Proceedings of the National Academy of Sciences · 2011 · 260 citations · 24 references
MedicineOrthopedic SurgeryBone MetabolismRegenerative MedicineStem Cell BiologyBone Marrow MicroenvironmentBone RegenerationMesenchymal Stem Cell TherapyRadiation Effects On Stem CellsRadiation TherapyTissue Responses To RadiationBone Marrow Microenvironment ToxicityHigh-dose Radiation Effects On Stem CellsIonizing IrradiationIrradiation DamageMesenchymal Stem Cell Radiation ResponseMicroenvironmental Effects On Stem CellsRadiation Effects On The Hematopoietic SystemRadiation-induced Free Radicals
Radiation therapy can result in bone injury with the development of fractures and often can lead to delayed and nonunion of bone. There is no prevention or treatment for irradiation-induced bone injury. We irradiated the distal half of the mouse left femur to study the mechanism of irradiation-induced bone injury and found that no mesenchymal stem cells (MSCs) were detected in irradiated distal femora or nonirradiated proximal femora. The MSCs in the circulation doubled at 1 week and increased fourfold after 4 wk of irradiation. The number of MSCs in the proximal femur quickly recovered, but no recovery was observed in the distal femur. The levels of free radicals were increased threefold at 1 wk and remained at this high level for 4 wk in distal femora, whereas the levels were increased at 1 wk and returned to the basal level at 4 wk in nonirradiated proximal femur. Free radicals diffuse ipsilaterally to the proximal femur through bone medullary canal. The blood vessels in the distal femora were destroyed in angiographic images, but not in the proximal femora. The osteoclasts and osteoblasts were decreased in the distal femora after irradiation, but no changes were observed in the proximal femora. The total bone volumes were not affected in proximal and distal femora. Our data indicate that irradiation produces free radicals that adversely affect the survival of MSCs in both distal and proximal femora. Irradiation injury to the vasculatures and the microenvironment affect the niches for stem cells during the recovery period.
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