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Journal of Clinical Densitometry : the... 2024Interventional studies offer strong evidence for exercise's osteogenic impact on bone particularly during growth. With rising osteoporosis rates in older women,... (Review)
Review
Interventional studies offer strong evidence for exercise's osteogenic impact on bone particularly during growth. With rising osteoporosis rates in older women, enhancing bone strength early in life is crucial. Thus, investigating the osteogenic effects of different types of physical activities in young females is crucial. Despite varied findings, only two systematic reviews tried to explore this topic without examining how different types of exercise may affect bone health in adolescent girls. The first aim of this systematic review was to assess the impact of exercise training on bone health parameters in adolescent girls, and the second aim was to investigate whether the type of exercise training can modulate this effect. A systematic literature search was conducted using common electronic databases from inception - January 2023. Seven studies (355 participants) were eligible for inclusion in this systematic review. Two studies dealt with resistance training, 3 studies applied plyometric training, 1 study used team sports, and 1 study used dancing. Results indicate that plyometric training increases lumbar spine bone mass in adolescent girls. Well-designed randomized controlled trials with a proper training period (> 12 weeks) are needed to advocate a specific type of training which has the highest osteogenic effect.
Topics: Humans; Adolescent; Female; Aged; Bone Density; Exercise; Bone and Bones; Osteoporosis; Osteogenesis
PubMed: 38052114
DOI: 10.1016/j.jocd.2023.101454 -
The American Journal of Sports Medicine Feb 2024Based in part on the results of randomized controlled trials (RCTs) that suggest a beneficial effect over alternative treatment options, the use of platelet-rich plasma...
Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials.
BACKGROUND
Based in part on the results of randomized controlled trials (RCTs) that suggest a beneficial effect over alternative treatment options, the use of platelet-rich plasma (PRP) for the management of knee osteoarthritis (OA) is widespread and increasing. However, the extent to which these studies are vulnerable to slight variations in the outcomes of patients remains unknown.
PURPOSE
To evaluate the statistical fragility of conclusions from RCTs that reported outcomes of patients with knee OA who were treated with PRP versus alternative nonoperative management strategies.
STUDY DESIGN
Systematic review and meta-analysis; Level of evidence, 2.
METHODS
All RCTs comparing PRP with alternative nonoperative treatment options for knee OA were identified. The fragility index (FI) and reverse FI were applied to assess the robustness of conclusions regarding the efficacy of PRP for knee OA. Meta-analyses were performed to determine the minimum number of patients from ≥1 trials included in the meta-analysis for which a modification on the event status would change the statistical significance of the pooled treatment effect.
RESULTS
In total, this analysis included outcomes from 1993 patients with a mean ± SD age of 58.0 ± 3.8 years. The mean number of events required to reverse significance of individual RCTs (FI) was 4.57 ± 5.85. Based on random-effects meta-analyses, PRP demonstrated a significantly higher rate of successful outcomes when compared with hyaluronic acid ( = .002; odds ratio [OR], 2.19; 95% CI, 1.33-3.62), as well as higher rates of patient-reported symptom relief ( = .019; OR, 1.55; 95% CI, 1.07-2.24), not requiring a reintervention after the initial injection treatment ( = .002; OR, 2.17; 95% CI, 1.33-3.53), and achieving the minimal clinically important difference (MCID) for pain improvement ( = .007; OR, 6.19; 95% CI, 1.63-23.42) when compared with all alternative nonoperative treatments. Overall, the mean number of events per meta-analysis required to change the statistical significance of the pooled treatment effect was 8.67 ± 4.50.
CONCLUSION
Conclusions drawn from individual RCTs evaluating PRP for knee OA demonstrated slight robustness. On meta-analysis, PRP demonstrated a significant advantage over hyaluronic acid as well as improved symptom relief, lower rates of reintervention, and more frequent achievement of the MCID for pain improvement when compared with alternative nonoperative treatment options. Statistically significant pooled treatment effects evaluating PRP for knee OA are more robust than approximately half of all comparable meta-analyses in medicine and health care. Future RCTs and meta-analyses should consider reporting FIs and fragility quotients to facilitate interpretation of results in their proper context.
