OBJECTIVESTo observe the regulation of Chinese herbal medicine, Modifified Qing'e Pill (, MQEP), on the expression of adiponectin, bone morphogenetic protein 2 (BMP2), osteoprotegerin (OPG) and other potentially relevant risk factors in patients with nontraumatic osteonecrosis of the femoral head (ONFH).

METHODSA total of 96 patients with nontraumatic ONFH were unequal randomly divided into treatment group (60 cases) and control group (36 cases). The treatment group were treated with MQEP while the control group were treated with simulated pills. Both groups were given caltrate D. Six months were taken as a treatment course. Patients were followed up every 2 months. The levels of plasma adiponectin, BMP2, OPG, von Willebrand factor (vWF), von Willebrand factor cleaving protease (vWF-cp), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (tPA), C-reactive protein (CRP), blood rheology, bone mineral density (BMD) of the femoral head and Harris Hip Score were measured before and after treatment.

RESULTSAfter 6 months of treatment, compared with the control group, patients in the treatment group had signifificantly higher adiponectin and BMP2 levels (P<0.01 and P=0.013, respectively), lower vWF, PAI-1 and CRP levels (P=0.019, P<0.01 and P<0.01, respectively), and lower blood rheology parameters. BMD of the femoral neck, triangle area and Harris Hip Score in the treatment group were signifificantly higher than those in the control group. Moreover, plasma adiponectin showed a positive association with BMP2 (r=0.231, P=0.003) and a negative association with PAI-1 (r=-0.159, P<0.05).

CONCLUSIONMQEP may play a protective role against nontraumatic ONFH by increasing the expression of adiponectin, regulating bone metabolism and improving the hypercoagulation state, which may provide an experimental base for its clinical effects.

Adiponectin ; metabolism ; Adult ; Blood Coagulation Factors ; metabolism ; Bone Density ; drug effects ; Bone Morphogenetic Protein 2 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Femur Head Necrosis ; blood ; drug therapy ; physiopathology ; Humans ; Male

PURPOSE: To investigate the molecular responses of various genes and proteins related to disc degeneration upon treatment with cytokines that affect disc-cell proliferation and phenotype in living human intervertebral discs (IVDs). Responsiveness to these cytokines according to the degree of disc degeneration was also evaluated. MATERIALS AND METHODS: The disc specimens were classified into two groups: group 1 (6 patients) showed mild degeneration of IVDs and group 2 (6 patients) exhibited severe degeneration of IVDs. Gene expression was analyzed after treatment with four cytokines: recombinant human bone morphogenic protein (rhBMP-2), transforming growth factor-beta (TGF-beta), interleukin-1beta (IL-1beta), and tumor necrosis factor-alpha (TNF-alpha). Molecular responses were assessed after exposure of cells from the IVD specimens to these cytokines via real-time polymerase chain reaction and immunofluorescence staining. RESULTS: mRNA gene expression was significantly greater for aggrecan, type I collagen, type II collagen, alkaline phosphatase, osteocalcin, and Sox9 in group 1 than mRNA gene expression in group 2, when the samples were not treated with cytokines. Analysis of mRNA levels for these molecules after morphogen treatment revealed significant increases in both groups, which were much higher in group 1 than in group 2. The average number of IVD cells that were immunofluorescence stained positive for alkaline phosphatase increased after treatment with rhBMP-2 and TGF-beta in group 1. CONCLUSION: The biologic responsiveness to treatment of rhBMP-2, TGF-beta, TNF-alpha, and IL-1beta in the degenerative living human IVD can be different according to the degree of degeneration of the IVD.
Adult ; Aggrecans/genetics/metabolism ; Alkaline Phosphatase/genetics/metabolism ; Biological Products/pharmacology/*therapeutic use ; Bone Morphogenetic Protein 2/pharmacology/therapeutic use ; Collagen Type I/genetics/metabolism ; Collagen Type II/genetics/metabolism ; Cytokines/*pharmacology/*therapeutic use ; Female ; Fluorescent Antibody Technique ; Gene Expression Regulation/drug effects ; Humans ; Interleukin-1/pharmacology/therapeutic use ; Intervertebral Disc/*drug effects/*pathology ; Intervertebral Disc Degeneration/*drug therapy/genetics/*pathology ; Male ; Middle Aged ; Osteocalcin/genetics/metabolism ; RNA, Messenger/genetics/metabolism ; Recombinant Proteins/pharmacology/therapeutic use ; SOX9 Transcription Factor/genetics/metabolism ; Transforming Growth Factor beta/pharmacology/therapeutic use ; Tumor Necrosis Factor-alpha/pharmacology

