Shriners Hospitals for Children researcher reveals important new biology leading to improved healing for bone fractures - 10% of bone fractures don't heal properly. In North America, that represents about 110,000 people a year whose fractures don't heal properly. (There are roughly 11 million traumatic bone fractures in North America a year). For people with metabolic diseases, such as the patients we treat with bone diseases like brittle bone disease, the percentage is much higher. For those patients, as many as 40% of bone fractures don't heal properly. The consequence of improperly-healed bone fractures: much lower quality of life, pain and medical issues for the patient. A higher socio-economic cost for patients and society as these improperly-healed fractures require subsequent medical care due to complications.
Most people have broken a bone or know someone who has.
A break is painful and takes time to heal. Recovering from a fracture is even more complicated and lengthy when your body is not able to produce what is needed to heal. More than 10% of fractures do not heal properly, and this percentage dramatically increases for patients, like those treated at Shriners Hospitals for Children®, who are affected by metabolic diseases. Improvements in the treatment of fractures are therefore highly beneficial.
In a study published in the August 2018 issue of the Journal of Clinical Investigation, René St-Arnaud, Ph.D., Director of Research at Shriners Hospitals for Children - Canada shares his discovery of a new way to stimulate bone fracture healing.
It is well known that vitamin D is produced in skin when exposed to sunlight and is found in some foods that we consume. In order to stimulate calcium absorption and benefit bone mineralization, our body must transform the vitamin D molecule in two steps.
During the first step of vitamin D transformation, another form of vitamin D, called 24,25(OH)2D, is created. Although 24,25(OH)2D has been mainly regarded as an inactive degradation product, the work from Dr. St-Arnaud's laboratory has not only revealed that 24,25(OH)2D improves bone fracture healing but he has discovered how this process works.
With the help of another molecule, 24,25(OH)2D synthesizes a waxy fat compound called lactosyl ceramide. This compound triggers the transmission of a signal in order to maximize the size and biomechanical properties of the callus, a stabilizing structure that surrounds a fracture and promotes its healing. Test subjects who were not able to produce either 24,25(OH)2D or lactosyl ceramide had a smaller and weaker callus but when treated with these compounds, both callus size and strength increased. By ensuring a stronger and optimal callus size, we promote better healing of a fracture.
"In this research, we have identified new biology and a previously unrecognized mechanism of action for a vitamin D molecule. It is the culmination of more than 15 years of work from my laboratory", states Dr. St-Arnaud.
Traumatic bone injury is a worldwide major public health issue with significant socioeconomic cost. Therefore, any improvement in fracture treatment would be of considerable benefit for our patients and the population at large.
"The next step is to try these compounds in clinical trials. We hope that they could play an important role in improving fracture repair and healing time", concludes Dr. St-Arnaud.
The full scientific article is available online on the Journal of Clinical Investigations' web site at www.jci.com
A video clip of Dr René St-Arnaud, Director of Research at Shriners Hospitals for Children – Canada, explaining the discovery can be viewed at https://vimeo.com/281615758
Shriners Hospitals for Children is a health care system with locations in the U.S., Canada and Mexico. Our staff is dedicated to improving the lives of children by providing pediatric specialty care, conducting innovative research, and offering outstanding teaching programs for medical professionals. Shriners Hospitals for Children - Canada is the only Canadian establishment within the Shriners hospitals for Children network. This bilingual, short-term, acute care hospital provides ultra-specialized orthopaedic care to children from coast to coast in Canada, the U.S. and around the world.
The mission of the hospital is to promote health and provide treatment and rehabilitation to infants, children and young adults with orthopaedic and neuromuscular problems such as scoliosis, osteogenesis imperfecta (brittle bone disease), club feet, hip dysplasia, leg length discrepancies and cerebral palsy. The hospital is committed to excellence and innovation in clinical practice, research and education and to ensuring patients and their families are treated in a caring, family-friendly environment. Affiliated with McGill University, the hospital provides clinical experience and teaching for residents and allied healthcare professionals.
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