Is human fracture hematoma inherently angiogenic?

Hdl Handle:
http://hdl.handle.net/10147/209111
Title:
Is human fracture hematoma inherently angiogenic?
Authors:
Street, J; Winter, D; Wang, J H; Wakai, A; McGuinness, A; Redmond, H P
Affiliation:
Department of Academic Surgery, Cork University Hospital, Ireland.
Citation:
Clin Orthop Relat Res. 2000 Sep;(378):224-37.
Journal:
Clinical orthopaedics and related research
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209111
PubMed ID:
10986998
Abstract:
This study attempts to explain the cellular events characterizing the changes seen in the medullary callus adjacent to the interfragmentary hematoma during the early stages of fracture healing. It also shows that human fracture hematoma contains the angiogenic cytokine vascular endothelial growth factor and has the inherent capability to induce angiogenesis and thus promote revascularization during bone repair. Patients undergoing emergency surgery for isolated bony injury were studied. Raised circulating levels of vascular endothelial growth factor were seen in all injured patients, whereas the fracture hematoma contained significantly higher levels of vascular endothelial growth factor than did plasma from these injured patients. However, incubation of endothelial cells in fracture hematoma supernatant significantly inhibited the in vitro angiogenic parameters of endothelial cell proliferation and microtubule formation. These phenomena are dependent on a local biochemical milieu that does not support cytokinesis. The hematoma potassium concentration is cytotoxic to endothelial cells and osteoblasts. Subcutaneous transplantation of the fracture hematoma into a murine wound model resulted in new blood vessel formation after hematoma resorption. This angiogenic effect is mediated by the significant concentrations of vascular endothelial growth factor found in the hematoma. This study identifies an angiogenic cytokine involved in human fracture healing and shows that fracture hematoma is inherently angiogenic. The differences between the in vitro and in vivo findings may explain the phenomenon of interfragmentary hematoma organization and resorption that precedes fracture revascularization.
Language:
eng
MeSH:
Adult; Animals; Bony Callus/*pathology; Cell Division; Cells, Cultured; Endothelial Growth Factors/blood; Endothelium, Vascular/cytology; Female; Fractures, Bone/complications; Hematoma/etiology/*pathology; Humans; Lymphokines/blood; Male; Mice; Mice, Inbred C57BL; Middle Aged; *Neovascularization, Pathologic; Protein Isoforms; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors
ISSN:
0009-921X (Print); 0009-921X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorStreet, Jen_GB
dc.contributor.authorWinter, Den_GB
dc.contributor.authorWang, J Hen_GB
dc.contributor.authorWakai, Aen_GB
dc.contributor.authorMcGuinness, Aen_GB
dc.contributor.authorRedmond, H Pen_GB
dc.date.accessioned2012-02-03T15:12:33Z-
dc.date.available2012-02-03T15:12:33Z-
dc.date.issued2012-02-03T15:12:33Z-
dc.identifier.citationClin Orthop Relat Res. 2000 Sep;(378):224-37.en_GB
dc.identifier.issn0009-921X (Print)en_GB
dc.identifier.issn0009-921X (Linking)en_GB
dc.identifier.pmid10986998en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209111-
dc.description.abstractThis study attempts to explain the cellular events characterizing the changes seen in the medullary callus adjacent to the interfragmentary hematoma during the early stages of fracture healing. It also shows that human fracture hematoma contains the angiogenic cytokine vascular endothelial growth factor and has the inherent capability to induce angiogenesis and thus promote revascularization during bone repair. Patients undergoing emergency surgery for isolated bony injury were studied. Raised circulating levels of vascular endothelial growth factor were seen in all injured patients, whereas the fracture hematoma contained significantly higher levels of vascular endothelial growth factor than did plasma from these injured patients. However, incubation of endothelial cells in fracture hematoma supernatant significantly inhibited the in vitro angiogenic parameters of endothelial cell proliferation and microtubule formation. These phenomena are dependent on a local biochemical milieu that does not support cytokinesis. The hematoma potassium concentration is cytotoxic to endothelial cells and osteoblasts. Subcutaneous transplantation of the fracture hematoma into a murine wound model resulted in new blood vessel formation after hematoma resorption. This angiogenic effect is mediated by the significant concentrations of vascular endothelial growth factor found in the hematoma. This study identifies an angiogenic cytokine involved in human fracture healing and shows that fracture hematoma is inherently angiogenic. The differences between the in vitro and in vivo findings may explain the phenomenon of interfragmentary hematoma organization and resorption that precedes fracture revascularization.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnimalsen_GB
dc.subject.meshBony Callus/*pathologyen_GB
dc.subject.meshCell Divisionen_GB
dc.subject.meshCells, Cultureden_GB
dc.subject.meshEndothelial Growth Factors/blooden_GB
dc.subject.meshEndothelium, Vascular/cytologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFractures, Bone/complicationsen_GB
dc.subject.meshHematoma/etiology/*pathologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLymphokines/blooden_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiceen_GB
dc.subject.meshMice, Inbred C57BLen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.mesh*Neovascularization, Pathologicen_GB
dc.subject.meshProtein Isoformsen_GB
dc.subject.meshVascular Endothelial Growth Factor Aen_GB
dc.subject.meshVascular Endothelial Growth Factorsen_GB
dc.titleIs human fracture hematoma inherently angiogenic?en_GB
dc.contributor.departmentDepartment of Academic Surgery, Cork University Hospital, Ireland.en_GB
dc.identifier.journalClinical orthopaedics and related researchen_GB
dc.description.provinceMunster-

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