Bone mineral density (BMD) is a reflection of the action of osteoblasts compared to osteoclasts. An imbalance in the activity of osteoblasts or osteoclasts, results in bone disease such as osteoporosis caused by overactive osteoclasts. BMD is influenced by genetic and environmental factors as demonstrated through twin studies, association studies and linkage analysis (Ralston, 1999). Several polymorphisms involved in the determination of BMD have been identified, with Vitamin D receptor and Collagen Type 1 showing reproducible associations. To identify genes influencing BMD two distinct strategies have been employed: 1) To determine if DNA polymorphism within the runt related transcription factor (RUNX2) gene is a determinant of BMD and fracture in women. 2) The identification of RANKL target genes in osteoclastogenesis. RUNX2 is a runt domain transcription factor (Werner et al., 1999) essential for osteoblast differentiation (Lee et al., 1997). RUNX2 gene knock-out mice have no osteoblasts due to a failure in osteoblast differentiation and consequently unmineralised skeletons, (Komori et al., 1997; Otto et al., 1997). In humans, mutations in RUNX2 cause cleidocranial dysplasia (CCD), a disorder characterised by hypoplasia or aplasia of the clavicles, short stature, supernumerary teeth, patent fontanelles and other changes in skeletal patterning and growth (Mundlos et al., 1997). RUNX2 contains a poly-glutamine poly-alanine (polyQ/polyA) repeat where mutations causing cleidocranial dysplasia have been observed. BMD has not been routinely examined in CCD, two studies have identified CCD patients with lower BMD with one fracture case identified (Quack et al., 1999; Bergwitz et al., 2001). The central role of RUNX2 in determining osteoblast differentiation makes RUNX2 a prime candidate gene for regulating adult bone density. To determine if polymorphism was present in the polyQ/polyA tract the repeat was amplified within the upper and lower deciles of femoral neck (FN) BMD in the Geelong Osteoporosis study (GOS). The upper and lower deciles of FN BMD acted as a surrogate for genotyping the entire cohort. This study identified two common variants within the polyA repeat: an 18 base pair deletion (11Ala) and a synonymous alanine codon polymorphism with alleles, GCA and GCG (noted as A and G alleles, respectively). The 11Ala and SNP polymorphism are found on codon 64 and 66 respectively (RUNX2 MRIPV variant). A allele frequencies were significantly different in a comparison of the upper and lower deciles of FN BMD (p=0.019). In 495 randomly selected women of the Geelong Osteoporosis Study (GOS), the A allele was associated with higher BMD at all sites tested. The association was maximal at the ultra-distal radius (p=0.001). In a separate fracture study, the A allele was significantly protective against Colles' fracture in elderly women but not spine and hip fracture. The 11Ala polymorphism was not related to BMD in GOS. To further decipher the role of the RUNX2 A allele we genotyped 992 women from a Scottish cohort. The alleles of RUNX2 within the glutamine/alanine repeat were determined by MspA1I restriction digest. To examine the possible influence on estrogen related therapies or estrogen status on the potential genetic effect conferred by RUNX2, we divided the cohort by menopausal and hormone replacement therapy status. Within postmenopausal Scottish women the RUNX2 A allele was associated with significantly higher FN BMD (p=0.028, n=312) but not lumbar spine (LS) BMD. The A allele was associated with higher FN BMD (p=0.035) within a postmenopausal subgroup of the population (n=312). To investigate the effect of weight on the RUNX2 alleles the Scottish cohort was segregated into thin/normal (BMI ≥ 25 kg/m2) and overweight /obese (BMI > 25 kg/m2). RUNX2 A allele showed a stronger effect on FN BMD in postmenopausal women above the median BMI. The 11Ala RUNX2 deletion allele was significantly associated with decreased LS BMD (p=0.018) within overweight/obese women (n=546). The 11Ala allele was significantly associated with increased levels of pyridinoline (p=0.014) and deoxypyridinoline (p=0.038) in the HRT treated subgroup of the population (n=492). Glutamine variants and an alanine insertion were identified within the group. These data suggest that the RUNX2 11Ala and A alleles exert differing affects on BMD showing preference for different skeletal sites in a weight dependent manner. We genotyped 78 individuals from an osteoarthritic population to elucidate the role of the RUNX2 alleles on markers of bone turnover and inflammation. The RUNX2 11Ala allele was significantly associated with decreased osteocalcin (OC) serum levels (p = 0.01). The RUNX2 A allele was significantly related to reduced tumor necrosis factor alpha (TNF-alpha) serum levels (p = 0.004). RUNX2 is known to bind to the OC promoter. An OC promoter polymorphism is found 7bp upstream from a putative