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Critical Reviews™ in Eukaryotic Gene Expression
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ISSN Imprimir: 1045-4403
ISSN En Línea: 2162-6502

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Critical Reviews™ in Eukaryotic Gene Expression

DOI: 10.1615/CritRevEukarGeneExpr.v20.i2.20
pages 105-127

Recent Advances in the Use of Serological Bone Formation Markers to Monitor Callus Development and Fracture Healing

Marlon O. Coulibaly
Grand Rapids Medical Education and Research Center
Debra L. Sietsema
Orthopaedic Associates of Michigan; Center for Skeletal Disease Research, Van Andel Research Institute; Michigan State University, Grand Rapids, Michigan
Travis A. Burgers
Center for Skeletal Disease Research, Van Andel Research Institute
Jim Mason
Center for Skeletal Disease Research, Van Andel Research Institute
Bart Williams
Center for Skeletal Disease Research, Van Andel Research Institute
Clifford B. Jones
Orthopaedic Associates of Michigan; Center for Skeletal Disease Research, Van Andel Research Institute; Michigan State University, Grand Rapids, Michigan

SINOPSIS

The failure of an osseous fracture to heal, or the development of a nonunion, is common; however, current diagnostic measures lack the capability of early and reliable detection of such events. Analyses of radiographic imaging and clinical examination, in combination, remain the gold standard for diagnosis; however, these methods are not reliable for early detection. Delayed diagnosis of a nonunion is costly from both the patient and treatment standpoints. In response, repeated efforts have been made to identify bone metabolic markers as diagnostic or prognostic tools for monitoring bone healing. Thus far, the evidence regarding a correlation between the kinetics of most bone metabolic markers and nonunion is very limited. With the aim of classifying the role of biological pathways of bone metabolism and of understanding bone conditions in the development of osteoporosis, advances have been made in our knowledge of the molecular basis of bone remodeling, fracture healing, and its failure. Procollagen type I amino-terminal propeptide has been shown to be a reliable bone formation marker in osteoporosis therapy and its kinetics during fracture healing has been recently described. In this article, we suggest that procollagen type I amino-terminal propeptide presents a good opportunity for early detection of nonunion. We also review the role and potential of serum PINP, as well as other markers, as indications of fracture healing.


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