OBJECTIVETo investigate the effect of Ermiao Recipe (, EMR) with medicinal guide Angelicae Pubescentis Radix (APR) on the homing of bone marrow stem cells (BMSCs) to focal zone in osteoarthritis (OA) rats.

METHODSForty-eight Sprague-Dawley rats were randomly assigned to the sham-operated, model, EMR, and EMR plus APR groups (12 rats in each group). The OA rat model was induced by anterior cruciate ligament transection and medial meniscus resection. All rats were injected with recombinant human granulocyte colonystimulating factor [rhG-CSF, 30 μg/(kg·d) for continuous 7 days], and rats in the EMR and EMR plus APR groups were treated with EMR or EMR plus APR at 1.6 or 1.9 g/(kg·d) for 3 or 6 weeks, respectively. Cartilage histopathologic changes were observed by hematoxylin and eosin staining. Chondrocytes apoptosis and cartilage matrix components were tested by transferase-mediated deoxyuridine triphosphate-biotin nick end labeling assay and special staining. Interleukin-1β (IL-1 β), tumor necrosis factor α (TNF-α), bone morphogenetic protein 2 (BMP-2), and transforming growth factor beta-1 (TGF-β1) in serum were detected by enzyme-linked immunosorbent assay or radioimmunoassay assay. Matrix metalloproteinase (MMP)-13, tissue inhibitors of metalloproteinase (TIMP)-1, bromodeoxyuridine (BrdU), cluster of differentiation 34 (CD34), and stromal cell derived factor 1 (SDF-1) were measured by immunohistochemistry assay.

RESULTSEMR and EMR plus APR significantly inhibited articular cartilage damage and synovium inflammation in OA rats at 3 or 6 weeks of treatment, the most obvious changes in these parameters were found in the EMR plus APR group. At 6 weeks, compared with EMR treatment, EMR plus APR remarkably inhibited chondrocytes apoptosis and the release of IL-1β and TNF-α, obviously decreased MMP-13 expression, and significantly increased expressions of proteoglycan, collagen, type II collagen and TIMP-1, serum levels of BMP-2 and TGF-β1 as well as expressions of BrdU, CD34 and SDF-1 in cartilage articular (P<0.01 or P<0.05).

CONCLUSIONThe medicinal guide APR improved the therapeutic effects of EMR on OA rats by promoting directional homing of BMSCs to focal zone.

Animals ; Apoptosis ; drug effects ; Bone Marrow Cells ; drug effects ; Bone Morphogenetic Protein 2 ; blood ; Bromodeoxyuridine ; metabolism ; Cartilage, Articular ; drug effects ; enzymology ; pathology ; Chemokine CXCL12 ; metabolism ; Chondrocytes ; drug effects ; pathology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; pharmacology ; Humans ; Interleukin-1beta ; blood ; Knee Joint ; drug effects ; pathology ; Male ; Matrix Metalloproteinase 13 ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; blood ; Osteoarthritis ; blood ; drug therapy ; pathology ; Rats, Sprague-Dawley ; Synovial Membrane ; pathology ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism ; Transforming Growth Factor beta1 ; blood ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo investigate the effect of Huogu II Formula (II) with medicinal guide Radix Achyranthis Bidentatae (Ach) on bone marrow stem cells (BMSCs) homing to necrosis area after osteonecrosis of the femoral head (ONFH) frozen by liquid nitrogen in rabbit as well as to explore the mechanism of prevention and treatment for ONFH.

