Changes to the cell, tissue and architecture levels in cranial suture synostosis reveal a problem of timing in bone development.

TY - JOUR

T1 - Changes to the cell, tissue and architecture levels in cranial suture synostosis reveal a problem of timing in bone development.

AU - Regelsberger, Jan

AU - Milovanovic, Petar

AU - Schmidt, T

AU - Hahn, Michael

AU - Zimmermann, E A

AU - Tsokos, M

AU - Zustin, Jozef

AU - Ritchie, R O

AU - Amling, Michael

AU - Busse, Björn

PY - 2012

Y1 - 2012

N2 - Premature fusion of cranial sutures is a common problem with an incidence of 3-5 per 10,000 live births. Despite progress in understanding molecular/genetic factors affecting suture function, the complex process of premature fusion is still poorly understood. In the present study, corresponding excised segments of nine patent and nine prematurely fused sagittal sutures from infants (age range 3-7 months) with a special emphasis on their hierarchical structural configuration were compared. Cell, tissue and architecture characteristics were analysed by transmitted and polarised light microscopy, 2D-histomorphometry, backscattered electron microscopy and energy-dispersive-x-ray analyses. Apart from wider sutural gaps, patent sutures showed histologically increased new bone formation compared to reduced new bone formation and osseous edges with a more mature structure in the fused portions of the sutures. This pattern was accompanied by a lower osteocyte lacunar density and a higher number of evenly mineralised osteons, reflecting pronounced lamellar bone characteristics along the prematurely fused sutures. In contrast, increases in osteocyte lacunar number and size accompanied by mineralisation heterogeneity and randomly oriented collagen fibres predominantly signified woven bone characteristics in patent, still growing suture segments. The already established woven-to-lamellar bone transition provides evidence of advanced bone development in synostotic sutures. Since structural and compositional features of prematurely fused sutures did not show signs of pathological/defective ossification processes, this supports the theory of a normal ossification process in suture synostosis - just locally commencing too early. These histomorphological findings may provide the basis for a better understanding of the pathomechanism of craniosynostosis, and for future strategies to predict suture fusion and to determine surgical intervention.

AB - Premature fusion of cranial sutures is a common problem with an incidence of 3-5 per 10,000 live births. Despite progress in understanding molecular/genetic factors affecting suture function, the complex process of premature fusion is still poorly understood. In the present study, corresponding excised segments of nine patent and nine prematurely fused sagittal sutures from infants (age range 3-7 months) with a special emphasis on their hierarchical structural configuration were compared. Cell, tissue and architecture characteristics were analysed by transmitted and polarised light microscopy, 2D-histomorphometry, backscattered electron microscopy and energy-dispersive-x-ray analyses. Apart from wider sutural gaps, patent sutures showed histologically increased new bone formation compared to reduced new bone formation and osseous edges with a more mature structure in the fused portions of the sutures. This pattern was accompanied by a lower osteocyte lacunar density and a higher number of evenly mineralised osteons, reflecting pronounced lamellar bone characteristics along the prematurely fused sutures. In contrast, increases in osteocyte lacunar number and size accompanied by mineralisation heterogeneity and randomly oriented collagen fibres predominantly signified woven bone characteristics in patent, still growing suture segments. The already established woven-to-lamellar bone transition provides evidence of advanced bone development in synostotic sutures. Since structural and compositional features of prematurely fused sutures did not show signs of pathological/defective ossification processes, this supports the theory of a normal ossification process in suture synostosis - just locally commencing too early. These histomorphological findings may provide the basis for a better understanding of the pathomechanism of craniosynostosis, and for future strategies to predict suture fusion and to determine surgical intervention.

KW - Humans

KW - Infant

KW - Case-Control Studies

KW - Bone Development

KW - Calcification, Physiologic

KW - Cranial Sutures/pathology

KW - Haversian System/cytology

KW - Osteocytes/cytology

KW - Synostosis/etiology/pathology

KW - Humans

KW - Infant

KW - Case-Control Studies

KW - Bone Development

KW - Calcification, Physiologic

KW - Cranial Sutures/pathology

KW - Haversian System/cytology

KW - Osteocytes/cytology

KW - Synostosis/etiology/pathology

U2 - 10.22203/ecm.v024a31

DO - 10.22203/ecm.v024a31

M3 - SCORING: Journal article

VL - 24

SP - 441

EP - 458

JO - EUR CELLS MATER

JF - EUR CELLS MATER

SN - 1473-2262

ER -