Role of endocrinal dysregulations in traumatic heterotopic ossification pathogenesis

The skeletal system is one of the main targets of endocrine hormone dysregulation. After briefly summarizing the endocrinal regulation of the skeleton, this review focuses on the recent advances in our understanding of how endocrine dysregulations promote the development of heterotopic bones after trauma.

Endocrinal regulation of skeletal fetal development, and growth is well established. However, whether trauma such as central nervous system insults, hip arthroplasty and severe burns trigger heterotopic ossifications via hormonal dysregulation has just begun to be investigated. Recent findings in mouse models of trauma-induced and most particularly spinal cord injury-induced heterotopic ossifications suggest that spinal cord injury leads to stimulation of catecholamine and glucocorticoid secretion by adrenal glands early post-injury, which triggers pathological bone formation in injured muscles.

This review summarizes the recently identified roles of adrenal hormones in driving pathological heterotopic ossification development after spinal cord injury. Further research into how endocrine hormones regulate heterotopic bone formation after trauma is essential and likely to reveal new targetable pathways to prevent pathological heterotopic ossifications.