Lymphatic contribution to the cellular niche in heterotopic ossification Journal Article


Authors: Loder, S.; Agarwal, S.; Sorkin, M.; Breuler, C.; Li, J.; Peterson, J.; Gardenier, J.; Hsieh, H. H. S.; Wang, S. C.; Mehrara, B. J.; Levi, B.
Article Title: Lymphatic contribution to the cellular niche in heterotopic ossification
Abstract: Objective: The objective of this study was to determine the contribution of lymphatic tissue to heterotopic ossification (HO). Background: HO is the pathologic development of ectopic bone within soft tissues often following severe trauma. Characterization of the tissue niche supporting HO is critical to identifying therapies directed against this condition. Lymphangiogenesis is upregulated during incidents of trauma, thereby coincident with the niche supportive of HO. We hypothesized that lymphatic tissues play a critical role in HO formation. Methods: Mice underwent hindlimb Achilles' tendon transection and dorsal burn injury (burn/tenotomy) to induce HO. The popliteal and inguinal lymph nodes were excised ipsilateral to the tenotomy site. Flow cytometry and immunostaining were used to quantify and localize lymphoendothelium. MicroCT was used to quantify HO. Results: Enrichment of mature lymphatic tissues was noted 2 weeks after injury at the tendon transection sites when compared with the contralateral, intact tendon based on LYVE1 tubules (10.9% vs 0.8%, P < 0.05). Excision of the inguinal and popliteal nodes with draining popliteal lymphatic vessel significantly decreased the presence of mature lymphoendothelium 2 weeks after injury (10.9% vs 3.3%, P < 0.05). Bone-cartilage-stromal progenitor cells (CD105/AlphaV/Tie2-/CD45-/CD90-/BP1-) were also significantly decreased after lymph node excision (10.2% vs 0.5%, P < 0.05). A significant decrease was noted in the volume of de novo HOpresent within the soft tissues (0.12 mm3 vs 0.02 mm3). Conclusion: These findings suggest that lymphatic vessels are intimately linked with the de novo formation bone within soft tissues following trauma, and their presence may facilitate bone formation. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: wound healing; immunology; bone; cartilage; heterotopic ossification; lymphatic; endochondral ossification
Journal Title: Annals of Surgery
Volume: 264
Issue: 6
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2016-12-01
Start Page: 1174
End Page: 1180
Language: English
DOI: 10.1097/sla.0000000000001619
PROVIDER: scopus
PMCID: PMC4947025
PUBMED: 26779981
DOI/URL:
Notes: Article -- Export Date: 6 December 2016 -- Source: Scopus
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  1. Babak Mehrara
    448 Mehrara