How osteoblast cells are induced is a central question for understanding skeletal formation. Abnormal osteoblast differentiation leads to a broad range of devastating craniofacial diseases. Here we have investigated i...How osteoblast cells are induced is a central question for understanding skeletal formation. Abnormal osteoblast differentiation leads to a broad range of devastating craniofacial diseases. Here we have investigated intramembranous ossification during cranial bone development in mouse models of skeletal genetic diseases that exhibit craniofacial bone defects. The GNAS gene encodes Gαs that transduces GPCR signaling. GNAS activation or loss-of-function mutations in humans cause fibrous dysplasia(FD) or progressive osseous heteroplasia(POH) that shows craniofacial hyperostosis or craniosynostosis, respectively. We find here that, while Hh ligand-dependent Hh signaling is essential for endochondral ossification, it is dispensable for intramembranous ossification, where Gαsregulates Hh signaling in a ligand-independent manner. We further show that Gαscontrols intramembranous ossification by regulating both Hh and Wnt/β-catenin signaling. In addition, Gαsactivation in the developing cranial bone leads to reduced ossification but increased cartilage presence due to reduced cartilage dissolution, not cell fate switch. Small molecule inhibitors of Hh and Wnt signaling can effectively ameliorate cranial bone phenotypes in mice caused by loss or gain of Gnas function mutations, respectively. Our work shows that studies of genetic diseases provide invaluable insights in both pathological bone defects and normal bone development, understanding both leads to better diagnosis and therapeutic treatment of bone diseases.展开更多
Large-sized cranial bone defect repair presents a great challenge in the clinic.The ideal cranioplasty materials to realize the functional and cosmetic recovery of the defect must have sufficient mechanical support,ex...Large-sized cranial bone defect repair presents a great challenge in the clinic.The ideal cranioplasty materials to realize the functional and cosmetic recovery of the defect must have sufficient mechanical support,excellent biocompatibility,good osseointegration and biodegradability as well.In this study,a high-strength mineralized collagen(MC)bone scaffold was developed with biomimetic composition,microstructure and mechanical properties for the repair of sheep largesized cranial bone defects in comparison with two traditional cranioplasty materials,polymethyl methacrylate and titanium mesh.The compact MC scaffold showed no distinct pore structure and therefore possessed good mechanical properties.The strength and elastic modulus of the scaffold were much higher than those of natural cancellous bone and slightly lower than those of natural compact bone.In vitro cytocompatibility evaluation revealed that the human bone marrow mesenchymal stem cells(hBMSC)had good viability,attachment and proliferation on the compact MC scaffold indicating its excellent biocompatibility.An adult sheep cranial bone defect model was constructed to evaluate the performances of these cranioplasty materials in repairing the cranial bone defects.The results were investigated by gross observation,computed tomography scanning as well as histological assessments.The in vivo evaluations indicated that compact MC scaffold showed notable osteoconductivity and osseointegration with surrounding cranial bone tissues by promoting bone regeneration.Our results suggested that the compact MC scaffold has a promising potential for large-sized cranial bone defect repair.展开更多
Appropriate mechanical support and excellent osteogenic capability are two essential prerequisites of customized implants for regenerating large-sized cranial bone defect.Although porous bone scaffolds have been widel...Appropriate mechanical support and excellent osteogenic capability are two essential prerequisites of customized implants for regenerating large-sized cranial bone defect.Although porous bone scaffolds have been widely proven to promote bone regeneration,their weak mechanical properties limit the clinical applications in cranioplasty.Herein,we applied two previously developed mineralized collagen-based bone scaffolds(MC),porous MC(pMC)and compact MC(cMC)to construct a biphasic MC composite bone scaffold(bMC)to repair the large-sized cranial bone defect in developing sheep.A supporting frame composed of cMC phase in the shape of tic–tac–toe structure was fabricated first and then embedded in pMC phase.The two phases had good interfacial bond,attributing to the formation