METHODSThe animal model of ONFH was established by liquid nitrogen frozen on the rabbit left hind leg. Forty-eight Japanese White rabbits were randomly assigned to sham-operated group, model group, Huogu II group, and Huogu II plus Ach group, with 12 rabbits in each. During the course of ONFH animal model establishment, all rabbits were subcutaneously injected with recombinant human granulocyte colony-stimulating factor [rhG-CSF, 30 μg/(kg·day) for continuous 7 days]. Meanwhile, normal saline and decoction of the two formulae were administrated by gavage, respectively. White blood cells (WBC) were counted in peripheral blood before and after injection of rhG-CSF. Materials were drawn on the 2nd and 4th weeks after model built; bone glutamine protein (BGP) and bone morphogenetic protein 2 (BMP2) levels in serum were tested. Histopathologic changes were observed by hematoxylin and eosin (HE) staining. BMP2 mRNA levels were detected with in situ hybridization (ISH) staining. 5-Bromo-2'-deoxyuridine (BrdU) and stromal cell derived factor 1 (SDF-1) were measured by immunohistochemical assay in femoral head of the left hind leg.

RESULTSCompared with the shamoperated group, the ratio of empty lacuna, serum BGP, and SDF-1 level in the model group increased significantly, and BMP2 in both serum and femoral head decreased significantly. However, in comparison with the model group, the empty lacuna ratio of Huogu II group and Huogu II plus Ach group decreased obviously in addition to the levels of serum BGP and BMP2, and the expressions of BMP2 mRNA, BrdU, and SDF-1 increased significantly. Above changes were particularly obvious in Huogu II plus Ach group. BGP and SDF-1 on the 2nd week and empty lacuna rate and serum BMP2 level on the 4th week in Huogu II group significantly exceeded their counterparts. On the 2nd week, only in Huogu II plus Ach group that the BrdU counting rose significantly. On the 4th week, empty lacuna rate and serum BMP2 level in Huogu II plus Ach group exceeded those in Huogu II group distinctively.

CONCLUSIONSTo a certain extent, the medicinal guide Ach improves the preventive and therapeutic effects of Huogu II Formula on experimental ONFH model. The possible mechanism of this is related to its promoting effect on directional homing of BMSCs to the necrosis area.

Achyranthes ; Animals ; Bone Marrow Cells ; cytology ; drug effects ; Bone Morphogenetic Protein 2 ; blood ; genetics ; Bromodeoxyuridine ; metabolism ; Cell Movement ; Chemokine CXCL12 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Femur Head ; drug effects ; pathology ; Femur Head Necrosis ; blood ; genetics ; pathology ; therapy ; Gene Expression Regulation ; drug effects ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; pharmacology ; Humans ; Leukocyte Count ; Male ; RNA, Messenger ; genetics ; metabolism ; Rabbits ; Radioimmunoassay ; Stem Cell Transplantation ; Stem Cells ; cytology ; drug effects

This paper is aimed to assess the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) and bone marrow stromal cell (BMSCs) composited tricalcium phosphate (TCP) in a rat model of posterolateral lumbar intertransverse process fusion. Rat BMSCs were cultured in vitro. Twenty SD rats underwent single-level bilateral intertransverse process spine arthrodesis at L4 and L5. These rats were assigned to two groups according to the graft materials. They received: 10 of the total were treated with the BMSCs with rhBMP-2 and tricalcium phosphate (TCP) as the experimental group, and the other 10 with TCP treatment alone as the control group. All the animals were killed at 4 weeks after surgery and the spine fusion results were assessed by gross inspection, manual palpation, radiography and histology. The fusion rate, the tensile strength and stiffness of the solidly fused levels in the experimental group were statistically higher than that of the controlled group (P < 0.05). These results showed that the spinal fusion could be improved mechanically when rhBMP-2 and BMSCs were added into the TCP.
Animals ; Bone Morphogenetic Protein 2 ; therapeutic use ; Calcium Phosphates ; therapeutic use ; Cells, Cultured ; Combined Modality Therapy ; Female ; Lumbar Vertebrae ; surgery ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Osseointegration ; physiology ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; therapeutic use ; Spinal Fusion ; methods ; Transforming Growth Factor beta ; therapeutic use