RUNX2 binding site. We hypothesized that OC polymorphism may effect the RUNX2 transactivation of the OC gene and thus affect OC serum levels. OC promoter polymorphism was not related to OC serum levels (n=78). These data present a novel link between RUNX2 alleles and OC and TNF serum levels, providing putative mechanisms of action for the RUNX2 alleles. Further studies in larger populations are required to confirm these findings. Ten individuals within the GOS and the Scottish cohort were found to carry rare mutations of the polyQ/polyA repeat. All polyQ variants had a normal polyA repeat (17 amino acids) and were heterozygous for a normal 23Q/17A allele. Variants observed were 15, 16, 24 and 30Q. One individual was observed with an extended polyA repeat (24A). Patient records indicated otherwise unremarkable clinical history except for fracture in 4/10 individuals from GOS (hip and spine). BMD data from the LS and the FN were expressed as T-scores, a measure that relates BMD in terms of standard deviations below the young normal value. In addition, BMD data were also expressed as Z-scores around the age-mean. Under the null hypothesis, where RUNX2 Q repeat variation has no effect on BMD, Z scores would be expected to be distributed around a mean of zero. However, when all variants were pooled the BMD was significantly lower than expected. This effect persisted when deletion variants were considered alone. The effect was stronger on FN BMD (p=0.001) rather than LS BMD (p=0.096), reflecting either difference in precision of BMD measurements at these sites or perhaps a differential genetic effect on different skeletal sites. These data suggest that polyQ and polyA variants are associated with significantly lower BMD, and may be an important determinant for fracture. Glutamine variants exist at high frequency (~0.7%): this rate of mutation could be important when considering large populations at risk of age related osteoporosis. Considering that these subjects are heterozygous for a normal allele, it suggests that a more severe phenotype might be expected in rare subjects homozygous for glutamine repeat variants. In summary, this study investigated the role of novel polymorphisms and rare variants of the RUNX2 gene in influencing BMD, fracture and markers of bone turnover. Two common polymorphisms were identified within the polyA repeat: an 18 base pair deletion and a synonymous alanine codon polymorphism with alleles, A and G. The A allele was associated with increased BMD and was protective against a common form of osteoporotic fracture within a Geelong population. To verify these findings the RUNX2 alleles were genotyped in 992 women from a Scottish cohort. The magnitude and the direction of the effect of the A allele was maintained in the Scottish cohort. Interestingly, the A allele was shown to exert a menopause specific effect, with postmenopausal women showing the strongest effect. On re-analysis of the GOS data the post-menopausal women were found to drive the significance identified in the cohort. The magnitude of the effect of the A allele on BMD was greater in overweight/obese postmenopausal women indicating a gene-weight interaction for RUNX2. The RUNX2 11Ala allele showed a significant relationship with decreased LS BMD in overweight/obese Scottish women. The 11Ala allele was also associated with higher levels of urinary PYD and DPD in women treated with HRT, indicating higher levels of bone turnover in carriers of the 11Ala allele. In contrast to the Scottish cohort, no significant association with heterozygous carriers of 11Ala was observed in GOS, although a significant association was detected for homozygous carriers and LS BMAD. The 11 Ala RUNX2 allele was significantly associated with decreased serum osteocalcin levels and the A allele was significantly associated with TNF in OA patients. Glutamine variants and an alanine insertion were identified within Geelong and Scottish cohorts, which showed low Z and T scores suggesting that RUNX2 variants may be related to genetic effects on BMD and osteoporosis. Polymorphism of the polyQ/polyA region of RUNX2 were identified within this study were shown to associate with significant differences in BMD. The A allele showed a significant association with increased BMD in postmenopausal women from a Geelong and Scottish cohort, with a decreased frequency of the A allele observed in Colles' fracture patients from Geelong. The 11Ala deletion allele was significantly associated with decreased LS BMD and increases in markers of bone turnover in the Scottish cohort. A significant decrease in OC serum levels was observed in OA patients suggesting a direct effect of the allele on the transactivation of the RUNX2 gene. Rare variants of RUNX2 were identified which showed low BMD. These studies have provided insight into the role of RUNX2 in influencing BMD, further studies are required to verify the role of the A allele