Angiogenesis and mineralization during distraction osteogenesis.
Distraction osteogenesis is currently a standard method of bone lengthening. It is a viable method for the treatment of short extremities as well as extensive bone defects, because large amounts of bone can be regenerated in the distraction gap. Mechanical stimulation by distraction induces biological responses of skeletal regeneration that is accomplished by a cascade of biologic processes that may include differentiation of pluripotential tissue, angiogenesis, mineralization, and remodeling. There are complex interactions between bone-forming osteoblasts and other cells present within the bone microenvironment, particularly vascular endothelial cells that may be pivotal members of a complex interactive communication network in bone. Regenerate bone forms by three modes of ossification, which include intramembranous, enchondral, and transchondroid ossifications, although intramembraneous bone formation is the predominant mechanism of ossification. In this review we discussed the coupling between angiogenesis and mineralization, the biological and mechanical factors affecting them, the cellular and molecular events occurring during distraction osteogenesis, and the emerging modalities to accelerate regenerate bone healing and remodeling.
Choi
In Ho
IH
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. inhoc@snu.ac.kr
Chung
Chin Youb
CY
Cho
Tae-Joon
TJ
Yoo
Won Joon
WJ
D000818:Animals; D015415:Biomarkers; D055396:Bone Morphogenetic Protein 2; D055415:Bone Morphogenetic Protein 4; D019485:Bone Morphogenetic Proteins / Q000235:genetics / Q000378:metabolism; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000648:ultrastructure; D002113:Calcification, Physiologic / Q000502:physiology*; D003094:Collagen / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D006133:Growth Substances / Q000378:metabolism; D006801:Humans; D018919:Neovascularization, Physiologic / Q000502:physiology*; D010006:Osteoblasts / Q000502:physiology; D019857:Osteogenesis, Distraction; D011859:Radiography; D016212:Transforming Growth Factor beta
C525718:BMP2 protein, human; C525809:BMP4 protein, human; D015415:Biomarkers; D055396:Bone Morphogenetic Protein 2; D055415:Bone Morphogenetic Protein 4; D019485:Bone Morphogenetic Proteins; D016207:Cytokines; D006133:Growth Substances; D016212:Transforming Growth Factor beta; D003094:Collagen