Different mechanisms of spinal fusion using equine bone protein extract,rhBMP-2 and autograft during the process of anterior lumbar interbody fusion |
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| Authors: | Xuenong Zou Lijin Zou Casper Foldager Michael Bendtsen Wenzhou Feng Cody E Bünger |
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| Institution: | 1. Department of Orthopaedic, Peking University Shenzhen Hospital, Shenzhen 518036, China;2. Department of Spinal Surgery/Orthopaedic Research Institute, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China;3. Orthopaedic Research Lab/The Institute of Clinical Medicine, Aarhus University Hospital, 8000 Aarhus C, Denmark;1. Orthopedic Department, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China;2. Guangdong Provincial Key Laboratory of Orthopedics and Traumatology/Orthopedic Research Institute, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510075, China;3. Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China;4. School of Materials Science and Engineering, South China University of Technology, Guangzhou 510640, China;5. National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, China;6. Department of Burn Surgery and Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330000, China;1. Department of Stomatology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China;2. Guangdong Provincial Key Laboratory of Orthopedics and Traumatology/Orthopedic Research Institute, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510075, China;3. Department of Musculoskeletal Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China;4. Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus 8000, Denmark;5. Guangdong Provincial Stomatological Hospital, Southern Medical University, Guangzhou 510280, China;1. Department of Orthopaedics, Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210, USA;2. Comparative Orthopedic Research Laboratory, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 380 VMAB 1900 Coffey Rd, Columbus, Ohio 43210, USA;3. Department of Orthopaedic Surgery, The Medical College of Wisconsin, Marquette University, Biomaterials Lab, William Wehr Physics, 540 N. 15th St, Room 127, Milwaukee, WI 53233, USA;1. Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, 510080 Guangzhou, China;2. Department of Pharmacy, Guangzhou Women and Children''s Medical Center, Guangzhou Medical University, 510623 Guangzhou, China;3. Department of Orthopaedic Surgery, The Second Affiliated Hospital, Guangzhou Medical University, 510260 Guangzhou, China;4. Department of Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, 510080 Guangzhou, China;5. Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, Department of Spinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, 510080 Guangzhou, China |
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| Abstract: | To elucidate the molecular mechanisms of spinal fusion with different graft materials during an anterior lumbar interbody fusion, we examined the gene-expression profiles after implantation of equine bone protein extract, rhBMP-2 and autograft using microarray technology and data analysis, including hierarchical clustering, self-organizing maps (SOM), KEGG pathway and Biological process GO analyses in a porcine model. The results suggest that equine bone protein extract exhibited a more similar expression pattern with autograft than that of rhBMP-2. rhBMP-2 recruits progenitor cells, proliferation and differentiation possibly by inducing various factors including PGHS-2, IFGBP-2, VEGF and chemokines and then leads to preferable membranous ossification and bone remodeling. Conversely, equine bone protein extract results in endochondral ossification via upregulation of cartilage-related genes. Ossification by inducing direct osteoblastic differentiation and obviating the cartilaginous intermediate phases may increase spinal fusion rate. |
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