Association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures

Background/Aim. The inflammatory response is of utmost importance in bone healing, but the precise role of cells and cytokines remains unclear. In our study, we examined the as-sociation between interleukin-1β (IL-1β), tumor necrosis fac-tors alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1)...

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Main Authors: Paunović Zoran, Milutinović Sanja, Stanković Nikola, Abazović Džihan, Stanojević Ivan, Rakić Mia, Đukić Mirjana, Šupić Gordana, Vojvodić Danilo, Marić Dušan, Khan Wasim S., Starčević Srđan
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2021-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900078P.pdf
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author Paunović Zoran
Milutinović Sanja
Stanković Nikola
Abazović Džihan
Stanojević Ivan
Rakić Mia
Đukić Mirjana
Šupić Gordana
Vojvodić Danilo
Marić Dušan
Khan Wasim S.
Starčević Srđan
author_facet Paunović Zoran
Milutinović Sanja
Stanković Nikola
Abazović Džihan
Stanojević Ivan
Rakić Mia
Đukić Mirjana
Šupić Gordana
Vojvodić Danilo
Marić Dušan
Khan Wasim S.
Starčević Srđan
author_sort Paunović Zoran
collection DOAJ
description Background/Aim. The inflammatory response is of utmost importance in bone healing, but the precise role of cells and cytokines remains unclear. In our study, we examined the as-sociation between interleukin-1β (IL-1β), tumor necrosis fac-tors alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) concentrations, fracture configuration, and callus formation. Methods. Serum cyto-kine concentrations were determined in 78 non-obese chil-dren with long bone fractures (group 1), 10 children with fin-ger fractures (group 2), and 10 healthy controls (group 3). Blood samples were taken immediately after fracture upon hospital admission for groups 1 and 2. Differences in cyto-kine concentrations were analyzed among groups and catego-rized according to fracture configuration and callus for-mation. Results. IL-1β and TNF-α levels were lower in pa-tients that went on to produce incomplete callus compared with patients that formed complete callus. Surprisingly, the average IL-1β concentration was highest in the healthy con-trol group. The only significant correlation between IL-1β and TNF-α was in the group with moderate callus formation. MCP-1 level was slightly increased in all patient groups com-pared to controls, with no mutual difference. An average IL-8 level showed a clear decrease tendency from the group with incompletely formed callus toward the group with completely formed callus compared to controls, without significant dif-ference. Children with epiphysiolysis had the lowest concen-trations of cytokines compared with all other fracture types including transverse, oblique, and spiral. There were signifi-cantly lower concentrations of IL-1β and MCP-1 in patients with less fragment displacement compared with patients with greater fragment displacement. Conclusion. The systemic in-flammatory response is important in physiological bone heal-ing. High early production of IL-1β, TNF-α, and MCP-1 is associated with greater callus formation and better healing outcome, while increased IL-8 level is associated with poor callus formation and worse healing outcome. Our results in-dicate that epiphysiolysis and larger fragment displacement are associated with delayed fracture healing.
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series Vojnosanitetski Pregled
spelling doaj-art-0727ffd5214b4bf698f1bfd64e12f1962025-08-20T01:59:10ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202021-01-0178439740210.2298/VSP190526078P0042-84501900078PAssociation of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fracturesPaunović Zoran0Milutinović Sanja1https://orcid.org/0000-0003-3225-3793Stanković Nikola2Abazović Džihan3Stanojević Ivan4Rakić Mia5https://orcid.org/0000-0001-7093-7956Đukić Mirjana6Šupić Gordana7https://orcid.org/0000-0003-0350-4733Vojvodić Danilo8https://orcid.org/0000-0001-9308-3076Marić Dušan9Khan Wasim S.10Starčević Srđan11Institute for Health Protection of Mother and Child of Serbia “Dr. Vukan Čupić“, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaInstitute for Health Protection of Mother and Child of Serbia “Dr. Vukan Čupić“, Belgrade, SerbiaEmergency Medical Center of Montenegro, Podgorica, MontenegroUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Institute for Medical Research, Belgrade, SerbiaUniversity of Nantes, Faculty of Dental Surgery, Nantes, France + University of Belgrade, Institute for Biological Research “Siniša Stanković“, Belgrade, Serbia University of Belgrade, Faculty of Pharmacy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Institute for Medical Research, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Institute for Medical Research, Belgrade, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, SerbianemaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy,Clinic for Orthopedics and Traumatology, Belgrade, SerbiaBackground/Aim. The inflammatory response is of utmost importance in bone healing, but the precise role of cells and cytokines remains unclear. In our study, we examined the as-sociation between interleukin-1β (IL-1β), tumor necrosis fac-tors alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) concentrations, fracture configuration, and callus formation. Methods. Serum cyto-kine concentrations were determined in 78 non-obese chil-dren with long bone fractures (group 1), 10 children with fin-ger fractures (group 2), and 10 healthy controls (group 3). Blood samples were taken immediately after fracture upon hospital admission for groups 1 and 2. Differences in cyto-kine concentrations were analyzed among groups and catego-rized according to fracture configuration and callus for-mation. Results. IL-1β and TNF-α levels were lower in pa-tients that went on to produce incomplete callus compared with patients that formed complete callus. Surprisingly, the average IL-1β concentration was highest in the healthy con-trol group. The only significant correlation between IL-1β and TNF-α was in the group with moderate callus formation. MCP-1 level was slightly increased in all patient groups com-pared to controls, with no mutual difference. An average IL-8 level showed a clear decrease tendency from the group with incompletely formed callus toward the group with completely formed callus compared to controls, without significant dif-ference. Children with epiphysiolysis had the lowest concen-trations of cytokines compared with all other fracture types including transverse, oblique, and spiral. There were signifi-cantly lower concentrations of IL-1β and MCP-1 in patients with less fragment displacement compared with patients with greater fragment displacement. Conclusion. The systemic in-flammatory response is important in physiological bone heal-ing. High early production of IL-1β, TNF-α, and MCP-1 is associated with greater callus formation and better healing outcome, while increased IL-8 level is associated with poor callus formation and worse healing outcome. Our results in-dicate that epiphysiolysis and larger fragment displacement are associated with delayed fracture healing.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900078P.pdfprognosisfractures, bonefracture healingchildadolescentbony callusinterleukin-1betatumor necrosis factor-alphamonocyte chemoattractant protein-1interleukin-8prognosis
spellingShingle Paunović Zoran
Milutinović Sanja
Stanković Nikola
Abazović Džihan
Stanojević Ivan
Rakić Mia
Đukić Mirjana
Šupić Gordana
Vojvodić Danilo
Marić Dušan
Khan Wasim S.
Starčević Srđan
Association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures
Vojnosanitetski Pregled
prognosis
fractures, bone
fracture healing
child
adolescent
bony callus
interleukin-1beta
tumor necrosis factor-alpha
monocyte chemoattractant protein-1
interleukin-8
prognosis
title Association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures
title_full Association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures
title_fullStr Association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures
title_full_unstemmed Association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures
title_short Association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures
title_sort association of fracture configuration and callus formation with a concentration of proinflammatory cytokines in children with long bone fractures
topic prognosis
fractures, bone
fracture healing
child
adolescent
bony callus
interleukin-1beta
tumor necrosis factor-alpha
monocyte chemoattractant protein-1
interleukin-8
prognosis
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900078P.pdf
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