Abstract
Background: Nitric oxide is a small gaseous molecule with significant bioactivity. It has been observed that NO may have a dual role dependent on its production and concentrations in the bone microenvironment. The objective of the study was to assess the concentration of total nitric oxide malonyldialdehyde, nitrotyrosine, and asymmetric dimethylarginine in the serum of patients with mandibular fractures and to understand the relationship between these compounds, in order to expand the knowledge base of the role of nitric oxide and its activity indicators in the process of bone fracture healing. Material and Methods: The study included 20 patients with mandibular fractures who were undergoing inpatient and outpatient treatments and a control group of 15 healthy people. Results were analyzed with respect to the measurement time. Total nitric oxide concentration in the blood serum was determined according to the Griess reaction, while the concentration of malonyldialdehyde, nitrotyrosine, and asymmetric dimethylarginine was estimated using the immunoenzymatic method (i.e., enzyme-linked immunosorbent assay). Results: Before the procedure, as well as on the first day and 2 and 6 weeks after the procedure, higher concentrations of total nitric oxide and lower concentrations of malonyldialdehyde were observed in the blood serum of patients with mandibular fractures compared to the control group. No statistically significant differences were found in nitrotyrosine concentrations in the blood serum of patients throughout the measurement period. However, a significantly higher asymmetric dimethylarginine concentration was observed in the patient serum before the procedure and on the first day of operation as compared with the control group. Analysis of the results observed in patient serum with respect to the number of fractures within the mandible demonstrated the same trend of concentrations for the tested compounds for the entire study group. Conclusions: In summary, our results revealed that the intensity of local processes resulting from mandibular fractures is associated with the concentration of nitric oxide, confirming its significant role, as well as that of its indicators, in the process of bone fracture healing in this patient population.
Highlights
IntroductionEven a very small one, induces a systemic reaction in the form of inflammation
Each tissue injury, even a very small one, induces a systemic reaction in the form of inflammation
As well as on the first day and 2 and 6 weeks after the procedure, significantly higher concentrations of total nitric oxide (NO) were observed in the blood serum of patients with mandibular fractures compared to the control group (Figure 9)
Summary
Even a very small one, induces a systemic reaction in the form of inflammation. Numerous antigens reach the extracellular space penetrating from the outer environment, as well as from the inside of damaged cells. These damaged endothelial cells, as well as the lymphocytes and macrophages that are present near the injury site, start releasing different proinflammatory mediators, including numerous cytokines, which in turn stimulate the cells of the immune system to produce considerable amounts of nitric oxide (NO) through prolonged activation of inducible nitric oxide synthase (iNOS). NO is a molecule that regulates numerous physiological processes, including the activity of bone-forming cells. The normal course of the processes of bone formation and resorption constitutes bone remodeling and maintenance of the correct balance between the actions of osteoblasts and osteoclasts, enabling the preservation of bone robustness and repairing of microscopic lesions within the bone [4,5]
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