Heterotopic ossification after the use of recombinant human bone morphogenetic protein-7

AIM To present the incidence of heterotopic ossification after the use of recombinant human bone morphogenetic protein-7(rhB MP-7) for the treatment of nonunions.METHODS Bone morphogenetic proteins(BMPs) promote bone formation by auto-induction. Recombinant human BMP-7 in combination with bone grafts was used in 84 patients for the treatment of long bone nonunions. All patients were evaluated radiographicaly for the development of heterotopic ossification during the standard assessment for the nonunion healing. In all patients(80.9%) with radiographic signs of heterotopic ossification, a CT scan was performed. Nonunion site palpation and ROM evaluation of the adjacent jointswere also carried out. Factors related to the patient(age, gender), the nonunion(location, size, chronicity, number of previous procedures, infection, surrounding tissues condition) and the surgical procedure(graft and fixation type, amount of rhB MP-7) were correlated with the development of heterotopic ossification and statistical analysis with Pearsons χ~2 test was performed.RESULTS Eighty point nine percent of the nonunions treated with rh BMP-7, healed with no need for further procedures. Heterotopic bone formation occurred in 15 of 84 patients(17.8%) and it was apparent in the routine radiologi-cal evaluation of the nonunion site, in a mean time of 5.5 mo after the rh BMP-7 application(range 3-12). The heterotopic ossification was located at the femur in 8 cases, at the tibia in 6, and at the humerus in οne patient. In 4 patients a palpable mass was present and only in one patient, with a para-articular knee nonunion treated with rhB MP-7, the size of heterotopic ossification affected the knee range of motion. All the patients with heterotopic ossification were male. Statistical analysis proved that patient's gender was the only important factor for the development of heterotopic ossification(P = 0.007). CONCLUSION Heterotopic ossification after the use of rh BMP-7 in nonunions was common but it did not compromise the final clinical outcome in most cases, and affected only male patients.

Construction of Adeno-associated Virus System for Human Bone Morphogenetic Protein 7 Gene

To construct the recombinant adeno-associated virus （rAAV） vector with human bone morphogenetic protein 7 （BMP7） and observe the BMP7 mRNA expression in vitro, BMP7 CDS sequence was cloned into expression plasmid pAAV-MCS of AAV Helper Free System. The recombinant plasmid was identified with enzyme digestion and sequencing. The recombinant plasmid, pAAV-RC, pHelper were co-transfected into AAV-293 cells according to the calcium phosphate-based protocol. The viral stock was collected by 4 rounds of freeze/thaw. After purified and concentrated, the recombinant virus titer was determined by dot-blot assay. HEK293 cells were transfected with the recombinant virus at different MOI, and the expression of BMP7 mRNA was detected by RT-PCR. The results showed rAAV-BMP7 was constructed and packaged successfully. The physical particle titer was 2.5×10^11 vector genomes/mL. There was different expression level of BMP7 mRNA after transfecton. These data suggested that recombinant AAV mediated a stable expression of hBMP7 mRNA in 293 cells. The AAV production method may pave the way of an effective strategy for the jaw bone defection around dental implants.

Potential bone-inducing activity in vitro of recombinant human bone morphogenetic protein-7 from a CHO expression system

Objective: To express the recombinant human bone morphogenetic protein-7(rhBMP-7) in Chinese hamster ovary(CHO) cells, and to establish the in vitro biological activity assay of rhBMP-7.Methods: Human BMP-7 cDNA was subcloned into p114 mammalian expression vector and transfected to CHO cells by using the Lipofectamine 2000 transfection method. CHO cell supernatants were harvested and analyzed to identify the molecule mass of secreted rhBMP-7 and examine its biological activity in vitro to stimulate the synthesis of alkaline phophatase(ALP), a characteristic of osteoblast phenotypes. Results: rhBMP-7 was produced stably in CHO cells, as a processed mature disulfide-linked homodimer, with an apparent molecular mass of 36 000. Examination of the rhBMP-7 biological activity showed that rhBMP-7 specifically stimulated the production of ALP(4-fold increase at 100 ng of rhBMP-7/ml). Conclusion: The rhBMP-7 from CHO expression system has significant biological activity in induction of osteoblast phenotype, which demonstrates rhBMP-7 has the potential bone regeneration activity.