on BMD and fracture, the role of the rare variants and to identify the precise mechanisms behind the observed changes in BMD. - 2) The identification of RANKL target genes in osteoclastogenesis. Osteoclastogenesis is regulated in vivo by the action of osteoblast/stromal cells that express membrane bound, receptor activator of NF-kB ligand (RANKL). Monocytes treated in vitro with a soluble form of RANKL and macrophage colony stimulating factor (M-CSF) differentiate to osteoclasts, whereas monocytes treated with M-CSF alone differentiate to macrophage-like cells. The gene expression profile of human osteoclasts has not been extensively explored. Genes highly expressed by rabbit osteoclasts were identified through random sequencing of an osteoclast cDNA library (Sakai et al., 1995). Differential gene expression of mouse osteoclastogenesis was elucidated by array analysis (Cappellen et al., 2002). To identify genes important for human osteoclastogenesis, total RNA was isolated from monocytes treated for three weeks with either M-CSF alone or with RANKL and M-CSF. RANKL treatment for 3 weeks and 12 hours was investigated in this study, to complement previous data. Differential display was performed on RNA (12 hour treatment with RANKL) and differential gene expression profiles examined. The differential display products were pooled to generate a probe for screening a gene array system derived from a human osteoclast cDNA library. cDNA (3 week treatment with RANKL) hybridisation experiments against the array revealed additional regulated genes. Gene clones that showed significant regulation in M-CSF and RANKL treated cells compared M-CSF treated cells represent genes that are targets for RANKL-specific regulation. Osteopontin, creatine kinase and various mitochondrial genes were up regulated by the treatment of RANKL. Changes in gene expression observed in the array data were confirmed with real-time PCR using mRNA derived from in vitro induced osteoclasts. Cathepsin K gene expression was more than 300 fold greater in osteoclasts compared to macrophage-like cells after one week treatment with RANKL and M-CSF. Cystatin C expression showed a six-fold induction at two weeks of RANKL and M-CSF treatment and cystatin B showed a steady increase in expression. Some of these regulated genes may provide useful targets for influencing BMD.

Non-healing bone defects have a significant socioeconomic impact in the U.S. with approximately 600,000 bone grafting procedures performed annually. Autografts and allografts are clinically the most common treatments; however, autologous donor bone is in limited supply, and allografts often have poor mechanical properties. Therefore, tissue engineering and regenerative medicine strategies are being developed to address issues with clinical bone grafting. The overall objective of this work was to develop bone tissue engineering strategies that enhance healing of orthotopic defects by targeting specific osteogenic cell signaling pathways. The general approach included the investigation of two different tissue engineering strategies, which both focused on directed osteoblastic differentiation to promote bone formation. In the first cell-based strategy, we hypothesized that constitutive overexpression of the osteoblast-specific transcription factor, Runx2, in bone marrow stromal cells (BMSCs) would promote orthotopic bone formation in vivo. We tested this hypothesis by delivering Runx2-modified BMSCs on synthetic scaffolds to critically-sized defects in rats. We found that Runx2-modified BMSCs significantly increased orthotopic bone formation compared to empty defects, cell-free scaffolds and unmodified BMSCs. This gene therapy approach to bone regeneration provides a mineralizing cell source which has clinical relevance. In the second biomaterial-based strategy, we hypothesized that incorporation of the collagen-mimetic peptide, GFOGER, into synthetic bone scaffolds would promote orthotopic bone formation in vivo without the use of cells or growth factors. We tested this hypothesis by passively adsorbing GFOGER onto poly-caprolactone (PCL) scaffolds and implanting them into critically-sized orthotopic defects in rats. We found that GFOGER-coated scaffolds significantly increased bone formation compared to uncoated scaffolds in a dose dependent manner. Development of this cell-free strategy for bone tissue engineering provides an inexpensive therapeutic alternative to clinical bone defect healing, which could be implemented as a point of care application. Both strategies developed in this work take advantage of specific osteoblastic signaling pathways involved in bone healing. Further development of these tissue engineering strategies for bone regeneration will provide clinically-relevant treatment options for healing large bone defects in humans by employing well-controlled signals to promote bone formation and eliminating the need for donor bone.

