ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 11 of 67
Up
УЖМБС 2020, 5(3): 89–97
https://doi.org/10.26693/jmbs05.03.089
Medicine. Reviews

Modern Aspects of Bone Tissue Reparative Regeneration and Analysis of Bone Metabolism Indices

Ryabenko T. V.
Abstract

According to the analysis of modern literary sources on the study of aspects of bone tissue reparative regeneration of, data on its staging were systematized, cellular and molecular mechanisms of reparative regeneration of bone tissue were studied, and bone metabolism indices were analyzed. It is necessary that the regeneration of bone tissue seamlessly lay down the functional activities of osteogenic clits. In the initial stage of reparative osteogenesis, osteoclasts provide resorption in the area of defect of necrotized bone fragments and participate in the remodeling of bone fragments. Osteoblasts form primary bone beams, which are made of collagen fibrils. They synthesize the bone matrix, ensure its mineralization, produce collagen proteins. Osteocytes provide the transmission of mechanical and chemical signals to osteoblasts and through the integument cells to osteoclasts, which initiates bone remodeling processes. An important role in the processes of local regulation of osteogenesis is to establish such signaling paths as the RANK / RANKL / OPG system, fast morphogenetic cells, Wnt signalization. Osteoclast activity and degree of bone resorption depend on the balance between RANKL and OPG. RANKL, which is located on the surface of osteoblasts, binds to the RANK receptor on the membranes of osteoclast precursor cells. This triggers osteoclastogenesis, which enhances bone resorption. Bone morphogenetic proteins stimulate osteoblast differentiation, promote bone and cartilage formation. Wnt proteins are regulators of the processes of bone regeneration and remodeling, differentiation of stem cells. Osteoblastic and osteoclastogenesis are characterized by biochemical markers of bone remodeling. For the evaluation of bone formation, the most informative is the determination of the level of osteocalcin, C and N-terminal propeptide of type I procollagen, and the assessment of the resorption-concentration of C-terminal telopeptide of collagen I type, tartrate-resistant acid phosphatase in blood plasma and the level of plasma dezinoxin. Using markers of bone remodeling, one can investigate the rate of bone metabolic processes, identify patients at risk for bone loss, conduct an early evaluation of the effectiveness of the prescribed treatment, predict the risk of complications, and diagnose the occurrence of bone metastases at an early date.

Keywords: reparative regeneration, osteoblasts, osteocytes, osteoclasts, markers of bone remodeling

Full text: PDF (Ukr) 234K

References
  1. Sherehii AA. Novi metody likuvannia diafizarnykh perelomiv [New methods of treatment of diaphyseal fractures]. Uzhgorod University Scientific Bulletin. 2010; 39: 238-41. [Ukrainian]
  2. Kyrylova YA. Kostnaia tkan kak osnova osteoplastycheskykh materyalov dlia vosstanovlenyia kostnoi struktury [Bone tissue as a basis of osteoplastic materials for restoration of bone structure]. Spine Surgery. 2011; 1: 68-74. [Russian] https://doi.org/10.14531/ss2011.1.68-74
  3. Bumeister VI, Pohorielov MV. Suchasnyi pohliad na reparatyvnyi osteohenez [A modern look at reparative osteogenesis]. The world of medicine and biology. 2008; 4: 104-10. [Ukrainian]
  4. Korzh AA, Dedukh NV. Reparatyvnaia reheneratsyia kosty: sovremennyi vzghliad na problemu.Stadyy reheneratsyy (soobshchenye 1) [A modern look at reparative osteogenesis]. The world of medicine and biology. 2008; 4: 104-10. [Ukrainian]
  5. Shteinle AV. Posttravmatycheskaia reheneratsyia kostnoi tkany [Post-traumatic bone regeneration]. Siberian Medical Journal. 2009; 4: 101-6. [Russian]