Molecular Cloning and Sequence Analysis of FullLength cDNA Encoding Human Bone Morphogenetic Protein—7

Objective:To clone the full-length human bane morphogenetic protein-7 (BMP-7 ) gene and analyse its sequence, to aid in investigation of its function and structure. Methods : Total RNA was isolated from Chinese fetal kidney by the acid gmnidinium thiocyanate phenol-chloroform method. Two overlapping segments of human BMP- 1 cDNA were obtained by reverse transcription (RT)-PCR. Following application, the two segments were ligated to each other and subcloned into POEM-T easy vector to form PEGM-T easy/hBMP-7 recombinant plasmid. Sanger dideoxy chain-termination method was used to sequence the cDNA. Results. There was 750 bp fragment obtained RT-PCR using #2 primer from 5' end of BMP-7 gene (PCR by using # 2 and # 1) ,and 540 bp fragment from 3' end was generated by KT-PCR using # 4 primer (PCR using # 3 and # 4). Full-length cDNA encoding BMP-7 was obtained by religation of two segments. When compared with hBMP-7 sequence in Gene bank (XM30619) ,our full-length BMP-7 cDNA has a G instead of a T at nucleotide 862. This change results in valine substituting for phenylalanine in the protein. Conclusion. This is the first time that BMP-7 cDNA was successfully cloned from Chinese fetal kidney. BMP-7 cDNA plays an important role in healing injuries of the osteo-articular system. This makes BMP-7 is an attractive target far various clinical applications.

Exogenous bone morphogenetic protein-7 reduces hepatic fibrosis inSchistosoma japonicum-infected micevia transforming growth factor-β/Smad signaling

AIM: To investigate the antifibrotic effects of bone morphogenetic protein-7 (BMP-7) on Schistosoma japonicum (S. japonicum )-induced hepatic fibrosis in BALB/C mice. METHODS: Sixty BALB/C mice were randomly divided into three groups, including a control group (group A, n = 20), model group (group B, n = 20) and BMP-7 treated group (group C, n = 20). The mice in group B and group C were abdominally infected with S. japonicum cercariae to induce a schistosomal hepatic fibrosis model. The mice in group C were administered human recombinant BMP-7. Liver samples were extracted from mice sacrificed at 9 and 15 wk after modeling. Hepatic histopathological changes were assessed using Masson's staining. Transforming growth factor-beta 1 (TGF-β1), alpha-smooth muscle actin (α-SMA), phosphorylated Smad2/3 (pSmad2/3) and Smad7 protein levels and localization were measured by Western blotting and immunohistochemistry, respectively, and their mRNA expressions were detected by reverse transcriptionpolymerase chain reaction (RT-PCR). RESULTS: The schistosomal hepatic fibrosis mouse model was successfully established, as the livers of mice in group B and group C showed varying degrees of typical schistosomal hepatopathologic changes such as egg granuloma and collagen deposition. The degree of collagen deposition in group C was higher than that in group A (week 9: 22.95±6.66vs 2.02±0.76; week 15: 12.84±4.36 vs 1.74±0.80; P<0.05), but significantly lower than that in group B (week 9: 22.95±6.66 vs 34.43±6.96; week 15: 12.84±4.36 vs 18.90±5.07;P<0.05) at both time points. According to immunohistochemistry data, the expressions of α-SMA, TGF-β1 and pSmad2/3 protein in group C were higher than those in group A (α-SMA: week 9: 21.24±5.73 vs 0.33±0.20; week 15: 12.42±4.88 vs 0.34±0.27; TGF-β1: week 9: 37.00±13.74 vs 3.73±2.14; week 15: 16.71±9.80 vs 3.08±2.35; pSmad2/3: week 9: 12.92±4.81 vs 0.83±0.48; week 15: 7.87±4.09 vs 0.90±0.45; P<0.05), but significantly lower than those in group B (α-SMA: week 9: 21.24±5.73 vs 34.39±5.74; week 15: 12.42±4.88 vs 25.90±7.01; TGF-β1: week 9: 37.00±13.74 vs 55.66±14.88; week 15: 16.71±9.80 vs 37.10±12.51; pSmad2/3: week 9: 12.92±4.81 vs 19.41±6.87; week 15: 7.87±4.09vs 13.00±4.98;P<0.05) at both time points; the expression of Smad7 protein in group B was higher than that in group A and group C at week 9 (8.46±3.95 vs 1.00±0.40 and 8.46±3.95 vs 0.77±0.42; P<0.05), while there were no differences in Smad7 expression between the three groups at week 15 (1.09±0.38 vs 0.97±0.42 vs 0.89±0.39; P>0.05). Although minor discrepancies were observed, the results of RT-PCR and Western blotting were mainly consistentwith the immunohistochemical results. CONCLUSION: Exogenous BMP-7 significantly decreased the degree of hepatic fibrosis in both the acute and chronic stages of hepato-schistosomiasis, and the regulatory mechanism may involve the TGF-β/Smad signaling pathway.

