Abstract
Bone is a mechanosensitive tissue for which mechanical stimuli are crucial in maintaining its structure and function. Bone cells react to their biomechanical environment by activating molecular signaling pathways, which regulate their proliferation, differentiation, and matrix production. Bone implants influence the mechanical conditions in the adjacent bone tissue. Optimizing their mechanical properties can support bone regeneration. Furthermore, external biomechanical stimulation can be applied to improve implant osseointegration and accelerate bone regeneration. One promising anabolic therapy is vertical whole-body low-magnitude high-frequency vibration (LMHFV). This form of vibration is currently extensively investigated to serve as an easy-to-apply, cost-effective, and efficient treatment for bone disorders and regeneration. This review aims to provide an overview of LMHFV effects on bone cells in vitro and on implant integration and bone fracture healing in vivo. In particular, we review the current knowledge on cellular signaling pathways which are influenced by LMHFV within bone tissue. Most of the in vitro experiments showed that LMHFV is able to enhance mesenchymal stem cell (MSC) and osteoblast proliferation. Furthermore, osteogenic differentiation of MSCs and osteoblasts was shown to be accelerated by LMHFV, whereas osteoclastogenic differentiation was inhibited. Furthermore, LMHFV increased bone regeneration during osteoporotic fracture healing and osseointegration of orthopedic implants. Important mechanosensitive pathways mediating the effects of LMHFV might be the Wnt/beta-catenin signaling pathway, the estrogen receptor (ER) signaling pathway, and cytoskeletal remodeling.
Highlights
MATERIALS AND METHODSBone is a mechanosensitive tissue which can react to changing loads by adapting bone mass and structure
mesenchymal stem cells (MSCs) Mesenchymal stem cells are multipotent stem cells with the capacity to differentiate into different lineages, that is, osteogenic, chondrogenic, adipogenic, and myogenic (Pittenger et al, 1999; Kolf et al, 2007; Rastegar et al, 2010)
It is of great interest for the development of regenerative strategies to investigate whether low-magnitude high-frequency vibration (LMHFV) can favor MSC differentiation toward one specific lineage and which molecular mechanisms are involved
Summary
MATERIALS AND METHODSBone is a mechanosensitive tissue which can react to changing loads by adapting bone mass and structure. Other bone cells, including osteochondroprogenitor cells and osteoblasts, were shown to react to their biomechanical environment by activating molecular signaling pathways, which regulate their proliferation, differentiation, and matrix production. The biomechanical environment plays a critical role during osseous implant integration. Because of the mechanosensitivity of bone, the application of external biophysical stimulation, including LMHFV, is considered to promote bone formation. This approach offers many benefits as a safe, easy-to-apply, and an effective treatment option which might be useful for preventing the risk of fractures and for improving bone regeneration and implant osseointegration. Studies applying LMHFV during fracture healing or implant integration are discussed in this review article
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