of an interfacial zone.The in vivo performance of the bMC scaffold was evaluated by using a cranial bone defect model in 1-month-old sheep.The computed tomography imaging,X-ray scanning and histological evaluation showed that the pMC phase in the bMC scaffold,similar to the pMC scaffold,was gradually replaced by the regenerative bone tissues with comprehensively increased bone mineral density and complete connection of bone bridge in the whole region.The cMC frame promoted new bone formation beneath the frame without obvious degradation,thus providing appropriate mechanical protection and ensuring the structural integrity of the implant.In general,the sheep with bMC implantation exhibited the best status of survival,growth and the repair effect.The biphasic structural design may be a prospective strategy for developing new generation of cranioplasty materials to regenerate cranial bone defect in clinic.展开更多
Human head impact injuries caused by a sudden impact force are very common in aviation lifesaving,car crash accident,war or sports activities. Yet,an intriguing example of nature is woodpecker which is free from head ...Human head impact injuries caused by a sudden impact force are very common in aviation lifesaving,car crash accident,war or sports activities. Yet,an intriguing example of nature is woodpecker which is free from head injury even it drums trunk continually at a speed of about 6-7 m/s and a deceleration of about 1000 g.Woodpecker must have special characteristics to attenuate repetitive impact force to sustain rapid pecking without brain injury. In this study,the effect of mechanical property of cranial bone on the brain during impact was investigated using the finite element(FE)approach. It was demonstrated that the pressure,Von-Mises stresses and shear stress at the same point on the posterior of woodpecker's brain were decreased greatly compared with hoopoe and lark. It was stated that the higher strength of woodpecker's cranial bone might play an important role for preventing woodpecker's head injury.展开更多
Bone is known to have a natural function to heal itself.However,if the bone damage is beyond a critical degree,intervention such as bone grafting may be imperative.In this work,the fabrication of a novel bone scaffold...Bone is known to have a natural function to heal itself.However,if the bone damage is beyond a critical degree,intervention such as bone grafting may be imperative.In this work,the fabrication of a novel bone scaffold composed of natural bone components and polycaprolactone(PCL)using 3D printing is put forward.α1,3-galactosyltransferase deficient pigs were used as the donor source of a xenograft.Decellularized porcine bone(DCB)with attenuated immunogenicity was used as the natural component of the scaffold with the aim to promote bone regeneration.The 3D printed DCB-PCL scaffolds combined essential advantages such as uniformity of the interconnected macropores and high porosity and enhanced compressive strength.The biological properties of the DCB-PCL scaffolds were evaluated by studying cell adhesion,viability,alkaline phosphatase activity and osteogenic gene expression of human bone marrow-derived mesenchymal stem cells.The in vitro results demonstrated that the DCB-PCL scaffolds exhibit an enhanced performance in promoting bone differentiation,which is correlated to the DCB content.Furthermore,critical-sized cranial rat defects were used to assess the effect of DCB-PCL scaffolds on bone regeneration in vivo.The results confirm that in comparison with PCL scaffolds,the DCB-PCL scaffolds can significantly improve new bone formation in cranial defects.Thus,the proposed 3D printed DCB-PCL scaffolds emerge as a promising regeneration alternative in the clinical treatment of large bone defects.展开更多
Inflammatory myofibroblastic tumor(IMT) is rare in clinical practice.As its treatment mainly involves surgery,radiotherapy alone is seldom reported in literature.Here we report a case of lowly malignant cranial IMT wi...Inflammatory myofibroblastic tumor(IMT) is rare in clinical practice.As its treatment mainly involves surgery,radiotherapy alone is seldom reported in literature.Here we report a case of lowly malignant cranial IMT with intracranial invasion in a female patient. As surgery was not suitable,intensity modulated radiation therapy(IMRT) was administered.After radiotherapy,the cranial lesions tended to show efficacy.展开更多
