Soluble activin type IIB receptor improves fracture healing in a closed tibial fracture mouse model

PLoS One. 2017 Jul 13;12(7):e0180593. doi: 10.1371/journal.pone.0180593. eCollection 2017.

Abstract

Fractures still present a significant burden to patients due to pain and periods of unproductivity. Numerous growth factors have been identified to regulate bone remodeling. However, to date, only the bone morphogenetic proteins (BMPs) are used to enhance fracture healing in clinical settings. Activins are pleiotropic growth factors belonging to the TGF-β superfamily. We and others have recently shown that treatment with recombinant fusion proteins of activin receptors greatly increases bone mass in different animal models by trapping activins and other ligands thus inhibiting their signaling pathways. However, their effects on fracture healing are less known. Twelve-week old male C57Bl mice were subjected to a standardized, closed tibial fracture model. Animals were divided into control and treatment groups and were administered either PBS control or a soluble activin type IIB receptor (ActRIIB-Fc) intraperitoneally once a week for a duration of two or four weeks. There were no significant differences between the groups at two weeks but we observed a significant increase in callus mineralization in ActRIIB-Fc-treated animals by microcomputed tomography imaging at four weeks. Bone volume per tissue volume was 60%, trabecular number 55% and bone mineral density 60% higher in the 4-week calluses of the ActRIIB-Fc-treated mice (p<0.05 in all). Biomechanical strength of 4-week calluses was also significantly improved by ActRIIB-Fc treatment as stiffness increased by 64% and maximum force by 45% (p<0.05) compared to the PBS-injected controls. These results demonstrate that ActRIIB-Fc treatment significantly improves healing of closed long bone fractures. Our findings support the previous reports of activin receptors increasing bone mass but also demonstrate a novel approach for using ActRIIB-Fc to enhance fracture healing.

MeSH terms

  • Activin Receptors, Type II / administration & dosage*
  • Activin Receptors, Type II / pharmacology
  • Animals
  • Bone Density / drug effects
  • Disease Models, Animal
  • Drug Administration Schedule
  • Fracture Healing / drug effects*
  • Injections, Intraperitoneal
  • Male
  • Mice
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / drug therapy*
  • Treatment Outcome
  • X-Ray Microtomography

Substances

  • Activin Receptors, Type II
  • activin receptor type II-B

Grants and funding

The work was supported by the following: RK: Academy of Finland- Grants 132962, 139165, 298535, http://webfocus.aka.fi/ibi_apps/WFServlet?IBIF_ex=x_HakKuvaus&CLICKED_ON=&HAKNRO1=268535&UILANG=en&IBIAPP_app=aka_ext&TULOSTE=HTML; Sigrid Juselius Foundation; Emil Aaltonen Foundation; and Finnish Cultural Foundation. Regarding the employer of Dr. Ari Hiltunen, the funder, Terveystalo Pulssi, provided support in the form of salaries for author AH but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of all the authors are articulated in the "author contributions" section.