The Genetics of Heterotopic Ossification: Insight Into the Bone Remodeling Pathway
The Genetics of Heterotopic Ossification: Insight Into the Bone Remodeling Pathway
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DOI：
10.1097/bot.0b013e3181ed147b
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发表时间：
2010-09-01
影响因子：
2.3
通讯作者：
Morris, John
中科院分区：
文献类型：
--
作者：
Mitchell, Erika J.;Canter, Jeffrey;Morris, John
目的：异位骨化（HO）是创伤后的一个重要并发症，发生率为12%至25%的骨折。尽管研究了临床预测因素来确定发生HO的可能性，但结果并不一致。本研究探讨了HO表型的遗传预测因素，以确定“高危”患者，并增加对遗传因素对形成hothod的理解。我们在1095例连续骨折的创伤患者中检查了61个单核苷酸多态性（SNP）的频率，这些患者的影像学研究在随访中检查了HO，研究中10%的患者显示了HO的影像学证据，并使用多因素logistic回归来独立分析每个SNP，同时调整损伤的严重程度（由创伤和损伤严重程度评分衡量）。三个snp （β(2)-肾上腺素能受体，toll样受体4）。β(2)-肾上腺素能受体基因的不常见多态性与HO的风险增加有关，对于toll样受体4和补体因子H，不常见的多态性与HO的风险降低有关结论：被确定为HO形成预测因子的snp代表了肾上腺素能系统、免疫系统。这代表了影响骨重塑的多种途径的相互作用，其中的畸变可能在基因组中发现
Objectives: Heterotopic Ossification (HO) is a significant complication after trauma occurring in 12% to 25% of fractures Although clinical predictors have been studied to determine the likelihood of developing HO, the results have been inconsistent This study examines genetic predictors of the HO phenotype to identify the "at-risk" patient and increase the understanding of the genetic contribution to the formation of HOMethods: We examined the frequency of 61 single nucleotide polymorphisms (SNPs) in 1095 consecutive trauma patients with fractures Radiographic studies of these patients were examined for HO in follow-up Ten percent of the patients in the study demonstrated radiographic evidence of HO Multivariate logistic regression was used to analyze each SNP independently while adjusting for severity of injury (as measured by the Trauma and Injury Severity Score)Results: Three SNPs (beta(2)-adrenergic receptor, toll-like receptor 4. complement factor H) were identified that were associated with an increased or decreased frequency of HO The less common polymorphism of the beta(2)-adrenergic receptor gene was associated with increased risk of HO For toll-like receptor 4 and complement factor H, the less common polymorphism was associated with a decreased risk of HOConclusions: The SNPs identified as predictors of HO formation are representative of the adrenergic system, immune system. and the alternative complement system This represents the interplay of multiple pathways that affect bone remodeling, aberrations of which may be found in the genome