This paper is aimed to investigate the repair of rabbit radial bone defect by the recombinant human bone morphogenetic protein 2/poly-lactideco-glycolic acid microsphere with fibrin sealant (rhBMP-2/PLGA/FS). The radial bone defect models were prepared using New Zealand white rabbits, which were randomly divided into 3 groups, experiment group which were injected with eMP-2/PLGA/FS at bone defect location, control group which were injected with FS at bone defect location, and blank control group without treatment. The ability of repairing bone defect was evaluated with X-ray radiograph. Bone mineral density in the defect regions was analysed using the level of ossification. The osteogenetic ability of repairing bone defect, the degradation of the material, the morphologic change and the bone formation were assessed by HE staining and Masson staining. The result showed that rhBMP-2/PLGA/FS had overwhelming superiority in the osteogenetic ability and quality of bone defect over the control group, and it could promote the repair of bone defect and could especially repair the radial bone defect of rabbit well. It may be a promising and efficient synthetic bone graft.
Animals ; Bone Morphogenetic Protein 2 ; therapeutic use ; Bone Regeneration ; drug effects ; Bone Substitutes ; therapeutic use ; Female ; Fibrin Tissue Adhesive ; therapeutic use ; Lactic Acid ; therapeutic use ; Male ; Microspheres ; Polyglycolic Acid ; therapeutic use ; Rabbits ; Radius Fractures ; therapy ; Recombinant Proteins ; therapeutic use ; Transforming Growth Factor beta ; therapeutic use

BACKGROUND: To determine if exogenously injected bone marrow derived platelet-rich plasma (PRP) plus bone morphogenetic protein (BMP)-2 could accelerate the healing of bone-tendon junction injuries and increase the junction holding strength during the early regeneration period. METHODS: A direct injury model of the bone-tendon junction was made using an Achilles tendon-calcaneus bone junction in a rabbit. In the PRP/BMP-2/fibrin group, 0.05 mL of bone marrow derived PRP and 100 ng/mL of BMP-2 both incorporated into 0.1 mL of fibrin glue were injected into Achilles tendon-calcaneus bone junctions. The effect of the intervention was tested by comparing the results of an intervention group to a control group. The results of biomechanical testing, and histological and gross analyses were compared between the 2 groups at the following time points after surgery: 2 weeks, 4 weeks, and 8 weeks. RESULTS: Histologic examinations showed that woven bone developed in tendon-bone junctions at 2 weeks after surgery in the PRP/BMP-2/fibrin group. Mechanical test results showed no significant difference between the PRP/BMP-2/fibrin and control groups at 2 and 4 weeks after surgery, but the mean maximal load in the PRP/BMP-2/fibrin group was significantly higher than in the control group (p < 0.05) at 8 weeks after surgery. CONCLUSIONS: Bone marrow derived PRP and BMP-2 in fibrin glue accelerated healing in a rabbit model of tendon-bone junction injury.
Achilles Tendon/*injuries ; Animals ; Bone Marrow ; Bone Morphogenetic Protein 2/*therapeutic use ; Calcaneus/*injuries ; Male ; *Platelet-Rich Plasma ; Rabbits

BACKGROUNDCalcium phosphate cement (CPC) is a biocompatible and osteoconductive bone substitute, and recombinant human bone morphogenetic protein-2 (rhBMP-2) has strong osteoinductibility, therefore we developed a composite bone substitute with CPC and rhBMP-2 and evaluate its reconstruction effect in rabbit orbital defect.