  6. Korzh NA, Dedukh NV. Yspolzovanye osseyn-hydroksyapatytnoho kompleksa v lechenyy osteoporoza y perelomov [Use of ossein-hydroxyapatite complex in the treatment of osteoporosis and fractures]. Orthopedics, Traumatology and Prosthetics. 2016; 2: 120-9. [Ukrainian] https://doi.org/10.15674/0030-598720162120-129
  7. Brusko AT, Haiko HV. Sovremennye predstavlenyia o stadyiakh reparatyvnoi reheneratsyy kostnoi tkany pry perelomakh [Modern ideas about the stages of reparative regeneration of bone tissue in fractures]. News of orthopedics, traumatology and prosthetics. 2014; 2: 5-8. [Ukrainian]
  8. Huminskyi YuY, Korenkov OV. Suchasni aspekty ekomorfolohii reparatyvnoho osteoheneza [Modern aspects of ecomorphology of reparative osteogenesis]. Bulletin of Sumy State University. 2009; 1 (2): 17-23. [Ukrainian]
  9. Kaminska MO. Porushennia reparatyvnoi reheneratsii pry perelomakh kistok u ditei [Disorders of reparative regeneration in bone fractures in children]. Medical perspectives. 2009; XIV (1); 21-6. [Ukrainian]
  10. Smyrnov AV, Rumiantsev ASh. Stroenye y funktsyy kostnoi tkany v norme y pry patolohyy. Soobshchenye I [Structure and function of bone tissue in normal and pathology. Message I]. Nephrology. 2014; 18(6): 9-25. [Russian]
  11. Yakymiuk DY, Kryvetskyi VV, Banul BYu, Kryvetskyi IV. Sovremennye predstavlenyia o roste, razvytyy y formoobrazovanyy kostnoho skeleta cheloveka [Modern ideas about the growth, development and shaping of the human skeleton]. Bukovinsky medical newsletter. 2013; 2(66): 181-5. [Ukrainian]
  12. Avrunyn AS, Tykhylov AS. Osteotsytarnoe remodelyrovanye kostnoi tkany:ystoryia voprosa, morfolohycheskye marker [Osteocyte bone remodeling: a history of the issue, morphological markers]. Morphology. 2011; 139(1): 86-95. [Russian]
  13. Chen H, Senda T, Kubo KY. The osteocyte plays multiple roles in bone remodeling and mineral homeostasis. Med Mol Morphol. 2015; 48(2): 61-8. https://www.ncbi.nlm.nih.gov/pubmed/25791218. https://doi.org/10.1007/s00795-015-0099-y
  14. Ahanov DS, Tyrenko VV, Tsyhan EN, Toporkov MM, Bolohov SH. Rol tsytokynovoi systemy RANK/RANKL/OPG v rehuliatsyy myneralnoho obmena kostnoi tkany [The role of the cytokine system RANK/RANKL/OPG in the regulation of bone mineral metabolism]. Genes € Cells. 2014; IX (4): 50-2. [Russian]
  15. Sagalovsky S, Schonert M. RANKL-RANK-OPG system and bone remodeling: a new approach on the treatment of osteoporosis. Clin Explt Pathol. 2011; 10(2): 146-153. [Russian]
  16. Onopryenko HA, Voloshyn VP. Sovremennye kontseptsyy protsessov fyzyolohycheskoho y reparatyvnoho osteoheneza [Modern concepts of processes of physiological and reparative osteogenesis]. Almanac of Clinical Medicine. 2017; 45(2): 79-93. [Russian] https://doi.org/10.18786/2072-0505-2017-45-2-79-79
  17. Smyrnov AV, Rumiantsev ASh. Stroenye y funktsyy kostnoi tkany v norme y pry patolohyy. Soobshchenye II. [Structure and function of bone tissue in normal and pathology. Message II]. Nephrology. 2015; 19(1): 8-17. [Russian]
  18. Sahalovsky S, Kuntse P, Shenert M. Rol tsytokynovoi systemy RANK-RANKL-OPG y katepsyna K v patoheneze osteoporoza: dostyzhenyia y perspektyvy v lechenyy zabolevanyia [The role of the cytokine system RANK-RANKL-OPG and cathepsin K in the pathogenesis of osteoporosis: achievements and prospects in the treatment of the disease]. Clinician. 2012; 2: 9-16. [Russian]
  19. Hershtein ES, Tymofeev YuS, Korotkova EA, Zuev AA, Bondarev AV, Kuznetsov YN, i dr. Retseptor-aktyvator yadernoho transkryptsyonnoho faktora NF-kB(RANK), eho lyhand (RANKL) y pryrodnyi ynhybytor osteoproteheryn (OPG) v syvorotke krovy bolnykh opukholiamy kostei [Receptor-activator of nuclear transcription factor NF-κB (RANK), its ligand (RANKL) and natural osteoprotegerin inhibitor (OPG) in the serum of patients with bone tumors]. Issues in Biological, Medical, and Pharmaceutical Chemistry. 2015; 10: 43-8. [Russian]
