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Bone Healing

Bone is an interesting tissue from the researchers view as it is able to regenerate after injury. However, even today and with an adequate treatment 5-20% of all fractured patients experience a delayed or non-union.

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General information about fracture healing

Fracture incidents were estimated at approximately 3,490,000 in the EU in 2010 for people above 50 years of age. This number of comprises approximately 620,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures. The demographic projection in the European Union for the upcoming years foresee an increase in the number of fractures, as age is an important risk factor for their occurence and the elderly population is projected to increase. In the European Union, the population over 50 years is expected to increase by approximately 20% in the next 10 years. In numbers this means that from 183 million in 2010 the population over 50 will increase to 219 million in 2025. Among these the population over 80 will see the highest increase of up to 32%. The annual number of fractures in the EU will rise from 3.5 million in 2010 to 4.5 million in 2025. Therefore the research into understanding the bone healing process and developing therapeutic approaches to enhance bone healing especially in elderly patients is still a very valid research areal. (Estimates are based on the UN World Population Projections using the medium variant.)

  • Illustration from Schmidt-Bleek et al.,Cytokine Growth Factor Rev 2016; 27:141-8.

    Illustration from Schmidt-Bleek et al.,Cytokine Growth Factor Rev 2016; 27:141-8. Image /

Interaktion des Immun- und Skelettsystems

Die Zellen des Knochen- und Immunsystems sind räumlich eng miteinander verbunden. Granulozyten, Monozyten, natürliche Killerzellen, dendritische Zellen und Lymphozyten werden im Knochenmark gebildet. Die im Knochenmark liegenden myeloide Vorläuferzellen können sich aufgrund unterschiedlicher Differenzierungssignale entweder zu Makrophagen, den Fresszellen des Immunsystems, oder zu Osteoklasten, den knochenabbauenden Zellen des skeletalen Systems entwickeln. Daher teilen sich  Knochen- und Immunsystem gemeinsame Vorläuferzellen und können dadurch auch auf die gleichen Signalmoleküle reagieren. Die Interaktion des Immunsystems mit der Knochenformation ist jedoch erst unlängst stärker in den Fokus der Forschung gerückt und hat in Folge dessen zur Gründung des Forschungsfeldes der Osteoimmunologie geführt.