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Extracorporeal Shock Wave Combined with Teriparatide-Loaded Hydrogel Injection Promotes Segmental Bone Defects Healing in Osteoporosis

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Tissue Engineering and Regenerative Medicine Aims and scope

Abstract

BACKGROUND:

Osteoporosis is a systemic bone disease characterized by decreased bone density and deterioration of bone microstructure, leading to an increased probability of fragility fractures. Once segmental bone defect occurs, it is easy to cause delayed union and nonunion.

METHODS:

The aim of this study is to investigate the efficacy of extracorporeal shock wave (ESW) and teriparatide-loaded hydrogel (T-Gel) combined strategy on the cell activity and differentiation of osteoporosis derived bone marrow mesenchymal stem cells (OP-BMSCs) in vitro and bone regeneration in osteoporotic segmental bone defects in vivo.

RESULTS:

In vitro, the strategy of combining ESW and T-Gel significantly enhanced OP-BMSCs proliferation, survival, migration, and osteogenic differentiation by up-regulating the alkaline phosphatase activity, mineralization, and expression of runt-related transcription factor-2, type I collagen, osteocalcin, and osteopontin. In the segmental bone defect models of osteoporotic rabbits, Micro-CT evaluation and histological observation demonstrated this ESW-combined with T-Gel injection significantly induced bone healing by enhancing the osteogenic activity of the local microenvironment in osteoporotic defects.

CONCLUSION:

In conclusion, ESW-combined with T-Gel injection could regulate the poor osteogenic microenvironment in osteoporotic defects and show potential for enhancing fragility fractures healing.

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Acknowledgements

This study has been supported by Health Science and Technology Plan Project of Zhejiang Province (Nos. 2021KY495 and 2021KY506).

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Author notes

  1. Qi Chen, Chen Xia, and Binbin Shi have contribute equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China

    Qi Chen, Chen Xia & Chuyong Chen

  2. Department of Orthopedic Surgery, Tongxiang First People’s Hospital, Tongxiang, 314500, People’s Republic of China

    Binbin Shi

  3. Department of Orthopedic Surgery, No 1 People’s Hospital of AkeSu, AkeSu, 843000, Xinjiang, People’s Republic of China

    Chen Yang

  4. Department of Orthopedic Surgery, The Third People Hospital of Zhuji, Shaoxing, 310014, People’s Republic of China

    Guangfeng Mao

  5. Department of Hematology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, 310014, People’s Republic of China

    Fangfang Shi

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  1. Qi Chen
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Correspondence to Fangfang Shi.

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Ethical statement

All animal procedures were performed in accordance with the guidelines for Care and Use of Laboratory Animal Experience and approved by the approved by the Animal Care and Use Ethics Committee of Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine (approval no. SHJT-MRJ-2020–087).

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Chen, Q., Xia, C., Shi, B. et al. Extracorporeal Shock Wave Combined with Teriparatide-Loaded Hydrogel Injection Promotes Segmental Bone Defects Healing in Osteoporosis. Tissue Eng Regen Med 18, 1021–1033 (2021). https://doi.org/10.1007/s13770-021-00381-w

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