Σκοπός: Πρόσφατα δεδομένα, υποδεικνύουν ότι διαταραχή της ισορροπίας του λιπιδικού μεταβολισμού επηρεάζει τη λειτουργία των κυττάρων του οστού, με αποτέλεσμα την ανάπτυξη εκφυλιστικών και μεταβολικών νόσων, όπως η οστεοπόρωση. Στην παρούσα εργασία, μελετήσαμε τον ρόλου της απολιποπρωτεΐνης Ε (apoE), βασικού συστατικού του συστήματος μεταβολισμού των χυλομικρών και της VLDL (Very Low-Density Lipoprotein), στη ρύθμιση της οστικής ανακατασκευής και στην παθογένεια της οστεοπόρωσης, σε πειραματικά μοντέλα ποντικιών που έλαβαν δίαιτα πλούσια σε λιπαρά. Υλικά και μέθοδοι: Για τον λόγο αυτό, χρησιμοποιήσαμε μοντέλα ποντικών με έλλειψη του γονιδίου της apoE (apoE-/-) και αγρίου τύπου (C57BL/6) (ομάδα ελέγχου) που τους χορηγήθηκε για 24 εβδομάδες δίαιτα δυτικού τύπου (WTD) πλούσια σε λιπαρά (10 ζώα/ομάδα). Επιλέχθηκε η δίαιτα δυτικού τύπου διότι προσομοιάζει τις διατροφικές συνήθειες του σύγχρονου δυτικού κόσμου. Κάθε 6 εβδομάδες γινόταν μέτρηση σωματικού βάρους. Δύο και επτά ημέρες προ της ευθανασίας πραγματοποιήθηκε ενδοπεριτοναϊκή ένεση καλσεΐνης. Την 24η εβδομάδα τα ζώα θυσιάστηκαν, απομονώθηκαν χειρουργικά το μηριαίο οστό και οι οσφυϊκοί σπόνδυλοι και έγιναν ιστολογικές και ιστομορφομετρικές αναλύσεις. Με τη χρήση microCT scanner (στατική ιστομορφομετρία) εκτιμήθηκε η ποιότητα και η ποσότητα του σπογγώδους και του φλοιώδους οστού. Με τη χρώση TRAP και την εναπόθεση καλσεΐνης (δυναμική ιστομορφομετρία) ελέγχθηκε η οστική αποδόμηση και ο ρυθμός σύνθεσης νεοσχηματιζόμενου οστού, αντίστοιχα. Με τη χρήση φασματοσκοπίας Raman, αξιολογήθηκε η κατάσταση του δικτύου κολλαγόνου των μηριαίων οστών. Επιπλέον, μεσεγχυματικά κύτταρα του μυελού των οστών (BMMSC) απομονώθηκαν από το μηριαίο οστό των πειραματόζωων και καλλιεργήθηκαν με σκοπό την εκτίμηση των επιπέδων έκφρασης, τόσο σε επίπεδο πρωτεΐνης όσο και σε επίπεδο mRNA, μορίων που εμπλέκονται στην οστεοβλαστική λειτουργία [(Runx2, Osterix (Osx), Κολλαγόνο I τύπου 1a (Col1a1)], στην οστεοκλαστική λειτουργία [osteprotegerin (OPG), RANK-Ligand (RANKL), λόγος OPG/RANKL, RANK, TRAP, cathepsin Κ] καθώς και στην λιπογένεση [Peroxisome-Proliferator-Activated receptor γ (PPARγ)]. Για την εκτίμηση των επιπέδων έκφρασης των πρωτεϊνών, χρησιμοποιήσαμε τις μοριακές τεχνικές Western Blot και κυτταρομετρία ροής ενώ για την αξιολόγηση των επιπέδων έκφρασης του mRNA χρησιμοποιήσαμε τη RT-PCR. Αποτελέσματα: 1) Τα apoE-/- πειραματόζωα που έλαβαν WTD δεν ανέπτυξαν παχυσαρκία σε αντίθεση με τα C57BL/6 WTD. 2) Στον μυελό των οστών των apoE-/- WTD ποντικιών παρατηρήθηκε πλήρης απουσία λιποκυττάρων, σε αντίθεση με τα C57BL/6 WTD ζώα των οποίων ο μυελός των οστών ήταν πλούσιος σε λιποκύτταρα. 