  20. Kukita A, Kukita T. Multifunctional properties of RANKL/RANK in cell differentiation, proliferation and metastasis. Future Oncol. 2013; 11(9): 1609-22. https://www.ncbi.nlm.nih.gov/pubmed/24156322. https://doi.org/10.2217/fon.13.115
  21. Ardura JA, Portal-Nunes S, Castelbon-Calvo I, Martínez de Toda I, De la Fuente M, Esbrit P. Parathyroid hormone-related protein protects osteoblastic cells from oxidative stress by activation of MKP1 phosphatase. J Cell Physiol. 2017; 232(4): 785-96. https://www.ncbi.nlm.nih.gov/pubmed/27357344. https://doi.org/10.1002/jcp.25473
  22. Esbrit P, Herrera S, Portal-Núñez S, Nogués X, Díez-Pérez A. Parathyroid Hormone-Related Protein analogs as Osteoporosis Therapies. Calcified Tissue international. 2016; 98(4): 359-69. https://www.ncbi.nlm.nih.gov/pubmed/26259869. https://doi.org/10.1007/s00223-015-0050-1
  23. Augustine M, Horwits MJ. Parathyroid hormone and parathyroid hormone-related protein analogs as therapies for osteoporosis. Curr Osteoporos Rep. 2013; 11: 400-6. https://www.ncbi.nlm.nih.gov/pubmed/24078470. https://www.ncbi.nlm.nih.gov/pmc/articles/3874264. https://doi.org/10.1007/s11914-013-0171-2
  24. Povorozniuk VV. Vlyianye kaltsytonyna na reparatyvnuiu reheneratsyiu kostnoi tkany [Effect of calcitonin on reparative bone tissue regeneration]. Trauma. 2015; 15(4): 30-4. [Ukrainian]
  25. Nurullyna HM, Akhmadullyna HA. Kostnoe remodelyrovanye v norme y pry pervychnom osteoporoze: znachenye markerov kostnoho remodelyrovanyia [Bone remodeling is normal and in primary osteoporosis: the significance of bone remodeling markers]. The Russian Archive of Internal Medicine. 2018; 2: 100-10. [Russian] https://doi.org/10.20514/2226-6704-2018-8-2-100-110
  26. Korshunova EYu, Dmytryeva LA, Lebedev VF. Tsytokynovaia rehuliatsmia metabolyzma kostnoi tkany [Cytokine renal bone metabolism]. Polytrauma. 2012; 3: 82-6. [Russian]
  27. Crane JL, Cao X. Bone marrow mesenchymal stem cells and TGF-β signaling in bone remodeling. J Clin Invest. 2014; 124(2): 466-72. https://www.ncbi.nlm.nih.gov/pubmed/24487640. https://www.ncbi.nlm.nih.gov/pmc/articles/3904610. https://doi.org/10.1172/JCI70050
  28. Hoffmeyer K, Raggioli A, Rudloff S, Anton R, Hierholzer A, Del Valle I, et al. Wnt/β-Catenin Signaling Regulates Telomerase in Stem Cells and Cancer Cells. Science. 2012; 336(6088): 1549-54. https://www.ncbi.nlm.nih.gov/pubmed/22723415. https://doi.org/10.1126/science.1218370
  29. Janda CY, Waghray D, Levin AM, Thomas C, Garcia KC. Structural basis of Wnt recognition by Frizzled. Science. 2012; 337(6090): 59-64. https://www.ncbi.nlm.nih.gov/pubmed/22653731. https://www.ncbi.nlm.nih.gov/pmc/articles/3577348. https://doi.org/10.1126/science.1222879
  30. Li VS, Nig SS, Boersema PJ, Low TY, Karthaus WR, Gerlach JP, et al. Wnt signaling through inhibition of β-catenin degradation in an intact Axin1 complex. Cell. 2012; 149(6): 1245-56. https://www.ncbi.nlm.nih.gov/pubmed/22682247. https://doi.org/10.1016/j.cell.2012.05.002
  31. Hrebennykova TA, Belaia ZhE, Rozhynskaia LYa, Melnychenko HA, Dedov YY. Epyhenetycheskye aspekty osteoporoza [Epigenetic aspects of osteoporosis]. Journal of RAMP. 2015; 70 (5): 541-8. [Russian] https://www.ncbi.nlm.nih.gov/pubmed/26846079. https://doi.org/10.15690/vramn.v70.i5.1440
  32. Slobodian OM, Lavriv LP, Lopushniak LYa, Bambuliak AV, Boichuk OM. Suchasnyi pohliad na molekuliarno-henetychni mekhanizmy mizhklitynnoi vzaiemodii u protsesi kistkovoho remodeliuvannia [A modern look at the molecular-genetic mechanisms of intercellular interaction in the process of bone remodeling]. Clinical anatomy and surgical surgery. 2018; 17(3): 88-97. [Ukrainian]
