Περίληψη:
Introduction: A potential complication in critically ill patients is the
formation of bone in soft tissues, termed heterotopic ossification. The
exact pathogenetic mechanisms are still undetermined. Bone morphogenetic
proteins induce bone formation, while signalling through the receptor
activator of nuclear factor kappa-B (RANK) and its ligand (RANKL),
regulates osteoclast formation, activation, and survival in normal bone
modelling and remodelling. Osteoprotegerin protects bone from excessive
bone loss by blocking RANKL from binding to RANK. Aim: The study aimed
to investigate these molecules as potential prognostic biomarkers of
heterotopic ossification development in critically ill patients.
Materials and Methods: In this prospective observational study, BMP-2,
RANKL, and osteoprotegerin were measured by ELISA in twenty-eight
critically-ill, initially non-septic patients, on admission to an ICU,
seven days post-admission, and thirty days after ICU discharge. Results:
In the critically-ill cohort, nine of the twenty-eight patients
developed heterotopic ossification up to the 30-day follow-up
time-point. The patients who developed heterotopic ossification
exhibited significantly reduced BMP-2 and RANKL levels on ICU admission,
compared to patients who did not; Osteoprotegerin readings were similar
in both groups. Conclusions: Critically-ill patients who will
subsequently develop heterotopic ossification, have significantly lower
BMP-2 and RANKL levels at the time of ICU admission, suggesting that
these proteins may be useful as prognostic markers for this debilitating
condition.
Συγγραφείς:
Vassiliou, Alice Georgia
Jahaj, Edison
Mastora, Zafeiria and
Karnezis, Ioannis
Dimopoulou, Ioanna
Orfanos, Stylianos E. and
Kotanidou, Anastasia