RETINOIC ACID DOWN-REGULATES BONE MORPHOGENETIC PROTEIN 7 EXPRESSION IN RAT WITH CLEFT PALATE

Objective To evaluate the effects of retinoic acid(RA)on expression of bone morphogenetic protein 7(BMP-7)in rat fetus with cleft palate,and the effects of RA on proliferation and apoptosis of osteoblasts.Methods All-trans RA(ATRA)was used to induce congenital cleft palate in Wistar rat.BMP-7 mRNA expression in maxillary bone tissue of fetal rats was measured by Northern blotting analysis.Flow cytometry and MTT assay were used to measure the apoptosis and proliferation of ATRA-treated MC-3T3-E1 cells.BMP-7 mRNA and protein expressions in ATRA-treated MC-3T3-E1 cells were detected by RT-PCR and Western blotting analysis.Results ATRA could induce cleft palate of rat fetus.The incidence rate of cleft palate induced by 100 mg/kg ATRA(45.5%)was significantly higher than 50 mg/kg ATRA(12.5%,P<0.05).BMP-7 mRNA expression decreased in maxillary bone tissue of rat fetus with cleft palate.MC-3T3-E1 cells proliferation treated with 1×10-6 mol/LATRA decreased by 60%,the cell apoptosis increased by 2 times.BMP-7 mRNA and protein levels in MC-3T3-E1 cells treated with 1×10-6 mol/L ATRA decreased by 60% and 80%,respectively,compared with ATRA-untreated cells(P<0.05).Conclusions BMP-7 may play an important role in embryonic palate development.RA may possess the ability to down-regulate cell proliferation through regulation of BMP-7 gene expression.

Roles and regulation of bone morphogenetic protein-7 in kidney development and diseases

The gene encoding bone morphogenetic protein-7(BMP7) is expressed in the developing kidney in embryos and also in the mature organ in adults. During kidney development, expression of BMP7 is essential to determine the final number of nephrons in and proper size of the organ. The secreted BMP7 acts on the nephron progenitor cells to exert its dual functions: To maintain and expand the progenitor population and to provide them with competence to respond to differentiation cues, each relying on distinct signaling pathways. Intriguingly, in the adult organ, BMP7 has been implicated in protection against and regeneration from injury. Exogenous administration of recombinant BMP7 to animal models of kidney diseases has shown promising effects in counteracting inflammation, apoptosis and fibrosis evoked upon injury. Although the expression pattern of BMP7 has been well described, the mechanisms by which it is regulated have remained elusive and the processes by which the secretion sites of BMP7 impinge upon its functions in kidney development and diseases have not yet been assessed. Understanding the regulatory mechanisms will pave the way towards gaining better insight into the roles of BMP7, and to achieving desired control of the gene expression as a therapeutic strategy for kidney diseases.

Bone morphogenetic protein 7 mediates stem cells migration and angiogenesis:therapeutic potential for endogenous pulp regeneration

Pulp loss is accompanied by the functional impairment of defense,sensory,and nutrition supply.The approach based on endogenous stem cells is a potential strategy for pulp regeneration.However,endogenous stem cell sources,exogenous regenerative signals,and neovascularization are major difficulties for pulp regeneration based on endogenous stem cells.Therefore,the purpose of our research is to seek an effective cytokines delivery strategy and bioactive materials to reestablish an ideal regenerative microenvironment for pulp regeneration.In in vitro study,we investigated the effects of Wnt3a,transforming growth factor-beta 1,and bone morphogenetic protein 7(BMP7)on human dental pulp stem cells(h-DPSCs)and human umbilical vein endothelial cells.2D and 3D culture systems based on collagen gel,matrigel,and gelatin methacryloyl were fabricated to evaluate the morphology and viability of h-DPSCs.In in vivo study,an ectopic nude mouse model and an in situ beagle dog model were established to investigate the possibility of pulp regeneration by implanting collagen gel loading BMP7.We concluded that BMP7promoted the migration and odontogenic differentiation of h-DPSCs and vessel formation.Collagen gel maintained the cell adhesion,cell spreading,and cell viability of h-DPSCs in 2D or 3D culture.The transplantation of collagen gel loading BMP7 induced vascularized pulp-like tissue regeneration in vivo.The injectable approach based on collagen gel loading BMP7 might exert promising therapeutic application in endogenous pulp regeneration.