PubMed: 38420745
DOI: 10.1177/03635465231224463 -
International Journal of Molecular... Oct 2023Tissue engineering and cell therapy for regenerative medicine have great potential to treat chronic disorders. In musculoskeletal disorders, mesenchymal stromal cells... (Review)
Review
Tissue engineering and cell therapy for regenerative medicine have great potential to treat chronic disorders. In musculoskeletal disorders, mesenchymal stromal cells (MSCs) have been identified as a relevant cell type in cell and regenerative strategies due to their multi-lineage potential, although this is likely to be a result of their trophic and immunomodulatory effects on other cells. This PRISMA systematic review aims to assess whether the age of the patient influences the chondrogenic potential of MSCs in regenerative therapy. We identified a total of 3027 studies after performing a search of four databases, including Cochrane, Web of Science, Medline, and PubMed. After applying inclusion and exclusion criteria, a total of 14 papers were identified that were reviewed, assessed, and reported. Cell surface characterization and proliferation, as well as the osteogenic, adipogenic, and chondrogenic differentiation, were investigated as part of the analysis of these studies. Most included studies suggest a clear link between aged donor MSCs and diminished clonogenic and proliferative potential. Our study reveals a heterogeneous and conflicting range of outcomes concerning the chondrogenic, osteogenic, and adipogenic potential of MSCs in relation to age. Further investigations on the in vitro effects of chronological age on the chondrogenic potential of MSCs should follow the outcomes of this systematic review, shedding more light on this complex relationship.
Topics: Humans; Aged; Mesenchymal Stem Cells; Cell Differentiation; Osteogenesis; Adipogenesis; Tissue Engineering; Cells, Cultured; Chondrogenesis
PubMed: 37895174
DOI: 10.3390/ijms242015494 -
Cell Biochemistry and Function Mar 2024The demand for efficient and accelerated osseointegration in dental implantology has led to the exploration of innovative tissue engineering strategies. Immediate... (Review)
Review
The demand for efficient and accelerated osseointegration in dental implantology has led to the exploration of innovative tissue engineering strategies. Immediate implant loading reduces treatment duration and necessitates robust osseointegration to ensure long-term implant success. This review article discusses the current studies of tissue engineering innovations for enhancing osseointegration in immediate dental implant loading in the recent decade. Keywords "tissue engineering," "osseointegration," "immediate implant loading," and related terms were systematically searched. The review highlights the potential of bioactive materials and growth factor delivery systems in promoting osteogenic activity and accelerating bone regeneration. The in vivo experiment demonstrates significantly improved osseointegration in the experimental group compared to traditional immediate loading techniques, as evidenced by histological analyses and biomechanical assessments. It is possible to revolutionize the treatment outcomes and patient satisfaction in dental implants by integrating bioactive materials and growth factors.
Topics: Humans; Osseointegration; Immediate Dental Implant Loading; Tissue Engineering; Treatment Outcome; Osteogenesis
PubMed: 38491807
DOI: 10.1002/cbf.3974 -
International Journal of Molecular... Aug 2023Muscular dystrophy is a heterogenous group of hereditary muscle disorders caused by mutations in the genes responsible for muscle development, and is generally defined... (Review)
Review
Muscular dystrophy is a heterogenous group of hereditary muscle disorders caused by mutations in the genes responsible for muscle development, and is generally defined by a disastrous progression of muscle wasting and massive loss in muscle regeneration. is closely associated with myogenesis, which is governed by various signaling pathways throughout a lifetime and is frequently used as an indicator in muscle research. In this review, an extensive literature search adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed to identify research that examined signaling pathways in living models, while quantifying expression in myogenesis. A total of 247 articles were retrieved from the Web of Science (WoS), PubMed and Scopus databases and were thoroughly examined and evaluated, resulting in 19 articles which met the inclusion criteria. Admittedly, we were only able to discuss the quantification of carried out in research affecting various type of genes and signaling pathways, rather than the expression of itself, due to the massive differences in approach, factor molecules and signaling pathways analyzed across the research. However, we highlighted the thorough evidence for the alteration of the muscle stem cell precursor in multiple signaling pathways described in different living models, with an emphasis on the novel approach that could be taken in manipulating expression itself in dystrophic muscle, towards the discovery of an effective treatment for muscular dystrophy. Therefore, we believe that this could be applied to the potential gap in muscle research that could be filled by tuning the well-established marker expression to improve dystrophic muscle.
