Coaxing the body to heal broken bones
What if a doctor could prescribe a pill that would help broken bones heal?
Robert Zondervan, an MSU College of Osteopathic Medicine medical student and doctoral candidate in the Department of Physiology, thinks that someday physicians will be able to do just that.
Bone injuries are extremely common and poor bone regeneration is a significant problem.
A study published in the journal Injury Prevention states that over 12 million fractures are treated in the United States each year, costing $80 billion. Treating improperly healed fractures can be risky, often requiring surgery. Additionally, according to the journal Contemporary Orthopaedics, about half of all fractures with insufficient blood supply will fail to heal properly.
Zondervan recently received a fellowship from the National Institute of Arthritis and Musculoskeletal and Skin Disease, also known as NIAMS, to explore bone regeneration at the cellular level. The $176,000 grant will fund the remainder of his doctoral and clinical training while he completes his dissertation research.
Zondervan is investigating cellular and molecular systems regulating bone regeneration, looking at mechanisms to promote fracture healing, specifically in ischemic fractures when there is a restricted blood supply. He is focused on a class of proteins called thrombospondins and the role they play in inhibiting blood vessel growth.
“Vascularization and blood flow are crucial to fracture healing," he said. "But our bodies have a natural mechanism to slow down blood vessel proliferation. You wouldn't want to have a car that just has a gas pedal and no brake. In your body, you're typically going to have some system that stops a process as well. That way it just doesn't take off.”
While limiting blood vessel growth might be a good thing, particularly in cases where a tumor is involved, when it comes to bone fractures, a diminished blood supply results in slow or incomplete healing.
Zondervan, along with other research colleagues, hypothesize that by inhibiting the system that slows blood vessel growth, they can actually promote it. They are exploring the use of a molecule that inhibits the blood vessel inhibitor for a short period.
Zondervan is hopeful that his research will lead to better treatment options and outcomes in the future.
One of the arms of his project is to develop a therapeutic treatment that could be given to a specific part of the body or even target the whole body.
“This is a very promising avenue. It wouldn't take much of a jump to get it into clinical practice,” he said.
Only four dual-degree fellowships from NIAMS, which is part of the National Institutes of Health, have been awarded to MSU students. This is the second awarded to an osteopathic medical and doctoral student.
Upon completion of his degrees, Zondervan plans to pursue a residency in orthopedic surgery and eventually direct his own translational research lab.