Translational treatment paradigm for managing non-unions secondary to radiation injury utilizing adipose derived stem cells and angiogenic therapy

利用脂肪干细胞和血管生成疗法治疗放射损伤继发骨不连的转化治疗范例

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作者:Alexis Donneys, Jordan T Blough, Noah S Nelson, Joseph E Perosky, Sagar S Deshpande, Stephen Y Kang, Peter A Felice, Christian Figueredo, Jonathan R Peterson, Kenneth M Kozloff, Benjamin Levi, Douglas B Chepeha, Steven R Buchman

Background

Bony non-unions arising in the aftermath of collateral radiation injury are commonly managed with vascularized free tissue transfers. Unfortunately, these procedures are invasive and fraught with attendant morbidities. This study investigated a novel, alternative treatment paradigm utilizing adipose-derived stem cells (ASCs) combined with angiogenic deferoxamine (DFO) in the rat mandible.

Conclusion

We support the continued investigation of this promising combination therapy in its potential translation for the management of radiation-induced bony pathology. © 2015 Wiley Periodicals, Inc. Head Neck 38: E837-E843, 2016.

Methods

Rats were exposed to a bioequivalent dose of radiation and mandibular osteotomy. Those exhibiting non-unions were subsequently treated with surgical debridement alone or debridement plus combination therapy. Radiographic and biomechanical outcomes were assessed after healing.

Results

Significant increases in biomechanical strength and radiographic metrics were observed in response to combination therapy (p < .05). Importantly, combined therapy enabled a 65% reduction in persisting non-unions when compared to debridement alone.

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