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Serum levels of fibroblast growth factor 2 in children with orthopedic diseases: Potential role in predicting bone healing
Author(s) -
Granchi Donatella,
Devescovi Valentina,
Pratelli Loredana,
Verri Elisabetta,
Magnani Marina,
Donzelli Onofrio,
Baldini Nicola
Publication year - 2013
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.22219
Subject(s) - medicine , orthopedic surgery , fibroblast growth factor , bone healing , fibroblast growth factor 23 , stromal cell , bone marrow , surgery , endocrinology , pathology , parathyroid hormone , receptor , calcium
Abstract Fibroblast growth factor 2 (FGF‐2) plays an important role in the early phases of bone healing. In this study, we measured FGF‐2 serum levels in 88 children undergoing surgical treatment for congenital ( n = 49) or acquired ( n = 39) orthopedic conditions, which were associated ( n = 35) or not ( n = 53) with bone lesions, to assess whether serum levels of FGF‐2 varied according to the underlying disease and may predict clinical outcomes. FGF‐2 serum levels were significantly lower in patients who did not heal after surgery ( p = 0.008). Diagnostic accuracy was validated statistically, and the ROC curve provided a threshold value useful in discriminating good versus poor outcomes. The relationship between FGF‐2 and bone healing was supported by in vitro experiments. A mineralization assay was performed on bone marrow stromal cells from three patients with congenital pseudarthrosis, who had low serum levels of FGF‐2 and a poor clinical outcome after surgical treatment. Autologous serum alone was not sufficient to induce in vitro mineralization, but it did occur when cells were cultured with different sources of exogenous growth factors (GFs), including recombinant FGF‐2 and homologous serum collected from children with fractures, high FGF‐2 levels, and a good clinical outcome. In conclusion, our findings suggest that osteoinductive GFs are essential for bone repair, and that the amount of circulating FGF‐2 may predict bone healing. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 249–256, 2013