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PloS one2019; 14(4); e0214276; doi: 10.1371/journal.pone.0214276

Hypoxia and mesenchymal stromal cells as key drivers of initial fracture healing in an equine in vitro fracture hematoma model.

Abstract: Fractures in horses-whether simple fractures with just one clean break, or incomplete greenstick with stress fractures, or complications such as shattered bones can all be either minimal or even catastrophic. Thus, improvement in fracture healing is a hallmark in equine orthopedics. The fracture healing process implements a complex sequence of events including the initial inflammatory phase removing damaged tissue, re-establishment of vessels and mesenchymal stromal cells, a soft and hard callus phase closing the fracture gap as well as the remodeling phase shaping the bone to a scar-free tissue. Detailed knowledge on processes in equine fracture healing in general and on the initial phase in particular is apparently very limited. Therefore, we generated equine in vitro fracture hematoma models (FH models) to study time-dependent changes in cell composition and RNA-expression for the most prominent cells in the FH model (immune cells, mesenchymal stromal cells) under conditions most closely adapted to the in vivo situation (hypoxia) by using flow cytometry and qPCR. In order to analyze the impact of mesenchymal stromal cells in greater detail, we also incubated blood clots without the addition of mesenchymal stromal cells under the same conditions as a control. We observed a superior survival capacity of mesenchymal stromal cells over immune cells within our FH model maintained under hypoxia. Furthermore, we demonstrate an upregulation of relevant angiogenic, osteogenic and hypoxia-induced markers within 48 h, a time well-known to be crucial for proper fracture healing.
Publication Date: 2019-04-04 PubMed ID: 30947253PubMed Central: PMC6449067DOI: 10.1371/journal.pone.0214276Google Scholar: Lookup
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

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This research studied the healing process of fractures in horses using in vitro models to better understand the role of mesenchymal stromal cells and hypoxia. It revealed that mesenchymal stromal cells have better survival capability under hypoxia and play a key role in promoting angiogenesis, osteogenesis and fracture healing.

Overview of the Research

  • This research attempted to boost the understanding of fracture healing in horses. The healing process of fractures involves many steps including inflammation, regeneration of the blood vessels, action of mesenchymal stromal cells and formation of bone tissue.
  • The researchers acknowledged that there is limited knowledge available regarding the initial phase of fracture healing.

Methodology

  • Equine in vitro fracture hematoma models were used in this study, also known as FH models. These helped the researchers study the changes in cell composition and RNA expression over time under hypoxia – a condition that most closely resembles that of an injured horse.
  • The main focus was on mesenchymal stromal cells and immune cells, and how these responded in the situation of low oxygen supply. Their responses were analyzed using flow cytometry and qPCR (quantitative Polymerase Chain Reaction).
  • To study the mesenchymal stromal cells more closely, the researchers also introduced a control group that lacked these cells.

Findings

  • It was observed that mesenchymal stromal cells survived better than immune cells in hypoxic conditions.
  • Data indicated an increase in angiogenic, osteogenic and hypoxia-induced markers within 48 hours, a period considered to be critical for successful fracture healing.

Significance of Results

  • The findings of this study are significant as they could lead to improvements in equine orthopedics in terms of fracture healing.
  • Understanding more about the survival capacity of mesenchymal stromal cells under hypoxia and their role in fracture healing could help develop better therapeutic methods or interventions.

Cite This Article

APA
Pfeiffenberger M, Bartsch J, Hoff P, Ponomarev I, Barnewitz D, Thöne-Reineke C, Buttgereit F, Gaber T, Lang A. (2019). Hypoxia and mesenchymal stromal cells as key drivers of initial fracture healing in an equine in vitro fracture hematoma model. PLoS One, 14(4), e0214276. https://doi.org/10.1371/journal.pone.0214276

Publication

ISSN: 1932-6203
NlmUniqueID: 101285081
Country: United States
Language: English
Volume: 14
Issue: 4
Pages: e0214276
PII: e0214276

Researcher Affiliations

Pfeiffenberger, Moritz
  • Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany.
Bartsch, Janika
  • Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Hoff, Paula
  • Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany.
Ponomarev, Igor
  • Research Center of Medical Technology and Biotechnology, Bad Langensalza, Germany.
Barnewitz, Dirk
  • Research Center of Medical Technology and Biotechnology, Bad Langensalza, Germany.
Thöne-Reineke, Christa
  • Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Buttgereit, Frank
  • Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany.
Gaber, Timo
  • Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany.
Lang, Annemarie
  • Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  • German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany.

MeSH Terms

  • Animals
  • Biomarkers / metabolism
  • Biopsy
  • Cell Survival / drug effects
  • Fracture Healing / drug effects
  • Fractures, Bone / pathology
  • Fractures, Bone / therapy
  • Hematoma / pathology
  • Hematoma / therapy
  • Horses
  • Hypoxia / pathology
  • Mesenchymal Stem Cells / cytology
  • Mesenchymal Stem Cells / drug effects
  • Mesenchymal Stem Cells / metabolism
  • Models, Biological
  • Neovascularization, Physiologic / drug effects
  • Osteogenesis / drug effects
  • Oxygen / pharmacology
  • RNA, Messenger / genetics
  • RNA, Messenger / metabolism
  • Time Factors
  • Up-Regulation / drug effects

Conflict of Interest Statement

The authors have declared that no competing interests exist.

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