3) Ο αριθμός των οστεοκλαστών ήταν σημαντικά αυξημένος, ενώ των οστεοβλαστών σημαντικά ελαττωμένος στα apoE-/- WTD πειραματόζωα σε σύγκριση με τα C57BL/6 WTD. 4) Η στατική και η δυναμική ιστομορφομετρία έδειξαν ότι τα apoE-/- ποντίκια, σε δίαιτα δυτικού τύπου, εμφάνισαν σημαντική ελάττωση της οστικής τους μάζας. 5) Το δίκτυο του κολλαγόνου στα apoE-/- WTD ποντίκια εμφανίστηκε σημαντικά πιο σκληρό, πιο άκαμπτο και κατά συνέπεια λιγότερο ελαστικό συγκρινόμενο με αυτό των C57BL/6 WTD. 6) Τα apoE-/- WTD ποντίκια, εμφάνισαν σημαντικά μειωμένα επίπεδα έκφρασης του ρυθμιστή της οστεοβλαστογένεσης Runx2, τόσο σε επίπεδο πρωτεΐνης όσο και σε επίπεδο mRNA, συγκρινόμενα με τα C57BL/6 WTD ζώα. 7) Τα επίπεδα έκφρασης των ρυθμιστών της οστικής ανακατασκευής RANK και RANKL, ήταν σημαντικά αυξημένα στα apoE-/- WTD ποντίκια σε σχέση με τα C57BL/6 WTD ποντίκια. Αντίθετα, τα επίπεδα έκφρασης του γονιδίου της OPG καθώς και η αναλογία OPG/RANKL, ήταν σημαντικά μειωμένα στα apoE-/- WTD ποντίκια. Δεν παρατηρήθηκαν σημαντικές διαφορές στην έκφραση των οστεοκλαστικών ρυθμιστών cathepsin K και TRAP μεταξύ των δύο υπό εξέταση ομάδων ζώων. 8) Ο ρυθμιστής της λιπογένεσης PPARγ, τόσο σε επίπεδο πρωτεΐνης όσο και σε επίπεδο mRNA, ήταν σημαντικά μειωμένος στα apoE-/- WTD ποντίκια σε σχέση με τα C57BL/6 WTD. Συμπεράσματα: 1) Η έλλειψη της apoE εμπλέκεται στην ελάττωση της οστικής μάζας σε ποντίκια υπό δίαιτα δυτικού τύπου 2) Η apoE φαίνεται ότι διαδραματίζει σημαντικό ρόλο στη ρύθμιση της λειτουργίας των οστεοβλαστών, ενώ δεν είναι σαφής ο ρόλος της στη λειτουργία των οστεοκλαστών 3) Η έλλειψη της apoE, προστατεύει από την παχυσαρκία αλλά και την εναπόθεση λιποκυττάρων στον μυελό των οστών, κατόπιν λήψεως δίαιτας πλούσιας σε λιπαρά. 4) Η apoE ρυθμίζει τη διαφοροποίηση των MSC’s σε ερχόμενο στάδιο, καθώς η έλλειψή της επηρεάζει τόσο την οστεοβλαστική όσο και τη λιποβλαστική διαφοροποίηση, μετά από κατανάλωση δίαιτας δυτικού τύπου, πλούσιας σε λιπαρά. / Introduction: Recent data suggest that lipid metabolism imbalances affect bone cell function and therefore may result in the development of metabolic diseases such as osteoporosis. In the present study, we investigated the role of apoE, a plasma protein playing cardinal role in lipoprotein metabolism, in the regulation of osteoblasts, osteoclasts and lipoblasts and in the pathogenesis of osteoporosis. Material and Methods: We used apoE deficient (apoE-/-) and wild type (C57BL/6) mice (10 animals/ group). Mice were fed with standard western-type diet (WTD) for 24 weeks. Body weight measurements were obtained every 6 weeks. Two and seven days before