Translational treatment paradigm for managing non-unions secondary to radiation injury utilizing adipose derived stem cells and angiogenic therapy

Alexis Donneys, Jordan T. Blough, Noah S. Nelson, Joseph E. Perosky, Sagar S. Deshpande, Stephen Y. Kang, Peter A. Felice, Christian Figueredo, Jonathan R. Peterson, Kenneth M. Kozloff, Benjamin Levi, Douglas B. Chepeha, Steven R. Buchman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background Bony non-unions arising in the aftermath of collateral radiation injury are commonly managed with vascularized free tissue transfers. Unfortunately, these procedures are invasive and fraught with attendant morbidities. This study investigated a novel, alternative treatment paradigm utilizing adipose-derived stem cells (ASCs) combined with angiogenic deferoxamine (DFO) in the rat mandible. Methods Rats were exposed to a bioequivalent dose of radiation and mandibular osteotomy. Those exhibiting non-unions were subsequently treated with surgical debridement alone or debridement plus combination therapy. Radiographic and biomechanical outcomes were assessed after healing. Results Significant increases in biomechanical strength and radiographic metrics were observed in response to combination therapy (p <.05). Importantly, combined therapy enabled a 65% reduction in persisting non-unions when compared to debridement alone. Conclusion We support the continued investigation of this promising combination therapy in its potential translation for the management of radiation-induced bony pathology.

Original languageEnglish
Pages (from-to)E837-E843
JournalHead and Neck
Volume38
DOIs
StatePublished - 1 Apr 2016
Externally publishedYes

Keywords

  • adipose-derived stromal cell
  • deferoxamine
  • osteoradionecrosis
  • pathologic fracture
  • radiotherapy

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