Citation

Sang X, Wang Z, Qin T, Li Y. Ann. Clin. Biochem. 2016; 54(5): 584-592.

Affiliation

Qilu Hospital of Shandong University.

Copyright

(Copyright © 2016, Royal Society of Medicine Press)

DOI

10.1177/0004563216673087

PMID

27687082

Abstract

BACKGROUND: Compelling evidence indicate that traumatic brain injury (TBI) is highly related to accelerated bone fracture repair, but the underlying mechanism still remains elusive. Fracture repair process relies greatly on the formation of new blood vessels in fracture site and angiogenic factors have been confirmed to be essential for the initiation and maintenance of the fracture healing. Hypoxia-inducible factor-1α (HIF-1α) was demonstrated to be a critical regulator of angiogenic-osteogenic coupling during bone development and regeneration. The aim of the present was to investigate the local and circulating concentrations of HIF-1α in patients with long-bone fractures and concomitant TBI and to determine the potential role of HIF-1α in fracture healing.

METHODS: 25 patients with a long-bone fracture and concomitant TBI (FT group) and 33 without a brain injury (Fr group) were enrolled in this study. Healthy subjects donated serum samples as control. Serum samples were collected over a period of 6 months, following a standardized time schedule. HIF-1α levels were measured in fracture hematoma and serum of patients in both groups using enzyme-linked immunosorbent assay.

RESULTS: Patients in FT group had a short time to union. Serum HIF-1α concentrations elevated in the early healing period and reached the maximum level during intramembranous bone formation phase in both groups. Thereafter, it decreased continuously and approached to the minimum levels until the end of the observation period. Serum HIF-1α concentrations in both group were significantly higher compared to controls and HIF-1α levels in both serum and fracture hematoma were higher in FT group than that in Fr group. Fracture hematoma contained significantly higher HIF-1α levels compared to HIF-1α levels in serum. Serum HIF-1α concentrations had a positive correlation with HIF-1α concentrations in fracture hematoma in patients with fractures.

CONCLUSIONS: These findings suggest the local and systemic involvement of HIF-1α in fracture healing and the accelerated fracture repair in patients with TBI might be associated with elevated HIF-1α levels in fracture hematoma and serum.

© 2016 Sage Publications, Inc.

Language: en