euthanasia calcein was injected intraperitonealy for the determination of new bone formation rate. Following sacrifice, lumbar vertebrae and femora were removed and quantitative/qualitative study of the cortical and cancellous bone was performed using microCT scanner. In the tissue sections we perfomed histological (H&E) and histochemical (TRAP) analyses. Static and dynamic histomorphometry were employed for the determination of bone quality and bone cell function. Using Raman spectroscopy, the quality and biochemical composition of the collagen fibers of the examined femora were evaluated. Bone marrow mesenchymal stem cells (BMMSC) were isolated from mice femora and then assessed for the expression of the osteoblastic (Runx2, OSX, Col1a1), osteoclastic (OPG, RANKL, OPG/RANKL, RANK, TRAP, cathepsin K) and lipoblastic (PPARγ) regulators using Western Blotting, Flow Cytometry and RT-PCR. Results: 1) apoE-/- mice under WTD did not develop obesity and their BM was devoid of adipocytes, in contrast to the control mice. 2) Osteoclast number was significantly increased, while bone synthesis was significantly reduced in apoE-/- compared to the C57BL/6 mice that consumed WTD. 3) Static and dynamic histomorphometry showed that apoE-/- mice had sugnificantly reduced bone mass and impared bone architecture. 4) The collagen network in apoE-/- WTD mice was significantly stiffer and more rigid compared to the C57BL/6 WTD mice. 5) BMMSCs from apoE-/- WTD mice displayed significantly reduced Runx2 expression at both protein and mRNA levels compared to the control group. 6) The expression levels of RANK and RANKL, were significantly elevated in apoE-/- WTD mice compared to C57BL/6 WTD mice. In contrast, the gene expression levels of OPG and the ratio OPG / RANKL, were statistically significantly reduced in apoE-/- WTD mice. No significant differences were observed in the expression of cathepsin K and TRAP genes between the two test groups of animals. 7) The expression of the major lipoblastic regulator PPARγ was significantly reduced in apoE-/- WTD compared to their WT counterparts. Conclusions: 1) Low levels of apoE result in reduced bone mass following WTD. 2) apoE is implicated in the regulation of osteoblast function; nevertheless, its role in osteoclast function warrants further investigation. 3) The absence of apoE prevents obesity and BM adipocity after the consumption of WT (high-fat) diet. 4) apoE deficiency, regulates MSC differentiation at early stages, since its absence affects both the osteoblastic and lipoblastic differentiation, after the consumption of high fat diet.

No description available.

