Polymorphisms in BMP4 and FGFR1 genes are associated with fracture non-union.
Fracture healing is a complex process influenced by a multitude of factors and expression of several thousand genes. Polymorphisms in these genes can lead to an extended healing process and explain why certain patients are more susceptible to develop non-union. A total of 16 SNPs within five genes involved in bone repair pathogenesis (FAM5C, BMP4, FGF3, FGF10, and FGFR1) were investigated in 167 patients with long bone fractures, 101 with uneventful healing, and 66 presenting aseptic non-unions. Exclusion criteria were patients presenting pathological fractures, osteoporosis, hypertrophic and infected non-unions, pregnancy, and children. All genetic markers were genotyped using TaqMan real-time PCR. Chi-square test was used to compare genotypes, allele frequencies, and haplotype differences between groups. Binary logistic regression analyzed the significance of many covariates and the incidence of non-union. Statistical analysis revealed open fracture to be a risk factor for non-union development (p < 0.001, OR 3.6 [1.70-7.67]). A significant association of haplotype GTAA in BMP4 (p = 0.01) and FGFR1 rs13317 (p = 0.005) with NU could be observed. Also, uneventful healing showed association with FAM5C rs1342913 (p = 0.04). Our work supported the role of BMP4 and FGFR1 in NU fracture independently of the presence of previously described risk factors.
Trauma and Orthopaedic Surgery, National Institute of Traumatology and Orthopaedics, Rio de Janeiro, Brazil.
João Matheus
JM
Guimarães
Isabel Cristina do Val
IC
Guimarães
Maria Eugenia Leite
ME
Duarte
Thays
T
Vieira
Verônica Fernandes
VF
Vianna
Marco Bernardo Cury
MB
Fernandes
Alexandre Rezende
AR
Vieira
Priscila Ladeira
PL
Casado
D000328:Adult; D000368:Aged; D055415:Bone Morphogenetic Protein 4 / Q000235:genetics*; D005260:Female; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000235:genetics*; D006239:Haplotypes; D006801:Humans; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D051496:Receptor, Fibroblast Growth Factor, Type 1 / Q000235:genetics*
C525809:BMP4 protein, human; D055415:Bone Morphogenetic Protein 4; C496348:FGFR1 protein, human; D051496:Receptor, Fibroblast Growth Factor, Type 1
bone healing; fracture repair; haplotype; non-union; polymorphism