Bone morphogenetic protein-7 induced bone marrow stromal cells differentiate into neuron-like cells

Bone morphogenetic protein-7 is widely accepted as an inducer for bone marrow stem cells differentiating into osteoblasts and chondrocytes. Whether bone marrow stromal cells differentiate into neuron-like cells remains unclear. The current study examined the presence of positive cells for intermediate filament protein and microtubule associated protein-2 in the cytoplasm of bone marrow stromal cells induced by bone morphogenetic protein-7 under an inverted microscope, while no expression of glial fibrillary acidic protein was found. Reverse transcription PCR electrophoresis also revealed a positive target band for intermediate filament protein and microtubule-associated protein 2 mRNA. These results confirmed that bone morphogenetic protein-7 induces rat bone marrow stromal cells differentiating into neuron-like cells.

Expression of bone morphogenetic protein 7 in the cerebral cortex of rats after ischemic-hypoxic injury

BACKGROUND： Some researches demonstrate that exogenous bone morphogenetic protein 7 （BMP-7） can protect ischemic cerebral nerve tissue and promote recovery of motor energy function; however, there is lack of direct evidences of endogenous BMP-7 effect. OBJECTIVE： To observe the expression of endogenous BMP-7 in nerve tissue with ischemic-hypoxic injury and investigate the possible effects on damaged nerve tissue. DESIGN： Observational contrast animal study. SETTING： Department of Anatomy and Histoembryology, Peking University Health Science Center. MATERIALS： The experiment was carried out in the Nerve Researching Laboratory of Anatomy Department, Peking University Health Science Center from October 2006 to March 2007. A total of 25 adult male SD rats weighing 250 - 300 g and several newborn SD rats were selected from Experimental Animal Center, Peking University Health Science Center. Rabbit-anti-BMP-7 polyclonal antibody was provided by Wuhan Boster Company. METHODS： ① Adult rats were randomly divided into ischemia group （n =10）, sham operation group （n = 10） and normal group （n =5）. Right external-internal carotid artery occlusion was used to infarct middle cerebral artery of adult rats in the ischemia group so as to copy focal cerebral infarction models. Line cork was inserted in crotch of internal and external carotid artery of adult rats in the sham operation group, while adult rats in the normal group were not given any treatments. ② Cerebral cortex of newborn rats was separated to obtain cell suspension. Cells which were cultured for 10 days were divided into control group and hypoxia/reoxygenation group. And then, cells in the hypoxia/reoxygenation group were cultured in hypoxic incubator for 4 hours and given reoxygenation for 24 hours. MAIN OUTCOME MEASURES： Immunohistochemical method was used to measure expression of BMP-7 in cerebral cortex at 24 hours after ischemia/reperfusion culture and in primary hypoxic culture. RESULTS： ① At 24 hours after cerebral ischemia, expression of BMP-7 in cerebral cortex on ischemic side was stronger than that on non-ischemic side in adult rats; meanwhile, numbers of cell expression were increased. However, expression of BMP-7 was not detected in bilateral cerebral cortex of adult rats in both control group and sham operation group. ② After hypoxia of cerebral cortex in primary culture, positive products of BMP-7 were observed in plasma of neuron, but expression of BMP-7 was not found in normal cerebral cortex. CONCLUSION： Endogenous BMP-7 has protective effects on nerve tissue induced by ischemic-hypoxic injury.

基于BMP-2/BMP-7机制探讨生龙接骨胶囊预防老年骨质疏松性胸腰椎骨折术后再发性骨折的作用

目的探讨生龙接骨胶囊对老年骨质疏松性胸腰椎骨折(OTF)术后再发性骨折的作用,并基于骨形态发生蛋白-2/骨形态发生蛋白-7(BMP-2/BMP-7)机制初步分析其作用机制。方法选取2020年1月至2022年10月在南昌市洪都中医院收治的100例行经皮椎体成形术(PVP)的老年OTF患者为研究对象,按随机数字表法分为常规组(50例)和胶囊组(50例)。常规组采用常规的PVP治疗,胶囊组患者在常规组基础上服用生龙接骨胶囊治疗。比较两组患者椎体结构(Cobb角和伤椎椎体前缘高度比)、治疗前后血清BMP-2、BMP-7水平、骨代谢指标[骨特异性碱性磷酸酶(BALP)、Ⅰ型原胶原N端前肽(PⅠNP)、骨钙素(OST)]、骨密度(BMD)、康复情况[Oswestry腰椎功能障碍指数(ODI)]评估、疼痛等级[视觉模拟评分法(VAS)]评分、临床有效率、椎体再骨折发生率和不良反应发生情况。结果治疗后,两组患者Cobb角改善,伤椎椎体前缘高度比优于治疗前,胶囊组均优于常规组,差异有统计学意义(P<0.05);胶囊组的BMP-2、BMP-7表达量高于常规组,差异有统计学意义(P<0.05);患者术后再发性骨折情况均良好,胶囊组愈合速度快于常规组,差异有统计学意义(P<0.05);治疗后,胶囊组的BALP、PⅠNP、OST均高于常规组,差异有统计学意义(P<0.05);两组患者的BMD高于治疗前,且胶囊组高于常规组,ODI评分、VAS评分均低于治疗前,且胶囊组低于常规组,差异有统计学意义(P<0.05);胶囊组的临床总有效率(95.0%)高于常规组(80.0%),胶囊组的再骨折发生率(4%)低于常规组(18%),差异有统计学意义(P<0.05);两组患者均未见明显不良反应。结论生龙接骨胶囊能通过上调患者血清BMP-2、BMP-7水平,改善BMD从而预防老年OTF的术后再发性骨折,其机制可能与生龙接骨胶囊能刺激BMP信号通路,加速成骨细胞分化有关。