Tissue engineering has emerged as a promising alternative to conventional orthopaedic grafting therapies. The general paradigm for this approach, in which phenotype-specific cells and/or bioactive growth factors are integrated into polymeric matrices, has been successfully applied in recent years toward the development of bone, ligament, and cartilage tissues in vitro and in vivo. Despite these advances, an optimal cell source for skeletal tissue repair and regeneration has not been identified. Furthermore, the lack of robust, functional orthopaedic tissue interfaces, such as the bone-ligament enthesis, severely limits the integration and biological performance of engineered tissue substitutes. This works aims to address these limitations by spatially controlling the genetic modification and differentiation of fibroblasts into a mineralizing osteoblastic phenotype within three-dimensional polymeric matrices. The overall objective of this project was to investigate transcription factor-based gene therapy strategies for the differentiation of fibroblasts into a mineralizing cell source for orthopaedic tissue engineering applications. Our central hypothesis was that fibroblasts genetically engineered to express Runx2 via conventional and biomaterial-mediated ex vivo gene transfer approaches will differentiate into a mineralizing osteoblastic phenotype. We have demonstrated that a combination of retroviral Runx2 overexpression and glucocorticoid hormone treatment synergistically induces osteoblastic differentiation and biological mineral deposition in primary dermal fibroblasts cultured in monolayer. We report for the first time that glucocorticoids induce osteoblastic differentiation in this model system by modulating the phosphorylation state of a negative regulatory serine residue (Ser125) on Runx2 through an MKP-1-dependent mechanism. Furthermore, we utilized these Runx2-genetically engineered fibroblasts to create mineralized templates for bone repair in vitro and in vivo. Finally, we engineered a heterogeneous bone-soft tissue interface with a novel biomaterial-mediated gene transfer approach. Overall, these results are significant toward the ultimate goal of regenerating complex, higher-order orthopaedic grafting templates which mimic the cellular and microstructural characteristics of native tissue. Cellular therapies based on primary dermal fibroblasts would be particularly beneficial for patients with a compromised ability to recruit progenitors to the sight of injury as result of traumatic injury, radiation treatment, or osteodegenerative disease.

A alveolite é uma complicação pós-operatória de carácter inflamatório que acomete alvéolos de dentes recém-extraídos. A incidência dessa complicação varia de 1 a 4% e pode chegar a 30%. O objetivo deste estudo foi analisar os mecanismos biológicos envolvidos no processo de reparo de alvéolos intencionalmente infectados, em ratos; comparar diferentes modalidades de tratamento e correlacionar os resultados encontrados através de duas análises (microscópica e molecular). Foram utilizados 84 ratos, divididos nos grupos: I: alvéolo não infectado; II: alvéolo infectado sem nenhum tratamento; III: alvéolo infectado tratado com irrigação de solução de iodeto de sódio a 2% e peróxido de hidrogênio a 3% na proporção de 1:1; e IV: alvéolo infectado submetido à curetagem, irrigação com soro fisiológico e preenchimento com uma pasta à base de metronidazol. Os animais foram eutanasiados aos 6, 15 e 28 dias pós-operatório. Foi realizada a análise quantitativa da expressão de genes envolvidos no processo de reparo [colágeno tipo I (COL-I), fator de crescimento do endotélio vascular (VEGF), osteocalcina (OCN), fosfatase alcalina (ALP), runt-related transcription factor 2 (RUNX2) e fator de necrose tumoral alfa (TNF-\'alfa\')], através da RealTimePCR, correlacionando sua expressão com as características microscópicas observadas qualitativa e quantitativamente. Com base nos resultados da análise microscópica e molecular, podemos concluir que os marcadores RUNX2, OCN e TNF-\'alfa\' podem ser usados como indicadores para avaliar a neoformação óssea e a quantidade de infiltrado inflamatório em alveolite. Os marcadores ALP e VEGF não representaram adequadamente o que se observou microscopicamente. Embora o tratamento da alveolite com a pasta à base de metronidazol promova maior densidade de neoformação óssea aos 28 dias, não há diferenças entre os tratamentos. / Dry socket is an inflammatory postoperative complication that undertakes sockets of recently extracted teeth. The incidence of such complication varies from 1 to 4% and might reach up to 30%. The objective of this study was to analyze the biological mechanisms involved in the repair process of intentionally infected sockets in mice; compare different treatment conditions and correlate the results of two different analysis (microscopic and molecular). 84 mice were used in this study, divided according the following groups: I: uninfected socket; II: infected socket without any treatment; III: infected socket treated with irrigation of 2% sodium iodide and 3% hydrogen peroxide solution at 1:1 proportion; and IV: infected socket submitted to curettage, physiological saline solution irrigation and fulfillment with metronidazole base paste. The animals were killed at a postoperative period of 6, 15 and 28 days. A quantitative analysis was performed using a RealTimePCR to evaluate the genes expression involved [Collagen Type I (COL-I), vascular endothelial growth factor (VEGF), osteocalcin (OCN), alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2) and tumor necrosis factor-alpha (TNF-\'alpha\')], in the repair process, correlating its expression with the microscopic characteristics observed in both qualitative and quantitative manner. Based in the results of the microscopic and molecular analysis, it can be concluded that the RUNX2, OCN and TNF-\'alpha\' markers can be used as indicators to evaluate the dry socket bone neoformation and inflammatory infiltrate quantity. The ALP and VEGF markers did not represented appropriately what was observed microscopically. Although the dry socket treatment with metronidazole base paste promotes an increase in the bone neoformation density at 28 days, no difference was found among the treatments.

