, rhBMP-2 and autograft during the process of anterior lumbar interbody fusion.
Abstract: To elucidate the molecular mechanisms of spinal fusion with different graft materials during an anterior lumbar interbody fusion, we examined the gene-expression profiles after implantation of equine bone protein extract, rhBMP-2 and autograft using microarray technology and data analysis, including hierarchical clustering, self-organizing maps (SOM), KEGG pathway and Biological process GO analyses in a porcine model. The results suggest that equine bone protein extract exhibited a more similar expression pattern with autograft than that of rhBMP-2. rhBMP-2 recruits progenitor cells, proliferation and differentiation possibly by inducing various factors including PGHS-2, IFGBP-2, VEGF and chemokines and then leads to preferable membranous ossification and bone remodeling. Conversely, equine bone protein extract results in endochondral ossification via upregulation of cartilage-related genes. Ossification by inducing direct osteoblastic differentiation and obviating the cartilaginous intermediate phases may increase spinal fusion rate.
Publication Date: 2008-11-29 PubMed ID: 19046765DOI: 10.1016/j.biomaterials.2008.10.061Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research study explores how different graft materials (equine bone protein extract, rhBMP-2, and autograft) affect the molecular mechanisms of spinal fusion during an anterior lumbar interbody fusion procedure, using a porcine model. The research highlighted that equine bone protein extract showed a similar gene-expression pattern to autograft and leads to endochondral ossification, while rhBMP-2 results in bone remodeling and preferable membranous ossification.
Exploration of Graft Materials
- The study compared the gene-expression profiles of three types of graft materials — equine bone protein extract, rhBMP-2, and autograft — after implantation.
- Microarray technology, hierarchical clustering, self-organizing maps (SOM), and different bioinformatics analyses such as KEGG pathway and Biological process GO were used in this comparison.
Comparison of Gene-Expression Profiles
- The results showed that the gene-expression profile of equine bone protein extract was closer to autograft than to rhBMP-2.
- rhBMP-2 was found to recruit progenitor cells, proliferation and differentiation by inducing various factors including PGHS-2, IFGBP-2, VEGF and chemokines.
- As a result, rhBMP-2 led to a preferable membranous ossification and bone remodeling.
Impact on Ossification
- Several different processes contribute to the creation and maintenance of bone in mammals. Two of these processes include membranous ossification and endochondral ossification.
- The results of the study suggest that while rhBMP-2 supports membranous ossification, equine bone protein extract involves in endochondral ossification. Endochondral ossification is achieved by upregulating cartilage-related genes.
Potential Benefits for Spinal Fusion
- The study suggests that inducing osteoblastic differentiation directly, and bypassing the intermediary phases of cartilage, might increase the rate of spinal fusion.
- This shift in the process of ossification could potentially improve the outcomes of spinal fusion surgeries in the future.
Cite This Article
APA
Zou X, Zou L, Foldager C, Bendtsen M, Feng W, Bünger CE.
(2008).
Different mechanisms of spinal fusion using equine bone protein extract, rhBMP-2 and autograft during the process of anterior lumbar interbody fusion.
Biomaterials, 30(6), 991-1004.
https://doi.org/10.1016/j.biomaterials.2008.10.061 Publication
Researcher Affiliations
- Department of Spine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. zxnong@hotmail.com
MeSH Terms
- Animals
- Biocompatible Materials
- Bone Morphogenetic Protein 2 / pharmacology
- Bone Substitutes / pharmacology
- Cluster Analysis
- Female
- Gene Expression Profiling
- Gene Expression Regulation / drug effects
- Horses
- Humans
- Lumbar Vertebrae / drug effects
- Lumbar Vertebrae / physiology
- Metabolic Networks and Pathways / drug effects
- Recombinant Proteins / pharmacology
- Spinal Fusion / methods
- Sus scrofa
- Time Factors
- Transplantation, Autologous
Citations
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