A型肉毒毒素防治额部外伤瘢痕的美学效果及对血清TGF-β_(1)、BMP-7水平的影响

目的:探讨A型肉毒毒素防治额部外伤瘢痕的美学效果及对血清TGF-β_(1)、BMP-7水平的影响。方法:选取2020年7月-2022年10月笔者医院收治的84例额部外伤患者为研究对象,按随机数字表法分为观察组和对照组,各42例。对照组采用清创美容缝合联合外用硅凝胶制剂防治瘢痕;观察组采用美容缝合拆线后伤口两侧注射A型肉毒毒素防治瘢痕。拆线后3个月,统计比较两组瘢痕临床防治有效率、瘢痕评分[温哥华瘢痕量表(Vancouver scar scale,VSS)]、瘢痕疼痛或瘙痒程度评分[视觉模拟评分法(Visual analogue scale,VAS)]、患者满意度、血清转化生长因子β_(1)(Transforming growth factor-β_(1),TGF-β_(1))和骨成型蛋白7(Recombinant bone morphogenetic protein 7,BMP-7)水平及不良反应。结果:观察组VSS评分、瘢痕疼痛或瘙痒程度VAS评分低于对照组(P<0.05);观察组瘢痕临床防治有效率为90.47%,高于对照组的69.04%(P<0.05);观察组患者满意度高于对照组(P<0.05);观察组TGF-β_(1)水平低于对照组,BMP-7水平高于对照组(P<0.05);两组均未发生严重不良反应。结论:额部软组织外伤患者美容缝合拆线后伤口两侧注射A型肉毒毒素可抑制瘢痕形成,有效提升瘢痕防治有效率及患者满意度,其临床效果可能与调控血清TGF-β_(1)和BMP-7水平有关,且安全性较高,具有一定的临床应用价值。

子宫内膜癌BMP7、Id1、Id3表达及其与病理特征的相关性

目的 探讨子宫内膜癌骨形态发生蛋白7(BMP7)、分化抑制蛋白1(Id1)、分化抑制蛋白3(Id3)表达及其与病理特征的相关性。方法 纳入2022年1~12月医院收治的60例子宫内膜癌患者为研究组,选择30例同期其他妇科手术行诊断性刮宫的正常子宫内膜患者为对照组,采用实时荧光定量及蛋白质印迹法检测两组BMP7、Id1、Id3的m RNA和蛋白含量,分析其与病理特征的相关性。结果 研究组BMP7、Id1、Id3的m RNA及蛋白表达高于对照组(P<0.05);除年龄、病理类型、宫颈间质受累外,BMP7、Id1、Id3蛋白表达水平比较,低分化者高于中+高分化者,国际妇产科协会(FIGO)分期Ⅲ期高于Ⅰ+Ⅱ期,肌层浸润≥1/2者高于肌层浸润<1/2者,有淋巴结转移者高于无淋巴结转移者,有附件转移者高于无附件转移者(P<0.05);经Spearman分析结果显示:BMP7、Id1、Id3 m RNA表达水平与分化程度、FIGO分期、肌层浸润、淋巴结转移及附件转移均呈中度正相关,r值为0.625~0.746(P<0.05)。结论BMP7、Id1、Id3表达与子宫内膜癌病理特征存在一定关联,通过监测其水平表达有助于评估子宫内膜癌病情。