Topics: Humans; Muscular Dystrophies; Muscles; Databases, Factual; Muscle Development; Signal Transduction; PAX7 Transcription Factor
PubMed: 37685856
DOI: 10.3390/ijms241713051 -
Effect of mechanical forces on the behavior of osteoblasts: a systematic review of in vitro studies.Dental and Medical Problems 2023Mechanical loading can play a critical role in bone modeling/remodeling through osteoblasts, with several factors being involved in this process.The present study aims... (Review)
Review
Mechanical loading can play a critical role in bone modeling/remodeling through osteoblasts, with several factors being involved in this process.The present study aims to systematically review the effect of mechanical stimulation on human osteoblast cell lineage combined with other variables.The PubMed and Scopus databases were electronically searched for studies analyzing the effect of compression and tension on human osteoblasts at different differentiation stages. Studies that used carcinogenic osteoblasts were excluded. In addition, studies that did not analyze the osteogenic differentiation or proliferation of cells were excluded. The risk of bias of the studies was evaluated using the modified CONSORT (Consolidated Standards of Reporting Trials) checklist. a total of 20 studies were included. The cells were subjected to tension and compression in 5 and 15 studies, respectively. The application of uniaxial and cyclic strain increased the proliferation of osteoblasts. The same increased pattern could be observed for the osteogenesis of the cells. The impact of the tensile force on the expression of the osteoclastic markers differed based on the loading characteristics. On the other side, the impact of compression on the proliferation of osteoblasts varied according to the magnitude and duration of the force. Besides, different patterns of alternations were observed among the osteogenic markers in response to compression. Meanwhile, compression increased the expression of the osteoclastic markers. It has been shown that the response of the markers related to bone formation or resorption can be altered based on the differentiation stage of the cells, the cell culture system, and the magnitude and duration of the force.
Topics: Humans; Osteogenesis; Stress, Mechanical; Osteoblasts; Cell Differentiation
PubMed: 38133991
DOI: 10.17219/dmp/151639 -
Journal of Nanobiotechnology Apr 2024Rare earth nanomaterials (RE NMs), which are based on rare earth elements, have emerged as remarkable biomaterials for use in bone regeneration. The effects of RE NMs on... (Review)
Review
Rare earth nanomaterials (RE NMs), which are based on rare earth elements, have emerged as remarkable biomaterials for use in bone regeneration. The effects of RE NMs on osteogenesis, such as promoting the osteogenic differentiation of mesenchymal stem cells, have been investigated. However, the contributions of the properties of RE NMs to bone regeneration and their interactions with various cell types during osteogenesis have not been reviewed. Here, we review the crucial roles of the physicochemical and biological properties of RE NMs and focus on their osteogenic mechanisms. RE NMs directly promote the proliferation, adhesion, migration, and osteogenic differentiation of mesenchymal stem cells. They also increase collagen secretion and mineralization to accelerate osteogenesis. Furthermore, RE NMs inhibit osteoclast formation and regulate the immune environment by modulating macrophages and promote angiogenesis by inducing hypoxia in endothelial cells. These effects create a microenvironment that is conducive to bone formation. This review will help researchers overcome current limitations to take full advantage of the osteogenic benefits of RE NMs and will suggest a potential approach for further osteogenesis research.
Topics: Osteogenesis; Endothelial Cells; Bone Regeneration; Osteoclasts; Nanostructures; Cell Differentiation
PubMed: 38627717
DOI: 10.1186/s12951-024-02442-3 -
Stem Cells Translational Medicine Dec 2023The development of extracellular vesicles (EVs) therapies has revolutionized personalized medicine, opening up new possibilities for treatment. EVs have emerged as a...
The development of extracellular vesicles (EVs) therapies has revolutionized personalized medicine, opening up new possibilities for treatment. EVs have emerged as a promising therapeutic tool within this field due to their crucial role in intercellular communication across various cell types and organisms. This systematic review aims to evaluate the therapeutic potential of oral mesenchymal stem cell (MSC)-derived EVs for bone regeneration, specifically focusing on findings from preclinical models. Sixteen articles meeting the inclusion criteria were selected following document analysis. The biological effects of oral MSC-derived EVs predominantly involve the upregulation of proteins associated with angiogenesis, and inflammation resolution, alongside the downregulation of proinflammatory cytokines. Moreover, these therapeutic agents have been found to contain a significant quantity of different molecules (proteins, lipids, DNA, microRNAs, etc) further contributing to their modulatory potential. The findings from this systematic review underscore that oral MSC-derived EVs, irrespective of their specific population, have the ability to enhance the osteogenic repair response in maxillary bone or periodontal defects. In summary, this systematic review highlights the promising potential of oral MSC-derived EVs for bone regeneration based on evidence from preclinical models. The comprehensive assessment of their biological effects and the presence of microRNAs underscores their therapeutic significance. These findings support the utilization of oral MSC-derived EVs in enhancing the osteogenic repair response in various maxillary bone or periodontal defects, providing insights into the mechanisms involved and potential therapeutic applications in the field of personalized medicine.
