Fracture healing as a post‐natal developmental process: molecular, spatial, and temporal aspects of its regulation

LC Gerstenfeld, DM Cullinane… - Journal of cellular …, 2003 - Wiley Online Library
LC Gerstenfeld, DM Cullinane, GL Barnes, DT Graves, TA Einhorn
Journal of cellular biochemistry, 2003Wiley Online Library
Fracture healing is a specialized post‐natal repair process that recapitulates aspects of
embryological skeletal development. While many of the molecular mechanisms that control
cellular differentiation and growth during embryogenesis recur during fracture healing, these
processes take place in a post‐natal environment that is unique and distinct from those
which exist during embryogenesis. This Prospect Article will highlight a number of central
biological processes that are believed to be crucial in the embryonic differentiation and …
Abstract
Fracture healing is a specialized post‐natal repair process that recapitulates aspects of embryological skeletal development. While many of the molecular mechanisms that control cellular differentiation and growth during embryogenesis recur during fracture healing, these processes take place in a post‐natal environment that is unique and distinct from those which exist during embryogenesis. This Prospect Article will highlight a number of central biological processes that are believed to be crucial in the embryonic differentiation and growth of skeletal tissues and review the functional role of these processes during fracture healing. Specific aspects of fracture healing that will be considered in relation to embryological development are: (1) the anatomic structure of the fracture callus as it evolves during healing; (2) the origins of stem cells and morphogenetic signals that facilitate the repair process; (3) the role of the biomechanical environment in controlling cellular differentiation during repair; (4) the role of three key groups of soluble factors, pro‐inflammatory cytokines, the TGF‐β superfamily, and angiogenic factors, during repair; and (5) the relationship of the genetic components that control bone mass and remodeling to the mechanisms that control skeletal tissue repair in response to fracture. J. Cell. Biochem. 88: 873–884, 2003. © 2003 Wiley‐Liss, Inc.
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