Osteoimmunology of Fracture Healing: A Brief Review on the Immune Systems’ Cellular Milieu Role in Bone Injury
Keywords:
Fracture Healing, Immune System, Bone Fracture, Bone Healing, Immune CellsAbstract
Bone fracture healing is the most common medical treatment in the usual clinical practice. Bone has the unique property for self-healing, which is in addition to the ability of not forming a scar. Following fracture, a chain of events takes place, which include the activation of healing processes in both the cellular and tissue level. These events, lead to a full bridging of the gap between the two bone-ends of the fracture. In that process the immune system is active and the immune cells are known to play a significant role. The process of fracture healing can be divided in three main steps; these are sequential in nature and independent. The first phase includes the inflammation phase, which involves the acute activation of the immune system, the second phase includes the repair phase, which involves the recruitment of mesenchymal progenitor cells differentiating to chondrocytes and the final phase involves remodeling, where osteocytes are recruited in order to form the new bone. In conclusion, immunity serves as the initial responder at the skeletal damaged site, restores the vasculature, and initiates cascades of signals to recruit cells to carry out the repair processes. Therefore, it is believed that the immune system can be considered as a promising therapeutic target for bone fracture healing.
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References
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9. Takayanagi H, Ogasawara K, Hida S, Chiba T, Murata S, Sato K, et al. T-cell-mediated regulation of osteoclastogenesis by signalling cross-talk between RANKL and IFN-gamma. Nature. 2000;408(6812):600-5. doi.10.1038/35046102.
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13. Schneider PS, Sandman E, Martineau PA. Osteoimmunology: Effects of Standard Orthopaedic Interventions on Inflammatory Response and Early Fracture Healing. The Journal of the American Academy of Orthopaedic Surgeons. 2018;26(10):343-52. doi.10.5435/jaaos-d-16-00646.
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2021-12-02
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