Purpose: Low intensity pulsed ultrasound stimulation (LIPUS) has been clinically applied to promote bone fracture healing in the orthopedic field. Thus, it is likely that LIPUS also stimulates bone regeneration in bon...Purpose: Low intensity pulsed ultrasound stimulation (LIPUS) has been clinically applied to promote bone fracture healing in the orthopedic field. Thus, it is likely that LIPUS also stimulates bone regeneration in bone defects in the cranial-maxillofacial area. However, this has not been clearly proved. Furthermore, optimal time point and period of the application after the surgery has not been reported. The purpose of the present study was to evaluate the effect of LIPUS on bone regeneration in the rat parietal bone defects especially focusing on time and period of the application. Materials and Methods: Eighteen Wistar rats (14 weeks old) were divided into 6 groups: 5 experimental groups and a control group. Bone defect of 5 mm diameter was prepared on each side of the parietal bone and customized gelatin membranes were placed over the bone defects. LIPUS (160 mW/cm2, 15 min/day) was applied to the defect area with an active transducer externally in the experimental groups according to the schedules of the applications: Group 1 (day 6 - 12), group 2 (day 13 - 19), group 3 (day 20 - 26), group 4 (day 6 - 19) and group 5 (day 6 - 26). All the animals were sacrificed at 28 days. The defects were analyzed with micro CT and then histologically. Results: In Group 1, new bone formation was significantly promoted and the newly-formed bone was thick and matured compared to the one of the control group. In other experimental groups there were tendencies of stimulation of new bone formation;however, they were not statistically significant. Discussion and Conclusion: The present study demonstrated that amount of new bone formation in the bone defect depended on the time and period of LIPUS application. It has been suggested that application of LIPUS at an early healing period, the second week after the surgery, effectively accelerated new bone formation.展开更多
An 11-year-old boy with acute lymphocytic leukemia(ALL) contracted disseminated candidiasis during induction therapy, which was complicated with rupture of a fungal cranial aneurysm. Ventricular drainage and coil embo...An 11-year-old boy with acute lymphocytic leukemia(ALL) contracted disseminated candidiasis during induction therapy, which was complicated with rupture of a fungal cranial aneurysm. Ventricular drainage and coil embolization of a residual aneurysm in combination with intensive antifungal therapy rescued the patient. Although clinical improvement was achieved, high fever and elevated levels of C-reactive protein and β-D-glucan continued for more than 10 mo. One year later, the ALL relapsed during maintenance therapy with methotrexate and 6-mercaptopurine. After salvage chemotherapy, the patient received unrelated bone marrow transplantation(BMT) in a non-complete remission condition and survived. During subsequent chemotherapy and BMT, no recurrence of the fungal infection was observed under the prophylactic anti-fungal therapy with micafungin.展开更多
基金supported by the NIH grants R01DE025866 from NIDCRR01AR070877 from NIAMSsupported by the 111 Project, MOE (B14038), China
文摘How osteoblast cells are induced is a central question for understanding skeletal formation. Abnormal osteoblast differentiation leads to a broad range of devastating craniofacial diseases. Here we have investigated intramembranous ossification during cranial bone development in mouse models of skeletal genetic diseases that exhibit craniofacial bone defects. The GNAS gene encodes Gαs that transduces GPCR signaling. GNAS activation or loss-of-function mutations in humans cause fibrous dysplasia(FD) or progressive osseous heteroplasia(POH) that shows craniofacial hyperostosis or craniosynostosis, respectively. We find here that, while Hh ligand-dependent Hh signaling is essential for endochondral ossification, it is dispensable for intramembranous ossification, where Gαsregulates Hh signaling in a ligand-independent manner. We further show that Gαscontrols intramembranous ossification by regulating both Hh and Wnt/β-catenin signaling. In addition, Gαsactivation in the developing cranial bone leads to reduced ossification but increased cartilage presence due to reduced cartilage dissolution, not cell fate switch. Small molecule inhibitors of Hh and Wnt signaling can effectively ameliorate cranial bone phenotypes in mice caused by loss or gain of Gnas function mutations, respectively. Our work shows that studies of genetic diseases provide invaluable insights in both pathological bone defects and normal bone development, understanding both leads to better diagnosis and therapeutic treatment of bone diseases.
