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ISSN 打印: 1045-4403
ISSN 在线: 2162-6502

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DOI: 10.1615/CritRevEukarGeneExpr.v20.i4.30
pages 313-324

Heterotopic Ossification Has Some Nerve

Elizabeth Salisbury
Center for Cell and Gene Therapy; and Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030, USA
Corinne Sonnet
Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA
Michael Heggeness
Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX 77030, USA
Alan R. Davis
Center for Cell and Gene Therapy; Translational Biology and Molecular Medicine; Department of Orthopedic Surgery; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
Elizabeth Olmsted-Davis
Center for Cell and Gene Therapy; Translational Biology and Molecular Medicine; Department of Orthopedic Surgery; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA

ABSTRACT

Heterotopic ossification, defined as the formation of bone in abnormal anatomic locations, can be clinically insignificant or devastating and debilitating, depending on the site and duration of new bone formation. There are many causes of heterotopic ossification (HO), including soft tissue trauma, central nervous system injury, vasculopathies, arthropathies, and inheritance. One of the least understood components of HO is the interaction of the peripheral nervous system with the induction of this process. Recent work has shown that, upon traumatic injury, a cascade of events termed neurogenic inflammation is initiated, which involves the release of neuropeptides, such as substance P and calcitonin gene related peptide. Release of these peptides ultimately leads to the recruitment of activated platelets, mast cells, and neutrophils to the injury site. These cells appear to be involved with both remodeling of the nerve, as well as potentially recruiting additional cells from the bone marrow to the injury site. Further, sensory neurons stimulated at the injury site relay local information to the brain, which can then redirect neuroendocrine signaling in the hypothalamus towards repair of the injured site. While numerous studies have highlighted the important role of nerve-derived signals, both central and peripheral, in the regulation of normal bone remodeling of the skeleton,1 this review focuses on the role of the local, peripheral nerves in the formation of heterotopic bone. We concentrate on the manner in which local changes in bone morphogenetic protein (BMP) expression contribute to a cascade of events within the peripheral nerves, both sensory and sympathetic, in the immediate area of HO formation.


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