The Journal of Bone and Joint Surgery (American). 2005;87:2052-2064.
doi:10.2106/JBJS.D.02752
© 2005 The Journal of Bone and Joint Surgery, Inc.
Platelet-Derived Growth Factor Inhibits Demineralized Bone Matrix-Induced Intramuscular Cartilage and Bone Formation
A Study of Immunocompromised Mice
Don M. Ranly, DDS, PhD1,
Jacquelyn McMillan, MBChB, FRCSEd, FRCS(Orth)2,
Todd Keller, DDS, MS3,
Christoph H. Lohmann, MD, MS4,
Timothy Meunch, PhD5,
David L. Cochran, DDS, PhD3,
Zvi Schwartz, DMD, PhD1 and
Barbara D. Boyan, PhD1
1 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of
Technology, 315 Ferst Drive N.W., Atlanta, GA 30332 E-mail address for B.D.
Boyan:
barbara.boyan{at}bme.gatech.edu
2 Institute for Bioengineering and Biosciences, Georgia Institute of Technology,
315 Ferst Drive, N.W., Atlanta, GA 30332-0363
3 Department of Periodontics, University of Texas Health Science Center at San
Antonio, San Antonio, TX 78229
4 Universitätsklinik Hamburg-Eppendorf, Klinik un Poliklinik für
Orthopädie, Martinisrasse 52, 20246, Hamburg, Germany
5 NAMSA, 6750 Wales Road, Northwood, OH 43619
Investigation performed at Georgia Institute of Technology, Atlanta,
Georgia
In support of their research or preparation of this manuscript, one or more
of the authors received grants or outside funding from BioMimetic
Pharmaceuticals; DePuy, Germany; Institut Straumann AG; and the ITI
Foundation. In addition, one or more of the authors received payments or other
benefits or a commitment or agreement to provide such benefits from a
commercial entity (BioMimetic Pharmaceuticals and LifeNet, Inc.). Also,
commercial entities (Deutsche Forschungsgemeinschaft,
Elsbeth-Bonhoff-Stiftung, Plus Endoprothetik, and Zimmer, Germany) paid or
directed, or agreed to pay or direct, benefits to a research fund, foundation,
educational institution, or other charitable or nonprofit organization with
which the authors are affiliated or associated.
Background: Platelet-derived growth factor (PDGF) has been proposed
as a therapeutic agent to promote bone-healing. The purpose of this study was
to examine the effect of PDGF on the ability of human demineralized bone
matrix to induce bone formation in a nude-mouse muscle-implantation model. We
also examined whether platelet-rich plasma, which contains PDGF, also
modulates osteoinduction in this model.
Methods: Human demineralized bone matrix, previously shown to be
osteoinductive in the calf muscles of nude mice, was mixed with PDGF-BB (0,
0.1, 1, and 10 µg/10 mg of demineralized bone matrix) and was implanted
bilaterally in the calf muscles of immunocompromised (nu/nu) mice (six mice in
each group). Heat-inactivated demineralized bone matrix was used as a control.
Tissue was harvested at fourteen, twenty-eight, and fifty-six days after
implantation. Platelet-rich plasma was prepared from the blood of a healthy
donor with use of the Harvest PRP preparation device, activated with thrombin,
and mixed with active and inactive demineralized bone matrix. Fifty-six days
post-implantation, tissues were harvested. Osteoinduction was assessed with
use of a qualitative scoring system and with quantitative
histomorphometry.
Results: Cartilage was present at fourteen days in all tissues that
had received an implant, but the amount decreased as the PDGF concentration
increased. PDGF reduced bone formation at twenty-eight days in a
dose-dependent manner. This inhibitory effect was resolved by fifty-six days,
except in tissues in which demineralized bone matrix and 10 µg of PDGF had
been implanted. In sites treated with 10 µg of PDGF, the area of new bone
was decreased and the area of bone marrow was reduced at twenty-eight and
fifty-six days. PDGF also appeared to retard resorption of demineralized bone
matrix in a dose-dependent manner. Platelet-rich plasma reduced osteoinduction
by human demineralized bone matrix that had high osteoinductive activity and
had no effect on osteoinduction by demineralized bone matrix with low
activity.
Conclusions: PDGF inhibits, in a dose-dependent manner,
intramuscular osteoinduction and chondrogenesis by demineralized bone matrix
in immunocompromised mice. Platelet-rich plasma also reduces the
osteoinductivity of active demineralized bone matrix.
Clinical Relevance: Osteoinduction in the nude mouse may not reflect
growth-factor effects in bone. However, these data indicate that PDGF and
platelet-rich plasma should not be used with demineralized bone matrix if the
purpose is to increase osteoinduction, although these substances may increase
other aspects of bone-healing. Additional studies are needed to determine the
clinical relevance of these observations.

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