骨形态发生蛋白7通过下调Ajuba减轻糖尿病肾病大鼠肾纤维化

目的:探讨在糖尿病肾病(DKD)大鼠模型中,骨形态发生蛋白7(BMP7)是否通过下调Ajuba水平,降低Yes相关蛋白1(YAP1)的表达,进而减轻细胞外基质(ECM)沉积从而减轻DKD大鼠肾组织纤维化程度。方法:18只SD大鼠随机分为正常对照组(NC组)、糖尿病组(DM组)和DM+过表达BMP7腺相关病毒组(DM+rAAVBMP7组),每组6只。采用尾静脉注射55 mg/kg链脲佐菌素(STZ)建立DM大鼠模型。NRK-52E细胞分为正常糖组、高糖(HG)组和HG+rhBMP7组。HE和天狼星红染色观察大鼠肾皮质病理形态学变化;免疫组织化学染色检测肾皮质Ajuba、YAP1的表达部位;Western blot法检测大鼠肾皮质及NRK-52E细胞中BMP7、Ajuba和YAP1、Ⅲ型胶原(Col-Ⅲ)和纤维连接蛋白(FN)的蛋白表达水平;RT-qPCR检测大鼠肾皮质Ajuba和YAP1 mRNA的表达水平。结果:生化指标检测显示DM组大鼠血糖、血肌酐、甘油三酯、总胆固醇及24 h尿蛋白水平较NC组显著升高(P<0.05),尿肌酐较NC组显著降低(P<0.05);与DM组相比,DM+rAAV-BMP7组大鼠血肌酐、24 h尿蛋白定量水平、甘油三酯和总胆固醇显著降低(P<0.05),尿肌酐显著升高(P<0.05);病理染色显示DM组肾间质出现炎症细胞浸润及胶原纤维沉积,肾小管萎缩且排列紊乱,DM+rAAV-BMP7组的病理变化较DM组显著改善;免疫组化结果显示在肾皮质中Ajuba和YAP1主要表达于细胞质和细胞核,且在DM组高表达,但DM+rAAV-BMP7组其表达则显著降低;Western blot结果显示DM组或HG组中FN、Col-Ⅲ、Ajuba和YAP1的蛋白水平上调(P<0.05),但在DM+rAAV-BMP7组中上述蛋白表达水平又显著降低(P<0.05);RT-qPCR结果显示DM组Ajuba、YAP1的mRNA水平较NC组显著上升(P<0.05),DM+rAAV-BMP7组Ajuba、YAP1的mRNA水平较DM组又显著降低(P<0.05)。结论:过表达BMP7可减轻DKD大鼠的肾纤维化,其机制可能与下调Ajuba,减少YAP1的表达,从而抑制了ECM的沉积有关。

碳酸司维拉姆联合血液透析对尿毒症后肾性骨病患者的影响

目的:观察并探讨尿毒症后肾性骨病患者临床治疗过程中血液透析与碳酸司维拉姆联合应用效果及对成纤维细胞生长因子23(FGF-23)、骨形态发生蛋白7(BMP-7)的影响。方法:于2022年1月—2023年1月广州市第一人民医院南沙医院接收72例尿毒症后肾性骨病患者,运用随机数字表法给进行分组,对照组(n=36)、联合组(n=36)。其中对照组进行血液透析治疗,联合组则在血液透析基础上加用碳酸司维拉姆。比较两组临床治疗效果、骨碱性磷酸酶(BAP)、FGF-23、BMP-7、甲状旁腺激素(PTH)、C反应蛋白(CRP)、β_(2)微球蛋白(β_(2)-MG)、骨钙素(OCN)、不良反应。结果:联合组临床总有效率为91.67%,高于对照组的72.22%,差异有统计学意义(P<0.05)。治疗前,两组BAP、FGF-23、BMP-7、PTH、CRP、β_(2)-MG、OCN比较,差异均无统计学意义(P>0.05);治疗后,联合组BMP-7高于对照组,BAP、FGF-23、PTH、CRP、β_(2)-MG、OCN均低于对照组,差异均有统计学意义(P<0.05);联合组胃胀气、腹泻、反胃、干呕等不良反应发生率为11.11%与对照组的16.67%比较,差异无统计学意义(P>0.05)。结论:尿毒症后肾性骨病患者在血液透析期间联合碳酸司维拉姆治疗具有确切效果,可调节骨代谢,改善肾功能,减轻微炎症反应,安全性高,患者耐受。

人骨形态发生蛋白7(hBMP7)在毕赤酵母中的分泌表达

依据酵母密码子使用偏好性,利用重叠延伸PCR(OE-PCR)介导的定点突变方法,对人骨形态发生蛋白-7(human Bone Morphogenetic Protein-7,hBMP7)成熟肽编码序列进行改造,将毕赤酵母低频使用的精氨酸密码子CGG或CGA突变为高频使用的同义密码子AGA,明显提高了hBMP7成熟肽在毕赤酵母中的表达量摇瓶培养表达量为25.45mg/L,是改造前序列的4.6倍;TricineSDS-PAGE及Western-blotting结果表明,rhBMP7成熟肽分子量为18kD,以单体形式存在,具有良好的免疫原性;利用梯度浓度G418筛选到一株高拷贝整合的转化子,该转化子摇瓶表达量为45.45mg/L,约为单拷贝转化子的2倍。表达上清经阳离子交换介质SPSepharoseR○FastFlow纯化后,目的蛋白纯度达到90%。纯化后的样品与I型胶原混合冻干后埋植于小鼠股部肌袋内,能异位诱导间充质细胞分化形成软骨细胞。

