Characterizing the Circulating Cell Populations in Traumatic Heterotopic Ossification

Shawn J. Loder, Shailesh Agarwal, Michael T. Chung, David Cholok, Charles Hwang, Noelle Visser, Kaetlin Vasquez, Michael Sorkin, Joe Habbouche, Hsiao H. Sung, Joshua Peterson, David Fireman, Kavitha Ranganathan, Christopher Breuler, Caitlin Priest, John Li, Xue Bai, Shuli Li, Paul S. Cederna, Benjamin Levi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Heterotopic ossification (HO) occurs secondary to trauma, causing pain and functional limitations. Identification of the cells that contribute to HO is critical to the development of therapies. Given that innate immune cells and mesenchymal stem cells are known contributors to HO, we sought to define the contribution of these populations to HO and to identify what, if any, contribution circulating populations have to HO. A shared circulation was obtained using a parabiosis model, established between an enhanced green fluorescent protein–positive/luciferase+ donor and a same-strain nonreporter recipient mouse. The nonreporter mouse received Achilles tendon transection and dorsal burn injury to induce HO formation. Bioluminescence imaging and immunostaining were performed to define the circulatory contribution of immune and mesenchymal cell populations. Histologic analysis showed circulating cells present throughout each stage of the developing HO anlagen. Circulating cells were present at the injury site during the inflammatory phase and proliferative period, with diminished contribution in mature HO. Immunostaining demonstrated that most early circulatory cells were from the innate immune system; only a small population of mesenchymal cells were present in the HO. We demonstrate the time course of the participation of circulatory cells in trauma-induced HO and identify populations of circulating cells present in different stages of HO. These findings further elucidate the relative contribution of local and systemic cell populations to HO.

Original languageEnglish
Pages (from-to)2464-2473
Number of pages10
JournalAmerican Journal of Pathology
Issue number11
StatePublished - Nov 2018
Externally publishedYes


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