Topics: Mesenchymal Stem Cells; Extracellular Vesicles; MicroRNAs; Bone Regeneration; Osteogenesis
PubMed: 37715961
DOI: 10.1093/stcltm/szad059 -
Spine Feb 2024A systematic review and meta-analysis. (Meta-Analysis)
Meta-Analysis
STUDY DESIGN
A systematic review and meta-analysis.
OBJECTIVE
This study systematically reviewed and evaluated the safety and efficacy of spinal endoscopic techniques as a treatment for thoracic ligamentum flavum ossification (TOLF).
SUMMARY OF BACKGROUND DATA
The use of spinal endoscopic techniques for the treatment of TOLF has increased in recent years. The present study is the first comprehensive systematic review and meta-analysis focused on the use of spinal endoscopic techniques for TOLF.
MATERIALS AND METHODS
The Cochrane Central, PubMed, Web of Science, and Embase databases were systematically searched for studies focused on patients undergoing spinal endoscopic techniques to treat symptomatic TOLF.
RESULTS
This meta-analysis included 23 studies. We included 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years, with 304 total recorded lesion locations of which 245 were located in the lower thoracic spine. Complications affected 35/323 patients, and the mean operative duration for 305 patients was 108.15±47.34 minutes. For 187 patients, the mean operative bleeding was 25.13±12.54 mL, while for 87 patients the mean duration of hospitalization was 4.59±1.93 days. At last follow-up, functional assessment was performed for 260 patients, of whom 200 were in excellent condition, visual analog scale (VAS) scores were assessed for 160 patients, with a mean improvement of 4.40 (3.95, 4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115 patients, with a mean improvement of 3.49 (2.79,4.18), and modified Japanese Orthopedic Association (mJOA) scores were recorded for 208 patients, with a mean improvement of 3.62 (2.89,4.35).
CONCLUSIONS
These results support several advantages of spinal endoscopic techniques for the treatment of symptomatic TOLF. These include low complication rates, rapid postoperative recovery, and good functional recovery when used for single-segment, non-nodular ossification and no combined dural ossification.
Topics: Male; Female; Humans; Middle Aged; Aged; Osteogenesis; Thoracic Vertebrae; Ossification, Heterotopic; Laminectomy; Decompression, Surgical; Ligamentum Flavum; Retrospective Studies; Treatment Outcome
PubMed: 37937419
DOI: 10.1097/BRS.0000000000004866 -
International Journal of Molecular... Jun 2024Fluoxetine, a commonly prescribed medication for depression, has been studied in Alzheimer's disease (AD) patients for its effectiveness on cognitive symptoms. The aim... (Review)
Review
Fluoxetine, a commonly prescribed medication for depression, has been studied in Alzheimer's disease (AD) patients for its effectiveness on cognitive symptoms. The aim of this systematic review is to investigate the therapeutic potential of fluoxetine in cognitive decline in AD, focusing on its anti-degenerative mechanisms of action and clinical implications. According to PRISMA, we searched MEDLINE, up to 1 April 2024, for animal and human studies examining the efficacy of fluoxetine with regard to the recovery of cognitive function in AD. Methodological quality was evaluated using the ARRIVE tool for animal AD studies and the Cochrane tool for clinical trials. In total, 22 studies were analyzed (19 animal AD studies and 3 clinical studies). Fluoxetine promoted neurogenesis and enhanced synaptic plasticity in preclinical models of AD, through a decrease in Aβ pathology and increase in BDNF, by activating diverse pathways (such as the DAF-16-mediated, TGF-beta1, ILK-AKT-GSK3beta, and CREB/p-CREB/BDNF). In addition, fluoxetine has anti-inflammatory properties/antioxidant effects via targeting antioxidant Nrf2/HO-1 and hindering TLR4/NLRP3 inflammasome. Only three clinical studies showed that fluoxetine ameliorated the cognitive performance of people with AD; however, several methodological issues limited the generalizability of these results. Overall, the high-quality preclinical evidence suggests that fluoxetine may have neuroprotective, antioxidant, and anti-inflammatory effects in AD animal models. While more high-quality clinical research is needed to fully understand the mechanisms underlying these effects, fluoxetine is a promising potential treatment for AD patients. If future clinical trials confirm its anti-degenerative and neuroprotective effects, fluoxetine could offer a new therapeutic approach for slowing down the progression of AD.
Topics: Fluoxetine; Alzheimer Disease; Humans; Animals; Cognitive Dysfunction; Disease Models, Animal; Neurogenesis; Neuronal Plasticity
PubMed: 38928248
DOI: 10.3390/ijms25126542