Hadassah orthopedists: Don’t smoke if you want your broken bones to recover well and fast

For the first time, cigarette smoking is linked to a major decrease in the concentration of bone marrow progenitor cells.

Smoking (photo credit: INGIMAGE / ASAP)
(photo credit: INGIMAGE / ASAP)
Orthopedic surgeons in Jerusalem linked cigarette smoking to a major decrease in the concentration of bone marrow progenitor cells (BMPCs), which significantly impairs the healing of bone fractures and hinders bone repairing operations.
Prof. Meir Liebergall, chairman of the orthopedic surgery department at Hadassah-University Medical Center in Jerusalem’s Ein Kerem, just published his team’s findings in the journal Bone Marrow Research.
Working with colleagues Shaul Beyth, Rami Mosheiff, Ori Safran and Anat Daskal, Liebergall said it is already known that tobacco consumption is associated with musculoskeletal degenerative disorders, delayed fracture healing and failure for bone tissues to unite.
BMPCs are known to express CD105 (endoglin), a protein that is central to musculoskeletal healing and regeneration.
The researchers thus hypothesized that smoking is associated with lower levels of BMPCs.
Samples were collected from consenting patients aged 18 to 65 during the first steps of pelvic surgery.
Thirteen smokers and 13 nonsmokers of comparable age and gender were included in the study, while patients with active infectious or cancer, a history of cytotoxic or radiation therapy, primary or secondary metabolic bone disease or bone marrow dysfunction were excluded.
Liebergall noted that “relatively little research has been performed with the aim of studying the effects of smoking on the musculoskeletal system,” as opposed to other organ systems.
BMPCs, also known as multipotent mesenchymal stromal cells, are rare multipotent cells residing in all musculoskeletal tissues that serve as a reservoir for tissue regeneration, the researchers wrote. Due to their capability for multipotent differentiation into specialized cells, and their secretion of a wide range of bioactive molecules, they are central to healing and regeneration, they continued.
“Since these cells are rare, it has been difficult to isolate them in quantities that are large enough to evaluate their concentration,” the Hadassah team said. Nonetheless, they managed to develop a safe and effective method.
The study was designed to determine the effect of smoking a pack of cigarettes daily on the BMPC cell population in bone marrow. They found a “significantly lower concentration” of BMPC cells in smokers’ bone marrow, compared to nonsmokers’ bone marrow.
This reduced cell population, they concluded, can lead to reduced bone regeneration in smokers, “with potentially important implications for physiological maintenance and repair in the musculoskeletal system.”