CHANGES IN THE BLOOD SERUM CONTENT OF BONE BIOMARKERS AND CYTOKINES IN CHILDREN WITH COMBINED TRAUMA

Abstract

Twenty-nine children (mean age of 12.6 ± 2.3 years) with combined bone trauma were examined. The reference group consisted of 20 conditionally healthy children (mean age of 11.8 ± 2.7 years) without the pathology of the locomotor system. The content of bone biomarkers - osteoprotegerin (OPG), bone isoenzyme of alkaline phosphatase (AP), osteocalcin (OC), hyaluronic acid (HA), as well as matrix metalloproteinases (MMPs) and cytokines - TGF-β, MCP-1 and MIP-1β in serum was determined by the enzyme immunoassay in dynamics: on the 1-3rd, 7-th, 14-th and 30-th days after the trauma. Remodeling of bone tissue after a combined trauma at the stage of formation of the regenerate was established to be characterized by diverse changes in the serum content of bone biomarkers, which are not substantially dependent on the severity of the trauma. At the same time, a significant increase in the concentrations of OPG, AP and HA was combined with a pronounced decrease in the content of OC. At 7-14th days after the injury OC levels were lower by more than 3 times compared with the control, indicating a slowdown in the mineralization of the osteoid and a disturbance in the formation of bone tissue during this period. By 30 days after trauma serum concentrations of gelatinases (MMP-2, MMP-9) and collagenases (MMP-8) increased significantly, stromelysin levels (MMP-3) did not change. By 30th day after the injury serum concentrations of gelatinases (MMP-2, MMP-9) and collagenases (MMP-8) increased significantly, stromelysin levels (MMP-3) did not change, and the TIMP-1 content declined. Early detection of changes in blood levels of bone biomarkers during the process of the recovery after combined trauma in children makes it possible to ensure timely correction of disturbances and choice of optimal individual treatment tactics for the management of a particular patient, taking into account the peculiarities of his bone metabolism