1464 E.A. Hughes I. Tracey* S. Singhal J. Patel Clinical Biochemistry, Sandwell General Hospital,
Correspondence Sandwell and West Birmingham Hospitals, NHS Trust, B714HJ, United Kingdom *Tel.: +44 121 607 3426; fax: +44 121 607 3515. E-mail address: [email protected]
Bone marrow may be a useful therapy in osteomyelitis Osteomyelitis, or bone infection, is an expensive, often intractable, and underappreciated public health problem . Osteomyelitis, if left untreated, the infection can become chronic and cause a loss of blood supply to the affected bone. The devitalized bone acts as a foreign body, perpetuating infection despite long-term antimicrobial therapy . Bone marrow grafting is a safe, simple, and reliable method of treating many problems, such as stroke, myocardial ischemia, delay union, muscle injury, etc. It is a limited invasive technique with minimal complications. It can be performed under local anesthesia, is cost effective and potentially can avoid major surgical reconstructions . Human bone marrow stromal cells secrete sufficient quantities of vascular endothelial growth factor (VEGF) to enhance survival and differentiation of endothelial cells . Vascular endothelial growth factor or VEGF is an important signal protein involved in angiogenesis. VEGF has six isoforms, ranging in weight from 35 to 44 kDa. Each bind to a specific combination of endothelial cell surface ligands (known as VEGFR-1, -2 and -3). VEGF production can be induced in cells that are not receiving enough oxygen. When a cell is deficient in oxygen, it produces hypoxia inducible factors (HIFs) a transcription factor. HIF stimulates the release of VEGF, among other functions (including modulation of erythropoiesis). Circulating VEGF then binds to VEGF receptors on endothelial cells, triggering a doi:10.1016/j.mehy.2006.06.002
tyrosine kinase pathway leading to angiogenesis . Based on the above mentioned evidences, it seems that bone marrow injection may be a potential therapeutic agent in osteomyelitis.
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Hamid Namazi Shiraz University, Iran-Shiraz-Chamran Hospital, Shiraz, Iran Tel.: +98 7116246093. E-mail address: [email protected]