促愈消肿汤对运动致肱骨远端骨折患者术后骨生长及功能恢复的影响

目的:探究促愈消肿汤对运动致肱骨远端骨折患者术后血清成纤维细胞生长因子2(FGF-2)、骨形态发生蛋白7(BMP-7)水平及骨愈合状态的影响。方法:选取2021年3月至2022年9月河南省中医院收治的运动致肱骨远端骨折患者86例作为研究对象,采用随机数字法分为对照组和观察组,每组43例。对照组术后采用常规康复治疗;观察组在对照组基础上服用促愈消肿汤治疗。对比治疗后2组临床疗效及术后恢复情况,术后1 d与术后7 d时2组肘关节功能、关节活动度及血清FGF-2、BMP-7水平差异。结果:观察组临床疗效为93.02%,显著高于对照组的76.74%(P<0.05);治疗后观察组疼痛消除时间、术处消肿时间及骨折愈合时间显著短于对照组(均P<0.05);术后7 d时,观察组Mayo肘关节功能量表,关节活动度(ROM)评分以及血清FGF-2、BMP-7水平显著升高,且高于对照组(均P<0.05);术后7 d时,观察组视觉模拟评分法(VAS)得分较术后1 d时显著降低,且低于对照组(均P<0.05)。结论:运动致肱骨远端骨折患者术后服用促愈消肿汤能有效促进血清FGF-2、BMP-7水平表达上调,改善肘关节活动功能,缓解术后疼痛,加速骨折愈合。

肾衰营养胶囊对肾性骨病模型大鼠肾功能和骨代谢的改善作用及其对BMP-7/Smads信号通路的影响

目的:探讨肾衰营养胶囊对肾性骨病模型大鼠的改善作用及其对骨形态发生蛋白(BMP)-7/Smads信号通路的影响,阐明肾性骨病模型大鼠肾功能和骨代谢与肾性骨病的关系。方法:选取50只SPF级SD大鼠,随机选取10只大鼠作为对照组,另外40只大鼠建立肾性骨病模型。将30只造模成功大鼠分为模型组、阳性对照组和肾衰营养胶囊组,每组各10只。对照组和模型组大鼠采用生理盐水灌胃,阳性对照组大鼠给予0.01 mg·kg^(-1)骨化三醇灌服,肾衰营养胶囊组大鼠给予1.2 g·kg^(-1)肾衰营养胶囊灌服,均灌胃12周。采用HE染色观察各组大鼠股骨组织病理形态表现,全自动生化分析仪和化学发光法检测各组大鼠血清中肾功能和钙磷代谢指标,实时荧光定量PCR(RT-qPCR)法检测各组大鼠股骨组织中BMP-7和Smad1/5/8 mRNA表达水平,Western blotting法检测各组大鼠股骨组织中BMP-7、磷酸化BMP-7(p-BMP-7)、Smad1/5/8和磷酸化Smad1/5/8(p-Smad1/5/8)蛋白表达水平。结果:HE染色,对照组大鼠骨小梁排列正常,成骨细胞和类骨质面积未发生改变;模型组大鼠骨小梁宽度和平均类骨质面积增加,成骨细胞数量减少;阳性对照组和肾衰营养胶囊组大鼠骨小梁宽度及平均类骨质面积减小,成骨细胞数量增加。与对照组比较,模型组大鼠血尿素氮(BUN)和血肌酐(Scr)水平均升高(P<0.05);与模型组比较,阳性对照组和肾衰营养胶囊组大鼠BUN及Scr水平均降低(P<0.05);与阳性对照组比较,肾衰营养胶囊组大鼠BUN和Scr水平均降低(P<0.05)。与对照组比较,模型组大鼠血清中钙离子(Ca2+)水平降低(P<0.05),磷离子(P3-)、甲状旁腺激素(PTH)和碱性磷酸酶(ALP)水平均升高(P<0.05);与模型组比较,阳性对照组和肾衰营养胶囊组大鼠血清中Ca2+水平升高(P<0.05),P3-、PTH和ALP水平均降低(P<0.05);与阳性对照组比较,肾衰营养胶囊组大鼠血清中Ca2+水平升高(P<0.05),P3-、PTH和ALP水平均降低(P<0.05)。RT-qPCR法,与对照组比较,模型组大鼠股骨组织中BMP-7和Smad1/5/8mRNA表达水平降低(P<0.05);与模型组比较,阳性对照药组和肾衰营养胶囊组大鼠股骨组织中BMP-7及Smad1/5/8 mRNA表达水平升高(P<0.05);与阳性对照组比较,肾衰营养胶囊组大鼠股骨组织中BMP-7和Smad1/5/8 mRNA表达水平升高(P<0.05)。Western blotting法,与对照组比较,模型组大鼠股骨组织中BMP-7、p-BMP-7、Smad1/5/8和p-Smad1/5/8蛋白表达水平均降低(P<0.05);与模型组比较,阳性对照组和肾衰营养胶囊组大鼠股骨组织中BMP-7、 p-BMP-7、 Smad1/5/8和p-Smad1/5/8蛋白表达水平均升高(P<0.05);与阳性对照组比较,肾衰营养胶囊组大鼠股骨组织中BMP-7、p-BMP-7、Smad1/5/8和p-Smad1/5/8蛋白表达水平均升高(P<0.05)。结论:肾衰营养胶囊可改善肾性骨病模型大鼠的肾功能和钙磷代谢紊乱,促进骨髓基质细胞增殖,改善骨代谢情况,其机制可能与激活BMP-7/Smads信号通路有关。

