title: Cell-based Assay System for Predicting Bone Regeneration in Patient Affected by Aseptic Nonunion and Treated with Platelet Rich Fibrin.
abstract: BACKGROUND
  Regenerative strategies based on the use of platelet concentrates as an autologous source of growth factors (GF) has been proposed to promote the healing of long bone nonunions. However, the relatively high failure rate stimulates interest in growing knowledge and developing solutions to obtain the best results from the regenerative approach.
  
  
  OBJECTIVE
  In this study we evaluated whether a cell-based assay system could be able to recognize patients who will benefit or not from the use of autologous platelet preparations.
  
  
  METHODS
  The autologous serum was used in culture medium to promote the osteogenic differentiation of normal bone-marrow stromal cells (BMSC). Blood samples were collected from 16 patients affected by aseptic long bone nonunion who were candidates to the treatment with autologous platelet-rich fibrin. The osteoinductive effect was detected by measuring the BMSC proliferation, the mineralization activity, and the expression of bone-related genes. Serum level of basic fibroblast growth factor (bFGF) was considered as a representative marker of the delivery of osteogenic GFs from platelets. Laboratory results were related to the characteristics of the disease before the treatment and to the outcome at 12 months.
  
  
  RESULTS
  Serum samples from &quot;good responders&quot; showed significantly higher levels of bFGF and were able to induce a significantly higher proliferation of BMSC, while no significant differences were observed in terms of osteoblast differentiation.
  
  
  CONCLUSIONS
  BMSC-based assay could be a useful tool to recognize patients who have a low probability to benefit from the use of autologous platelet concentrate to promote the healing of long bone nonunion.
authors.affiliation: Laboratory for Orthopedic Pathophysiology and Regenerative Medicine, Rizzoli Orthopedic Institute, via di Barbiano 1/10, 40136 Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Perut
authors.forename: Dante
authors.initials: D
authors.lastname: Dallari
authors.forename: Nicola
authors.initials: N
authors.lastname: Rani
authors.forename: Nicola
authors.initials: N
authors.lastname: Baldini
authors.forename: Donatella
authors.initials: D
authors.lastname: Granchi
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000378:metabolism*; D001861:Bone Regeneration / Q000502:physiology*; D002454:Cell Differentiation / Q000502:physiology; D005260:Female; D005337:Fibrin / Q000494:pharmacology*; D005599:Fractures, Ununited / Q000378:metabolism*; D006801:Humans; D008297:Male; D059630:Mesenchymal Stem Cells / Q000166:cytology / Q000378:metabolism*; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology
chemical_list: D005337:Fibrin