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Changes in serum levels of receptor activator of nuclear factor-κB ligand, osteoprotegerin, IL-6 and TNF-α in patients with a concomitant head injury and fracture

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Abstract

Introduction

Several reports indicated that interleukin-6 (IL-6) and tumor necrosis factor α (TNF- α) play important regulatory roles in bone remodeling and homeostasis. In addition, receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) have been shown to be important regulators of osteoclastogenesis during bone remodeling, and their expressions were examined during fracture healing in a mouse model of tibial fracture. However, studies linking RANKL, OPG, IL-6 and TNF-α in patients with head injury and fracture are lacking.

Patients and methods

Within the first few hours of admission to hospital and at 4, 8, and 12 weeks after the injury, we evaluated changes in serum levels of RANKL, OPG, IL-6 and TNF-α in 24 male patients with a concomitant head injury and fracture and in 26 male patients with fracture only. These levels were compared with those found in 36 healthy controls.

Results

The RANKL/OPG ratios were found to significantly lower in patients with a concomitant head injury and fracture than in the controls immediately after admission and at 4, 8, and 12 weeks after the injury. In addition, RANKL/OPG ratios were significantly lower in patients with a concomitant head injury and fracture than in those with fracture at 8 and 12 weeks after the injury. The serum IL-6 levels were significantly higher in patients with a concomitant head injury and fracture than in the controls upon admission, and at 4, 8, and 12 weeks after the injury. Moreover, the serum IL-6 levels were significantly higher in patients with a head injury and fracture than in those with just a fracture at 4, 8, and 12 weeks after the injury.

Conclusions

Based on these changes in the profiles of RANKL, OPG, and IL-6 and the RANKL/OPG ratio, altered repair of a fracture can occur in patients with a concomitant head injury and fracture.

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Correspondence to Kuen Tak Suh.

Additional information

J. S. Lee and C. H. Ryu contributed equally to this study.

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Lee, J.S., Ryu, C.H., Moon, N.H. et al. Changes in serum levels of receptor activator of nuclear factor-κB ligand, osteoprotegerin, IL-6 and TNF-α in patients with a concomitant head injury and fracture. Arch Orthop Trauma Surg 129, 711–718 (2009). https://doi.org/10.1007/s00402-008-0632-8

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  • DOI: https://doi.org/10.1007/s00402-008-0632-8

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