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Sabaté-Brescó M, Berset CM, Zeiter S, et al. Fracture biomechanics influence local and systemic immune responses in a murine fracture-related infection model. Biol Open. 2021;10(9)doi: 10.1242/bio.057315.
Sabaté-Brescó, M., Berset, C. M., Zeiter, S., Stanic, B., Thompson, K., Ziegler, M., Richards, R. G., O'Mahony, L., & Moriarty, T. F. (2021). Fracture biomechanics influence local and systemic immune responses in a murine fracture-related infection model. Biology open, 10(9), . https://doi.org/10.1242/bio.057315
Sabaté-Brescó, Marina, et al. "Fracture biomechanics influence local and systemic immune responses in a murine fracture-related infection model." Biology open vol. 10,9 (2021). doi: https://doi.org/10.1242/bio.057315
Sabaté-Brescó M, Berset CM, Zeiter S, Stanic B, Thompson K, Ziegler M, Richards RG, O'Mahony L, Moriarty TF. Fracture biomechanics influence local and systemic immune responses in a murine fracture-related infection model. Biol Open. 2021 Sep 15;10(9). doi: 10.1242/bio.057315. Epub 2021 Oct 01. PMID: 34240122; PMCID: PMC8496694.
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Biol Open. 2021 Sep 15;10(9). doi: 10.1242/bio.057315. Epub 2021 Oct 01.

Fracture biomechanics influence local and systemic immune responses in a murine fracture-related infection model.

Biology open

Marina Sabaté-Brescó, Corina M Berset, Stephan Zeiter, Barbara Stanic, Keith Thompson, Mario Ziegler, R Geoff Richards, Liam O'Mahony, T Fintan Moriarty

Affiliations

  1. AO Research Institute Davos, AO Foundation, 7270, Davos, Switzerland.
  2. Swiss Institute of Asthma and Allergy Research, University of Zurich, 7270, Davos, Switzerland.

PMID: 34240122 PMCID: PMC8496694 DOI: 10.1242/bio.057315

Abstract

Biomechanical stability plays an important role in fracture healing, with unstable fixation being associated with healing disturbances. A lack of stability is also considered a risk factor for fracture-related infection (FRI), although confirmatory studies and an understanding of the underlying mechanisms are lacking. In the present study, we investigate whether biomechanical (in)stability can lead to altered immune responses in mice under sterile or experimentally inoculated conditions. In non-inoculated C57BL/6 mice, instability resulted in an early increase of inflammatory markers such as granulocyte-colony stimulating factor (G-CSF), keratinocyte chemoattractant (KC) and interleukin (IL)-6 within the bone. When inoculated with Staphylococcus epidermidis, instability resulted in a further significant increase in G-CSF, IL-6 and KC in bone tissue. Staphylococcus aureus infection led to rapid osteolysis and instability in all animals and was not further studied. Gene expression measurements also showed significant upregulation in CCL2 and G-CSF in these mice. IL-17A was found to be upregulated in all S. epidermidis infected mice, with higher systemic IL-17A cell responses in mice that cleared the infection, which was found to be produced by CD4+ and γδ+ T cells in the bone marrow. IL-17A knock-out (KO) mice displayed a trend of delayed clearance of infection (P=0.22, Fisher's exact test) and an increase in interferon (IFN)-γ production. Biomechanical instability leads to a more pronounced local inflammatory response, which is exaggerated by bacterial infection. This study provides insights into long-held beliefs that biomechanics are crucial not only for fracture healing, but also for control of infection.

© 2021. Published by The Company of Biologists Ltd.

Keywords: S. aureus ; S. epidermidis ; Bone infection; Fracture-related infection; Implant stability; Interleukin-17A

Conflict of interest statement

Competing interests The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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