Demographic Factors Affect the BMAC Proteome

Area of Science:

• Orthobiologics
• Proteomics
• Regenerative Medicine

Background:

• Bone marrow aspirate concentrate (BMAC) is a key orthobiologic.
• Its proteomic profile and response to patient demographics are not fully understood.
• Understanding these factors is crucial for optimizing BMAC efficacy.

Purpose of the Study:

• To investigate how patient demographics, specifically smoking status, age, sex, and BMI, affect the protein composition of BMAC.
• To identify specific protein alterations related to these demographic factors.
• To assess the impact of smoking on BMAC's inflammatory and regenerative potential.

Main Methods:

• Analyzed 109 analytes in BMAC samples from 120 patients using antibody microarrays.
• Stratified samples by smoking status (current, former, never-smokers) and collection site (iliac crest, humeral head).
• Utilized nonparametric statistical analyses with FDR correction to identify significant proteomic differences.

Main Results:

• Smokers showed significantly upregulated pro-inflammatory cytokines (e.g., IL-17, TNF-α) and downregulated anabolic factors (e.g., TGF-β1, BMP-9) in iliac crest BMAC.
• Former smokers displayed intermediate proteomic profiles, suggesting partial recovery.
• Humeral head samples exhibited fewer smoking-related proteomic changes compared to iliac crest samples.

Conclusions:

• Smoking has a detrimental catabolic effect on the therapeutic potential of BMAC, particularly from the iliac crest.
• Proteomic alterations in BMAC due to smoking involve both increased inflammation and reduced tissue regeneration.
• Pretreatment smoking cessation protocols should be considered to enhance BMAC treatment outcomes.