Abstract：
BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition of the adult skeleton where new bone growth occurs in entheseal and bony regions. The cause for the new bone growth is unclear but many lines of evidence point to a role for growth factors linked to abnormal metabolism in these patients. The bone targets for these presumed growth factors are poorly defined. This review summarises the clinical evidence relevant to the sites of origin of new bone formation in DISH to better define potential cellular targets for bone growth in DISH.
METHODS: This is a narrative review of relevant papers identified from searches of PubMed and online journals.
RESULTS: Sites of new bone growth in the enthesis were identified in patients with DISH, with likely cellular targets for growth factors being mesenchymal stem cells in the outer part of the enthesis. Similar undifferentiated skeletal stem cells are present in the outer annulus fibrosis and in the bony eminences of vertebral bodies and other bones, with the potential for response to growth factors.
CONCLUSIONS: Mesenchymal stem cells are present in specific entheseal and bony locations that are likely responsive to putative growth factors leading to new bone formation characteristic of DISH. Further study of these regions in the context of metabolic abnormalities in DISH will allow for better understanding of the pathophysiology of this common condition.
METHODS: This is a narrative review of relevant papers identified from searches of PubMed and online journals.
RESULTS: Sites of new bone growth in the enthesis were identified in patients with DISH, with likely cellular targets for growth factors being mesenchymal stem cells in the outer part of the enthesis. Similar undifferentiated skeletal stem cells are present in the outer annulus fibrosis and in the bony eminences of vertebral bodies and other bones, with the potential for response to growth factors.
CONCLUSIONS: Mesenchymal stem cells are present in specific entheseal and bony locations that are likely responsive to putative growth factors leading to new bone formation characteristic of DISH. Further study of these regions in the context of metabolic abnormalities in DISH will allow for better understanding of the pathophysiology of this common condition.
摘要：
背景：弥漫性特发性骨骼肥大（DISH）是成人骨骼的常见病，其中新骨生长发生在骨和骨区域。新骨生长的原因尚不清楚，但许多证据表明，生长因子与这些患者的异常代谢有关。这些假定的生长因子的骨目标定义不清。这篇综述总结了与DISH中新骨形成的起源部位相关的临床证据，以更好地定义DISH中骨生长的潜在细胞靶标。
方法：这是对从PubMed和在线期刊搜索中确定的相关论文的叙述性综述。
结果：在DISH患者中发现了新骨生长的部位，生长因子的可能的细胞靶标是在外面的间充质干细胞。类似的未分化的骨骼干细胞存在于外环纤维化和椎体和其他骨骼的骨隆起中。具有对生长因子做出反应的潜力。
结论：间充质干细胞存在于特定的表面和骨性部位，可能对推定的生长因子产生反应，导致DISH的新骨形成特征。在DISH代谢异常的背景下对这些区域的进一步研究将允许更好地理解这种常见病症的病理生理学。
方法：这是对从PubMed和在线期刊搜索中确定的相关论文的叙述性综述。
结果：在DISH患者中发现了新骨生长的部位，生长因子的可能的细胞靶标是在外面的间充质干细胞。类似的未分化的骨骼干细胞存在于外环纤维化和椎体和其他骨骼的骨隆起中。具有对生长因子做出反应的潜力。
结论：间充质干细胞存在于特定的表面和骨性部位，可能对推定的生长因子产生反应，导致DISH的新骨形成特征。在DISH代谢异常的背景下对这些区域的进一步研究将允许更好地理解这种常见病症的病理生理学。
