Growth factors of the TGF-b family in blood of achondroplasia patients at stages of orthopedic treatment
Elaboration of simple and effective ways for managing the distraction rate to provide an optimum regimen of limb lengthening for different groups of patients is an important task in implementation of transosseous osteosynthesis. The aim of this study was to analyze blood serum concentrations of TGFb-1, TGFb-2, BMP-4, and BMP-6 in individuals undergoing cosmetic height increase and patients with achondroplasia at different stages of distraction osteogenesis in tibial lengthening using the Ilizarov method. Methods. Concentrations of growth factors were measured using a set of Thermofisher (USA) equipment, including a Multiscan FC detector, iEMS Shaker, and automatic WellWash Washer and ELISA kits (eBioscience and RayBiotech Inc., USA). Results. Serum concentrations of TGFb-2 and BMP-4 were lower and TGFb-1 and BMP-6 were higher in achondroplasia patients than in individuals with cosmetic height increase even before any orthopedic treatment. Long bone lengthening for cosmetic height increase was associated with increases in serum levels of TGFb-1 and TGFb-2 at the start and in the middle of distraction. In achondroplasia patients, opposite changes were observed; serum concentrations of BMP-4 and BMP-3 increased 3.5 and 2 times, respectively, by the end of distraction and decreased during fixation. Conclusion. Therefore, we observed a disorder of the stage-by-stage bone remodeling process in achondroplasia patients.