  33. Koh JM. Osteoclast-derived SLIT3 is a coupling factor linking bone resorption to bone formation. BMB Rep. 2018; 51(6): 263-4. https://www.ncbi.nlm.nih.gov/pubmed/29764562. https://www.ncbi.nlm.nih.gov/pmc/articles/6033072. https://doi.org/10.5483/BMBRep.2018.51.6.109
  34. Liubymova NV, Kushlynskyi NE. Byokhymycheskye markery yetastazyrovanyia v kosty [Biochemical markers of bone metastasis]. Advances in Molecular Oncology. 2015; 1: 61-75. [Russian]
  35. Kuzniak NB, Boitsaniuk SI, Sukhovolets IO. Vykorystannia kistkovykh markeriv kistkovoho metabolizmu v stomatolohii [Use of bone markers of bone metabolism in dentistry]. Clinical dentistry. 2015; 1: 99-104. [Ukrainian]
  36. Masheiko YV. Byokhymycheskye markery v otsenke protsessov remodelyrovanyia kostnoi tkany pry osteopenyy y osteoporoze [Biochemical markers in the evaluation of bone remodeling processes in osteopenia and osteoporosis]. Journal of the Grodno State Medical University. 2017; 2: 149-53. [Ukrainian]
  37. Sykora VZ, Pohorelov MV, Tkach HF, Bumeister VY. Nekollahenovye belky kostnoho matryksa kak markery remodelyrovanyia kosty [Bone matrix collagen proteins as markers of bone remodeling]. Ukrainian morphological almanakh. 2011; 9(3): 28-35. [Ukrainian]
  38. Zakharov YS, Kolpynskyi HY, Ushakova HA, Vavyn HV. Byokhymycheskye yarkeri v dyahnostyke narushenyi remodelyrovanyia kostnoi tkany pry osteoporoze [Biochemical markers in the diagnosis of disorders of bone remodeling in osteoporosis]. Avicenna Herald. 2013; 4: 120-2. [Russian]
  39. Kabalyk MA. Byomarkery y uchastnyky remodelyrovanyia subkhondralnoi kosty pry osteoartroze [Biomarkers and participants in subchondral bone remodeling in osteoarthritis]. Pacific Medical Journal. 2017; 1: 36-41. [Russian]
  40. Laryna VN, Mykhailusova MP, Raspopova TN. Prymenenye byokhymycheskykh markerov kostnoho obmena v povsednevnoi deiatelnosty vracha [The use of biochemical markers of bone metabolism in the daily activity of a physician]. Medical Affairs. 2015; 2: 10-4. [Russian]
  41. Streich NA, Zimmermann D, Schmitt H, Bode G. Biochemical markers in the diagnosis of chondral defects following anterior cruciate ligament insufficiency. Int Orthop. 2011; 35(11): 1633-7. https://www.ncbi.nlm.nih.gov/pubmed/21221577. https://www.ncbi.nlm.nih.gov/pmc/articles/3193972. https://doi.org/10.1007/s00264-010-1191-5
  42. Richette P, Roux C. Impact of treatments for osteoporosis on cartilage biomarkers in humans. Osteoporos Int. 2012; 23(8): 877-80. https://www.ncbi.nlm.nih.gov/pubmed/23179570. https://doi.org/10.1007/s00198-012-2165-9
  43. Romero Barco CM, Manrigue Arija S, Rodriguez M. Biochemical Markers in Osteoporosis: usefulness in Clinical Practice. Reumatol Clin. 2012; 8(3): 149-52. https://www.ncbi.nlm.nih.gov/pubmed/22089065. https://doi.org/10.1016/j.reumae.2011.05.004
  44. Ehudyna ED, Holovach YYu. Laboratornye aspekty i klynycheskaia znachymost markerov kostnoho remodelyrovanyia [Laboratory aspects and clinical relevance of bone remodeling markers]. Annals of Mechnikov Institute. 2019; 3: 7-18. [Ukrainian]
  45. Tomniuk ND, Spyrydonov AV, Munyn AM, Danylyna EP. Osteoporoz-bolezn skeleta liudei pozhyloho y starcheskoho vozrasta [Osteoporosis is a skeleton disease of the elderly and senile]. International Journal of Applied and Basic Research. 2020; 1: 47-51. [Russian]
  46. Tsyskarashvyly AV, Rodyonova SS, Myronov SP, Bukhtyn KM, Horbatiuk DS, Taraskyn AYu. Metabolycheskye narushenyia kostnoi tkany u patsyentov s perelomamy dlynnykh kostei, oslozhnennykh khronycheskym osteomyelytom [Metabolic bone disorders in patients with long bone fractures complicated by chronic osteomyelitis]. The genius of Orthopedics. 2019; 25 (2): 149-55. [Russian] https://doi.org/10.18019/1028-4427-2019-25-2-149-155