METHODSThirty-six rabbits were randomly divided into two groups and a 5 mm × 5 mm × 2 mm bone defect in the infraorbital rim was induced by surgery in each orbit (72 orbits in all). The orbital defects were treated with pure CPC or composite of CPC and rhBMP-2. The osteogenesis ability of different bone substitute was evaluated by gross observation, histological examination, histomorphometrical evaluation, compressive load-to-failure testing, and scanning electron microscope (SEM).

RESULTSGross observation showed that both bone substitutes were safe and effective for reconstruction of orbital defect. However, histological examination, histomorphometrical evaluation and SEM showed that CPC/rhBMP-2 group had faster speed in new bone formation and degradation of substitute material than CPC group. Compressive load-to-failure testing showed that CPC/rhBMP-2 group had stronger compressive strength than CPC group at every stage with significant difference (P < 0.05).

CONCLUSIONComposite of CPC/rhBMP-2 is an ideal bioactive material for repairing orbital defect, with good osteoconductibility and osteoinductibility.

Animals ; Bone Cements ; therapeutic use ; Bone Morphogenetic Protein 2 ; therapeutic use ; Bone Substitutes ; therapeutic use ; Calcium Phosphates ; therapeutic use ; Female ; Male ; Microscopy, Electron, Scanning ; Orbit ; pathology ; surgery ; ultrastructure ; Osteogenesis ; Rabbits ; Recombinant Proteins ; therapeutic use ; Reconstructive Surgical Procedures ; methods ; Transforming Growth Factor beta ; therapeutic use

OBJECTIVETo explore methods for one-stage repairing of nose deformity and alveolar cleft, as well as primary unilateral complete cleft lip.

METHODSThe nose deformity and alveolar cleft were repaired by Carstens' surgical methods, rhBMP-2 was used for correction of alveolar cleft.

RESULTSFrom 2004 to 2008, 45 cases of cleft lip were treated in the United States and followed up for 3-5 years. In 2007, 10 cases of cleft lip were treated in China and followed up for 1 year. All results were satisfactory.

CONCLUSIONSCarstens' surgical methods can be applied for early correction of nose deformity and alveolar cleft in patients with complete cleft lip.

Alveolar Process ; abnormalities ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; therapeutic use ; Cleft Lip ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Nose ; abnormalities ; Recombinant Proteins ; therapeutic use ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Transforming Growth Factor beta ; therapeutic use

OBJECTIVETo observe the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) in promoting the tendon-bone healing in rabbits after anterior cruciate ligament reconstruction.

METHODSThirty normal adult New Zealand rabbits were divided into 3 groups for anterior cruciate ligament reconstruction using autologous semitendinosus tendons as the graft material. In the rhBMP-2 group, fibrin glue (FG) containing rhBMP-2 was applied to the interface between the tendon graft and the bone tunnel, while in the FG control group, only FG was applied. The blank control group received no treatment after the surgery. The grafts were collected at 2, 4, 8 weeks after the surgery for gross observation and histological examination of the graft incorporation.

RESULTSIn the FG control group, the tendon-bone interface was filled with granulation tissue 2 weeks after the surgery, and the newly generated tissue growing into the bone tunnel and fibroblasts were observed at 4 weeks. Till week 8, Sharpey's fibers were found in the interface with the formation of indirect insertion. In the rhBMP-2 group, the tendon-bone interface was filled with cartilage tissue at 2 weeks, and the four-layer direct insertion was formed at 4 weeks; till week 8, the interface was mainly composed of the direct insertion.

CONCLUSIONrhBMP-2 can induce direct insertion formation in the tendon-bone interface after early anterior cruciate ligament reconstruction. The direct insertion possesses better biomechanical properties than indirect insertion.

Animals ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; therapeutic use ; Bone Regeneration ; drug effects ; Bone and Bones ; physiology ; Humans ; Rabbits ; Recombinant Proteins ; therapeutic use ; Reconstructive Surgical Procedures ; methods ; Tendons ; physiology ; Transforming Growth Factor beta ; therapeutic use ; Wound Healing ; drug effects