基金supported by National Natural Science Foundation of China(No.51572144,81360164 and 81660214)111 Project(No.B17026)Beijing Nova Program(Z161100004916051)。
文摘Large-sized cranial bone defect repair presents a great challenge in the clinic.The ideal cranioplasty materials to realize the functional and cosmetic recovery of the defect must have sufficient mechanical support,excellent biocompatibility,good osseointegration and biodegradability as well.In this study,a high-strength mineralized collagen(MC)bone scaffold was developed with biomimetic composition,microstructure and mechanical properties for the repair of sheep largesized cranial bone defects in comparison with two traditional cranioplasty materials,polymethyl methacrylate and titanium mesh.The compact MC scaffold showed no distinct pore structure and therefore possessed good mechanical properties.The strength and elastic modulus of the scaffold were much higher than those of natural cancellous bone and slightly lower than those of natural compact bone.In vitro cytocompatibility evaluation revealed that the human bone marrow mesenchymal stem cells(hBMSC)had good viability,attachment and proliferation on the compact MC scaffold indicating its excellent biocompatibility.An adult sheep cranial bone defect model was constructed to evaluate the performances of these cranioplasty materials in repairing the cranial bone defects.The results were investigated by gross observation,computed tomography scanning as well as histological assessments.The in vivo evaluations indicated that compact MC scaffold showed notable osteoconductivity and osseointegration with surrounding cranial bone tissues by promoting bone regeneration.Our results suggested that the compact MC scaffold has a promising potential for large-sized cranial bone defect repair.
基金financial support from the National Key R&D Program of China(2020YFC1107602)Shandong Province Key R&D Program of China(2019JZZY011106)the National Natural Science Foundation of China(No.81660214,81960238,82160250).
文摘Appropriate mechanical support and excellent osteogenic capability are two essential prerequisites of customized implants for regenerating large-sized cranial bone defect.Although porous bone scaffolds have been widely proven to promote bone regeneration,their weak mechanical properties limit the clinical applications in cranioplasty.Herein,we applied two previously developed mineralized collagen-based bone scaffolds(MC),porous MC(pMC)and compact MC(cMC)to construct a biphasic MC composite bone scaffold(bMC)to repair the large-sized cranial bone defect in developing sheep.A supporting frame composed of cMC phase in the shape of tic–tac–toe structure was fabricated first and then embedded in pMC phase.The two phases had good interfacial bond,attributing to the formation of an interfacial zone.The in vivo performance of the bMC scaffold was evaluated by using a cranial bone defect model in 1-month-old sheep.The computed tomography imaging,X-ray scanning and histological evaluation showed that the pMC phase in the bMC scaffold,similar to the pMC scaffold,was gradually replaced by the regenerative bone tissues with comprehensively increased bone mineral density and complete connection of bone bridge in the whole region.The cMC frame promoted new bone formation beneath the frame without obvious degradation,thus providing appropriate mechanical protection and ensuring the structural integrity of the implant.In general,the sheep with bMC implantation exhibited the best status of survival,growth and the repair effect.The biphasic structural design may be a prospective strategy for developing new generation of cranioplasty materials to regenerate cranial bone defect in clinic.
基金National Natural Science Foundation of Chinagrant number:10925208 and 11120101001
文摘Human head impact injuries caused by a sudden impact force are very common in aviation lifesaving,car crash accident,war or sports activities. Yet,an intriguing example of nature is woodpecker which is free from head injury even it drums trunk continually at a speed of about 6-7 m/s and a deceleration of about 1000 g.Woodpecker must have special characteristics to attenuate repetitive impact force to sustain rapid pecking without brain injury. In this study,the effect of mechanical property of cranial bone on the brain during impact was investigated using the finite element(FE)approach. It was demonstrated that the pressure,Von-Mises stresses and shear stress at the same point on the posterior of woodpecker's brain were decreased greatly compared with hoopoe and lark. It was stated that the higher strength of woodpecker's cranial bone might play an important role for preventing woodpecker's head injury.
基金the financial support from National Natural Science Foundation of China(81601626)Zhejiang Provincial Natural Science of Foundation of China(Y20C070010)+1 种基金start-up funding from Wenzhou Institute,University of Chinese Academy of Sciences(WIUCASQD2019002)Singapore MOE Tier 1 Grant RG46/18.
