Most people have broken a bone or know someone who has. A break is painful and takes time to heal. Recovering from a fracture is even more complicated and lengthy when your body is not able to produce what is needed to heal. More than 10% of fractures do not heal properly, and this percentage dramatically increases for patients, like those treated at Shriners Hospitals for Children®, who are affected by metabolic diseases. Improvements in the treatment of fractures are therefore highly beneficial. In a study published in the August 2018 issue of the Journal of Clinical Investigation, René St-Arnaud, Ph.D., Director of Research at Shriners Hospitals for Children - Canada shares his discovery of a new way to stimulate bone fracture healing.
It is well known that vitamin D is produced in skin when exposed to sunlight and is found in some foods that we consume. In order to stimulate calcium absorption and benefit bone mineralization, our body must transform the vitamin D molecule in two steps.
During the first step of vitamin D transformation, another form of vitamin D, called 24,25(OH)2D, is created. Although 24,25(OH)2D has been mainly regarded as an inactive degradation product, the work from Dr. St-Arnaud's laboratory has not only revealed that 24,25(OH)2D improves bone fracture healing but he has discovered how this process works.
With the help of another molecule, 24,25(OH)2D synthesizes a waxy fat compound called lactosyl ceramide. This compound triggers the transmission of a signal in order to maximize the size and biomechanical properties of the callus, a stabilizing structure that surrounds a fracture and promotes its healing. Test subjects who were not able to produce either 24,25(OH)2D or lactosyl ceramide had a smaller and weaker callus but when treated with these compounds, both callus size and strength increased. By ensuring a stronger and optimal callus size, we promote better healing of a fracture.
"In this research, we have identified new biology and a previously unrecognized mechanism of action for a vitamin D molecule. It is the culmination of more than 15 years of work from my laboratory", states Dr. St-Arnaud.
Traumatic bone injury is a worldwide major public health issue with significant socioeconomic cost. Therefore, any improvement in fracture treatment would be of considerable benefit for our patients and the population at large.
"The next step is to try these compounds in clinical trials. We hope that they could play an important role in improving fracture repair and healing time", concludes Dr. St-Arnaud.