A alveolite é uma complicação pós-operatória de carácter inflamatório que acomete alvéolos de dentes recém-extraídos. A incidência dessa complicação varia de 1 a 4% e pode chegar a 30%. O objetivo deste estudo foi analisar os mecanismos biológicos envolvidos no processo de reparo de alvéolos intencionalmente infectados, em ratos; comparar diferentes modalidades de tratamento e correlacionar os resultados encontrados através de duas análises (microscópica e molecular). Foram utilizados 84 ratos, divididos nos grupos: I: alvéolo não infectado; II: alvéolo infectado sem nenhum tratamento; III: alvéolo infectado tratado com irrigação de solução de iodeto de sódio a 2% e peróxido de hidrogênio a 3% na proporção de 1:1; e IV: alvéolo infectado submetido à curetagem, irrigação com soro fisiológico e preenchimento com uma pasta à base de metronidazol. Os animais foram eutanasiados aos 6, 15 e 28 dias pós-operatório. Foi realizada a análise quantitativa da expressão de genes envolvidos no processo de reparo [colágeno tipo I (COL-I), fator de crescimento do endotélio vascular (VEGF), osteocalcina (OCN), fosfatase alcalina (ALP), runt-related transcription factor 2 (RUNX2) e fator de necrose tumoral alfa (TNF-\'alfa\')], através da RealTimePCR, correlacionando sua expressão com as características microscópicas observadas qualitativa e quantitativamente. Com base nos resultados da análise microscópica e molecular, podemos concluir que os marcadores RUNX2, OCN e TNF-\'alfa\' podem ser usados como indicadores para avaliar a neoformação óssea e a quantidade de infiltrado inflamatório em alveolite. Os marcadores ALP e VEGF não representaram adequadamente o que se observou microscopicamente. Embora o tratamento da alveolite com a pasta à base de metronidazol promova maior densidade de neoformação óssea aos 28 dias, não há diferenças entre os tratamentos. / Dry socket is an inflammatory postoperative complication that undertakes sockets of recently extracted teeth. The incidence of such complication varies from 1 to 4% and might reach up to 30%. The objective of this study was to analyze the biological mechanisms involved in the repair process of intentionally infected sockets in mice; compare different treatment conditions and correlate the results of two different analysis (microscopic and molecular). 84 mice were used in this study, divided according the following groups: I: uninfected socket; II: infected socket without any treatment; III: infected socket treated with irrigation of 2% sodium iodide and 3% hydrogen peroxide solution at 1:1 proportion; and IV: infected socket submitted to curettage, physiological saline solution irrigation and fulfillment with metronidazole base paste. The animals were killed at a postoperative period of 6, 15 and 28 days. A quantitative analysis was performed using a RealTimePCR to evaluate the genes expression involved [Collagen Type I (COL-I), vascular endothelial growth factor (VEGF), osteocalcin (OCN), alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2) and tumor necrosis factor-alpha (TNF-\'alpha\')], in the repair process, correlating its expression with the microscopic characteristics observed in both qualitative and quantitative manner. Based in the results of the microscopic and molecular analysis, it can be concluded that the RUNX2, OCN and TNF-\'alpha\' markers can be used as indicators to evaluate the dry socket bone neoformation and inflammatory infiltrate quantity. The ALP and VEGF markers did not represented appropriately what was observed microscopically. Although the dry socket treatment with metronidazole base paste promotes an increase in the bone neoformation density at 28 days, no difference was found among the treatments.