帕立骨化醇对肾性骨病大鼠骨代谢及TGF-β/BMP-7/Smad通路的影响

目的:探讨帕立骨化醇对肾性骨病(ROD)大鼠骨代谢及转化生长因子-β(TGF-β)/骨形态发生蛋白-7(BMP-7)/Smad通路的影响。方法:将90只大鼠随机分为6组:对照组、模型组、帕立骨化醇低剂量(0.2μg/kg)组、帕立骨化醇中剂量(0.4μg/kg)组、帕立骨化醇高剂量(0.8μg/kg)组、骨化三醇(10μg/kg)组,每组15只,对照组大鼠以普通饲料喂养,其余各组大鼠用含有腺嘌呤的饲料喂养,诱导建立ROD模型。分组进行药物治疗后,测定各组大鼠肾功能指标血尿素氮(BUN)与血肌酐(Scr)水平、血钙与血磷水平、股骨骨密度(BMD)、股骨生物力学指标最大载荷、弹性模量与屈服载荷、血清炎症因子IL-6、IL-17水平;采用蛋白免疫印迹法检测骨组织TGF-β/BMP-7/Smad通路蛋白表达情况。再次取45只大鼠随机分为3组:帕立骨化醇(0.8μg/kg)组、TGF-β抑制(LY2157299,150 mg/kg)组、帕立骨化醇(0.8μg/kg)+TGF-β抑制(LY2157299,150 mg/kg)组,每组15只,同样方法建立ROD模型。分组以药物治疗后,测定各组大鼠肾功能指标与股骨生物力学指标水平。结果:与对照组比较,模型组大鼠血钙水平、BMD、弹性模量、最大载荷、屈服载荷、骨组织TGF-β/BMP-7/Smad通路蛋白TGF-β及BMP-7表达、p-Smad3/Smad3显著降低(P<0.05),BUN与Scr水平、血磷水平、血清IL-6与IL-17水平显著升高(P<0.05)。与模型组比较,帕立骨化醇低、中、高剂量组和骨化三醇组大鼠血钙水平、BMD、弹性模量、最大载荷、屈服载荷、骨组织TGF-β/BMP-7/Smad通路蛋白TGF-β及BMP-7表达、p-Smad3/Smad3均升高,BUN与Scr水平、血磷水平、血清IL-6与IL-17水平均降低,且帕立骨化醇各组之间呈剂量依赖性(P<0.05),帕立骨化醇高剂量组和骨化三醇组比较,大鼠各指标差异无统计学意义(P>0.05)。与帕立骨化醇+TGF-β抑制组比较,帕立骨化醇组大鼠肾功能指标BUN、Scr与血磷水平降低(P<0.05),血钙水平、BMD、弹性模量、最大载荷、屈服载荷升高(P<0.05);TGF-β抑制组大鼠肾功能指标BUN、Scr与血磷水平升高(P<0.05),血钙水平、BMD、弹性模量、最大载荷、屈服载荷降低(P<0.05)。结论:帕立骨化醇可通过激活TGF-β/BMP-7/Smad信号通路抑制炎症反应,改善ROD大鼠肾功能及骨代谢异常,降低血磷水平,提高血钙水平及骨密度,修复骨生物力学,改善骨病症状。