文摘Bone is known to have a natural function to heal itself.However,if the bone damage is beyond a critical degree,intervention such as bone grafting may be imperative.In this work,the fabrication of a novel bone scaffold composed of natural bone components and polycaprolactone(PCL)using 3D printing is put forward.α1,3-galactosyltransferase deficient pigs were used as the donor source of a xenograft.Decellularized porcine bone(DCB)with attenuated immunogenicity was used as the natural component of the scaffold with the aim to promote bone regeneration.The 3D printed DCB-PCL scaffolds combined essential advantages such as uniformity of the interconnected macropores and high porosity and enhanced compressive strength.The biological properties of the DCB-PCL scaffolds were evaluated by studying cell adhesion,viability,alkaline phosphatase activity and osteogenic gene expression of human bone marrow-derived mesenchymal stem cells.The in vitro results demonstrated that the DCB-PCL scaffolds exhibit an enhanced performance in promoting bone differentiation,which is correlated to the DCB content.Furthermore,critical-sized cranial rat defects were used to assess the effect of DCB-PCL scaffolds on bone regeneration in vivo.The results confirm that in comparison with PCL scaffolds,the DCB-PCL scaffolds can significantly improve new bone formation in cranial defects.Thus,the proposed 3D printed DCB-PCL scaffolds emerge as a promising regeneration alternative in the clinical treatment of large bone defects.
文摘Inflammatory myofibroblastic tumor(IMT) is rare in clinical practice.As its treatment mainly involves surgery,radiotherapy alone is seldom reported in literature.Here we report a case of lowly malignant cranial IMT with intracranial invasion in a female patient. As surgery was not suitable,intensity modulated radiation therapy(IMRT) was administered.After radiotherapy,the cranial lesions tended to show efficacy.
文摘Purpose: Low intensity pulsed ultrasound stimulation (LIPUS) has been clinically applied to promote bone fracture healing in the orthopedic field. Thus, it is likely that LIPUS also stimulates bone regeneration in bone defects in the cranial-maxillofacial area. However, this has not been clearly proved. Furthermore, optimal time point and period of the application after the surgery has not been reported. The purpose of the present study was to evaluate the effect of LIPUS on bone regeneration in the rat parietal bone defects especially focusing on time and period of the application. Materials and Methods: Eighteen Wistar rats (14 weeks old) were divided into 6 groups: 5 experimental groups and a control group. Bone defect of 5 mm diameter was prepared on each side of the parietal bone and customized gelatin membranes were placed over the bone defects. LIPUS (160 mW/cm2, 15 min/day) was applied to the defect area with an active transducer externally in the experimental groups according to the schedules of the applications: Group 1 (day 6 - 12), group 2 (day 13 - 19), group 3 (day 20 - 26), group 4 (day 6 - 19) and group 5 (day 6 - 26). All the animals were sacrificed at 28 days. The defects were analyzed with micro CT and then histologically. Results: In Group 1, new bone formation was significantly promoted and the newly-formed bone was thick and matured compared to the one of the control group. In other experimental groups there were tendencies of stimulation of new bone formation;however, they were not statistically significant. Discussion and Conclusion: The present study demonstrated that amount of new bone formation in the bone defect depended on the time and period of LIPUS application. It has been suggested that application of LIPUS at an early healing period, the second week after the surgery, effectively accelerated new bone formation.
基金Supported by The Grant-in-Aid for Scientific Research from Ministry of Education,Science and Culture Japan,No.24591541 to Masayuki Nagasawa
文摘An 11-year-old boy with acute lymphocytic leukemia(ALL) contracted disseminated candidiasis during induction therapy, which was complicated with rupture of a fungal cranial aneurysm. Ventricular drainage and coil embolization of a residual aneurysm in combination with intensive antifungal therapy rescued the patient. Although clinical improvement was achieved, high fever and elevated levels of C-reactive protein and β-D-glucan continued for more than 10 mo. One year later, the ALL relapsed during maintenance therapy with methotrexate and 6-mercaptopurine. After salvage chemotherapy, the patient received unrelated bone marrow transplantation(BMT) in a non-complete remission condition and survived. During subsequent chemotherapy and BMT, no recurrence of the fungal infection was observed under the prophylactic anti-fungal therapy with micafungin.
