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Inflammation Research

, Volume 60, Issue 1, pp 3–10 | Cite as

Inflammation as death or life signal in diabetic fracture healing

  • Tamás RőszerEmail author
Review

Abstract

Increased apoptosis of chondrocytes and osteoblasts and prolonged survival of osteoclasts lead to early destruction of callus tissue and impair bone remodeling in fracture healing of diabetic patients. Diabetes is accompanied by an increased inflammatory state, reactive oxgen species (ROS) generation and accumulation of advanced glycation end products (AGEs), a heterogenous group of toxic metabolites that can induce inflammation. Prolonged hyperglycemia and insulin resistance correlate with increased apoptosis rate and, accordingly, the proapoptotic role of several inflammatory mediators, ROS and AGEs has been also documented. In this review we summarize the most recent reports supporting the idea that inflammatory signaling increases chondrocyte and osteoblast death and prolongs osteoclast survival, resulting in impaired bone regeneration in diabetes. Antagonising inflammatory signal pathways and solution of inflammation may deserve greater attention in the management of diabetic fracture healing.

Keywords

Diabetes mellitus Apoptosis Inflammation Bone homeostasis Regeneration 

Notes

Acknowledgments

The Author is supported by a Hungarian Research Fund (OTKA #76091) Grant. Thank you to Dr. Christian Hellriegel for the valuable discussion.

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© Springer Basel AG 2010

Authors and Affiliations

  1. 1.Research Group of Apoptosis and GenomicsHungarian Academy of SciencesDebrecenHungary
  2. 2.Department of Regenerative CardiologySpanish National Cardiovascular Research Center (CNIC)MadridSpain

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