Therapeutic potential of vasculogenesis and osteogenesis promoted by peripheral blood CD34-positive cells for functional bone healing

Am J Pathol. 2006 Oct;169(4):1440-57. doi: 10.2353/ajpath.2006.060064.

Abstract

Failures in fracture healing are mainly caused by a lack of vascularization. Adult human circulating CD34+ cells, an endothelial/hematopoietic progenitor-enriched cell population, have been reported to differentiate into osteoblasts in vitro; however, the therapeutic potential of CD34+ cells for fracture healing is still unclear. Therefore, we performed a series of experiments to test our hypothesis that functional fracture healing is supported by vasculogenesis and osteogenesis via regenerative plasticity of CD34+ cells. Peripheral blood CD34+ cells, isolated from total mononuclear cells of adult human volunteers, showed gene expression of osteocalcin in 4 of 20 freshly isolated cells by single cell reverse transcriptase-polymerase chain reaction analysis. Phosphate-buffered saline, mononuclear cells, or CD34+ cells were intravenously transplanted after producing nonhealing femoral fractures in nude rats. Reverse transcriptase-polymerase chain reaction and immunohistochemical staining at the peri-fracture site demonstrated molecular and histological expression of human-specific markers for endothelial cells and osteoblasts at week 2. Functional bone healing assessed by biomechanical as well as radiological and histological examinations was significantly enhanced by CD34+ cell transplantation compared with the other groups. Our data suggest circulating human CD34+ cells have therapeutic potential to promote an environment conducive to neovascularization and osteogenesis in damaged skeletal tissue, allowing the complete healing of fractures.

MeSH terms

  • Angiogenesis Inhibitors / pharmacology
  • Animals
  • Antigens, CD34 / analysis*
  • Cell Movement
  • Cells, Cultured
  • Endothelial Cells
  • Female
  • Femoral Fractures / pathology
  • Femoral Fractures / therapy*
  • Femur / blood supply*
  • Femur / pathology
  • Gene Expression
  • Humans
  • Leukocytes, Mononuclear / chemistry
  • Leukocytes, Mononuclear / transplantation*
  • Mice
  • Neovascularization, Physiologic* / drug effects
  • Osteocalcin / genetics
  • Osteogenesis* / genetics
  • RNA, Messenger / analysis
  • Rats
  • Rats, Nude

Substances

  • Angiogenesis Inhibitors
  • Antigens, CD34
  • RNA, Messenger
  • Osteocalcin