BMP-2 adverse reactions treated with human dose equivalent dexamethasone in a rodent model of soft-tissue inflammation

Chengjie Xiong, Michael D. Daubs, Scott R. Montgomery, Bayan Aghdasi, Hirokazu Inoue, Haijun Tian, Akinobu Suzuki, Yanlin Tan, Tetsuo Hayashi, Monchai Ruangchainikom, Timothy Chai, Megan Corey, Jeffrey C. Wang

Research output: Contribution to journalArticlepeer-review

Abstract

Study Design. Basic science rodent model of bone morphogenetic protein-2 (BMP-2) soft-tissue inflammation. Objective. This study investigated the anti-inflammatory effect of human dose equivalent (HDE) dexamethasone (DM) for treatment of BMP-2-related soft-tissue inflammation in a rodent model and suggests an appropriate dose for utilization in the clinical practice of spine surgeons. Summary of Background Data. BMP-2 is frequently used in spinal surgery to augment fusion. Yet, side effects of soft-tissue inflammation have been observed. DM decreases proinflammatory cytokine production and cellular immune response. However, the anti-inflammatory effects of HDE DM in a rodent model of BMP-2- Associated soft-tissue inflammation have not been reported. Methods. Five, 10, and 15 mg of HDE DM were administered 3 times perioperatively to rodent cohorts receiving BMP-2 paraspinal implants and compared against BMP-2 only positive controls and phosphate buffer negative controls (n = 6 subjects per group). Histopathology, magnetic resonance imaging, and gross dissection were used as measures of cellular, edematous, and exudative inflammatory response. Serial killings were made on day 2 and day 7 postoperatively. Results. Magnetic resonance imaging volume rendering demonstrated inflammatory edema decreased by 49% from 605.4 mm 3to 304.03 mm 3 in subjects treated with 5, 10, or 15 mg of HDE DM ( P < 0.05). Histopathological analysis demonstrated inflammatory cross-sectional area decreased 28.8% from 1.84 mm 2 to 1.31 mm2 in subjects treated with 5, 10 or 15 mg of HDE DM ( P < 0.05). Immune cellular infiltration depth decreased 38.5% from 0.26 mm to 0.16 in subjects treated with 15 mg of HDE DM ( P < 0.05). Gross anatomical inflammatory exudates were prevented in 100% of subjects treated with 10 or 15 mg of HDE DM ( P < 0.05). Conclusion. Low-dose DM administration is effective in controlling the cellular inflammation and edema resulting from BMP-2. Ten or 15 mg of DM might be considered by spine surgeons for controlling the inflammation and edema seen in spine surgery with BMP-2.

Original languageEnglish (US)
Pages (from-to)1640-1647
Number of pages8
JournalSpine
Volume38
Issue number19
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

Keywords

  • Adverse reaction
  • Anterior cervical discectomy and fusion
  • Bone morphogenetic protein
  • Decadron
  • Dexamethasone
  • Dysphagia
  • Histology
  • Human dose equivalent
  • Inflammation
  • MRI
  • Respiratory compromise
  • Rodent model
  • Side effect
  • Steroid
  • Treatment

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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