Early protection against bone stress injuries by mobilization of endogenous targeted bone remodeling

Yuanjun Ding; Yongqing Yang; Fei Xu; Zhifen Tan; Xiyu Liu; Xi Shao; Fei Kang; Zedong Yan; Erping Luo; Jing Wang; Zhuojing Luo; Jing Cai; Da Jing

doi:10.1016/j.isci.2023.107605

Early protection against bone stress injuries by mobilization of endogenous targeted bone remodeling

iScience. 2023 Aug 11;26(9):107605. doi: 10.1016/j.isci.2023.107605. eCollection 2023 Sep 15.

Authors

Yuanjun Ding¹, Yongqing Yang¹, Fei Xu², Zhifen Tan¹, Xiyu Liu¹, Xi Shao¹, Fei Kang³, Zedong Yan¹, Erping Luo¹, Jing Wang³, Zhuojing Luo⁴, Jing Cai⁵, Da Jing¹

Affiliations

¹ Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China.
² Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
³ Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
⁴ Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
⁵ College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China.

Abstract

Bone stress injuries are common overuse injuries, especially in soldiers, athletes, and performers. In contrast to various post-injury treatments, early protection against bone stress injuries can provide greater benefit. This study explored the early protection strategies against bone stress injuries by mobilization of endogenous targeted bone remodeling. The effects of various pharmaceutical/biophysical approaches, individual or combinational, were investigated by giving intervention before fatigue loading. We optimized the dosage and administration parameters and found that early intervention with pulsed electromagnetic field and parathyroid hormone (i.e., PEMF+PTH) resulted in the most pronounced protective effects among all the approaches against the bone stress injuries. In addition, the mechanisms by which the strategy mobilizes targeted bone remodeling and enhances the self-repair capacity of bone were systematically investigated. This study proposes strategies to reduce the incidence of bone stress injuries in high-risk populations (e.g., soldiers and athletes), particularly for those before sudden increased physical training.

Keywords: Electromagnetic waves; Functional aspects of cell biology; Model organism; Orthopedics; Vibration.