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Platelet-Derived Growth Factor Inhibits Demineralized Bone Matrix-Induced Intramuscular Cartilage and Bone FormationA Study of Immunocompromised Mice
Don M. Ranly, DDS, PhD1; Jacquelyn McMillan, MBChB, FRCSEd, FRCS(Orth)2; Todd Keller, DDS, MS3; Christoph H. Lohmann, MD, MS4; Timothy Meunch, PhD5; David L. Cochran, DDS, PhD3; Zvi Schwartz, DMD, PhD1; Barbara D. Boyan, PhD1
1 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive N.W., Atlanta, GA 30332 E-mail address for B.D. Boyan: barbara.boyan@bme.gatech.edu
2 Institute for Bioengineering and Biosciences, Georgia Institute of Technology, 315 Ferst Drive, N.W., Atlanta, GA 30332-0363
3 Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
4 Universitätsklinik Hamburg-Eppendorf, Klinik un Poliklinik für Orthopädie, Martinisrasse 52, 20246, Hamburg, Germany
5 NAMSA, 6750 Wales Road, Northwood, OH 43619
View Disclosures and Other Information
In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from BioMimetic Pharmaceuticals; DePuy, Germany; Institut Straumann AG; and the ITI Foundation. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (BioMimetic Pharmaceuticals and LifeNet, Inc.). Also, commercial entities (Deutsche Forschungsgemeinschaft, Elsbeth-Bonhoff-Stiftung, Plus Endoprothetik, and Zimmer, Germany) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at Georgia Institute of Technology, Atlanta, Georgia

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Sep 01;87(9):2052-2064. doi: 10.2106/JBJS.D.02752
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Background: Platelet-derived growth factor (PDGF) has been proposed as a therapeutic agent to promote bone-healing. The purpose of this study was to examine the effect of PDGF on the ability of human demineralized bone matrix to induce bone formation in a nude-mouse muscle-implantation model. We also examined whether platelet-rich plasma, which contains PDGF, also modulates osteoinduction in this model.

Methods: Human demineralized bone matrix, previously shown to be osteoinductive in the calf muscles of nude mice, was mixed with PDGF-BB (0, 0.1, 1, and 10 µg/10 mg of demineralized bone matrix) and was implanted bilaterally in the calf muscles of immunocompromised (nu/nu) mice (six mice in each group). Heat-inactivated demineralized bone matrix was used as a control. Tissue was harvested at fourteen, twenty-eight, and fifty-six days after implantation. Platelet-rich plasma was prepared from the blood of a healthy donor with use of the Harvest PRP preparation device, activated with thrombin, and mixed with active and inactive demineralized bone matrix. Fifty-six days post-implantation, tissues were harvested. Osteoinduction was assessed with use of a qualitative scoring system and with quantitative histomorphometry.

Results: Cartilage was present at fourteen days in all tissues that had received an implant, but the amount decreased as the PDGF concentration increased. PDGF reduced bone formation at twenty-eight days in a dose-dependent manner. This inhibitory effect was resolved by fifty-six days, except in tissues in which demineralized bone matrix and 10 µg of PDGF had been implanted. In sites treated with 10 µg of PDGF, the area of new bone was decreased and the area of bone marrow was reduced at twenty-eight and fifty-six days. PDGF also appeared to retard resorption of demineralized bone matrix in a dose-dependent manner. Platelet-rich plasma reduced osteoinduction by human demineralized bone matrix that had high osteoinductive activity and had no effect on osteoinduction by demineralized bone matrix with low activity.

Conclusions: PDGF inhibits, in a dose-dependent manner, intramuscular osteoinduction and chondrogenesis by demineralized bone matrix in immunocompromised mice. Platelet-rich plasma also reduces the osteoinductivity of active demineralized bone matrix.

Clinical Relevance: Osteoinduction in the nude mouse may not reflect growth-factor effects in bone. However, these data indicate that PDGF and platelet-rich plasma should not be used with demineralized bone matrix if the purpose is to increase osteoinduction, although these substances may increase other aspects of bone-healing. Additional studies are needed to determine the clinical relevance of these observations.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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