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Effect Of Lidocaine On Bone Matrix Formation By Osteoblasts

paymanz

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Effect of lidocaine on bone matrix formation by osteoblasts

Effect of lidocaine on bone matrix formation by osteoblasts

Srinivas Pentyala*, Emily Hughes, Pooja Mysore, Supriya Mishra, Julie Miller, Aleef Rahman and Kyle Urbanczyk

Correspondence: Srinivas Pentyala srinivas.pentyala@stonybrook.edu

Author Affiliations

Department of Anesthesiology, Stony Brook Medical Center, Stony Brook, NY 11794-8480.


DOI : Effect of lidocaine on bone matrix formation by osteoblasts
© 2012 Pentyala et al; licensee Herbert Publications Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (Creative Commons — Attribution 3.0 Unported — CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Local anesthetics are widely used as an intraosseous injection particularly in the field of dentistry. Occasionally, large doses of anesthetics are injected to elicit the desired effect during many surgical procedures. In this study we examined the effect of a local anesthetic, lidocaine, on osteoblasts as there are only a few reports on the effect of local anesthetics directly on bone cells. Our results showed that physiological as well as supra physiological concentrations of lidocaine cause cell death. At low concentrations, lidocaine was found to enhance both proliferation of osteoblasts and bone matrix production. In addition, low concentration of lidocaine increased the expression of osteocalcin, a key regulator in the signaling pathway of bone matrix production. Our results show that lidocaine has a biphasic effect on osteoblasts and low concentrations of this anesthetic may assist in bone matrix production. This preliminary study can lead to the therapeutic usage of intraosseous lidocaine as a bone strengthening agent.

Osteocalcin expression was found to increase in cells treated with 2 mM lidocaine and quantification of the pixel intensities of the osteocalcin signal showing a 1.6 times increase in the levels of osteocalcin expression confirmed this observation[.....] We initiated this study to evaluate the toxic effects of lidocaine on osteoblasts. Interestingly it was observed that cells appeared to not only thrive, but to also proliferate and produce more bone matrix at low doses of lidocaine.
Procaine may act differently
Both richlocaine and lidocaine belong to the “amide” class of local anesthetics and most of the studies on osteoblasts with local anesthetics were performed with “ester” class of drugs (Cocaine, procaine, and tetracaine). All these ester class drugs were shown to be toxic to osteoblasts even at low range of concen-trations [15,17,23]. Amide drugs might interact differentially with osteoblasts at low concentration by activating signaling pathways (as shown by induction of osteocalcin) while ester drugs might trigger the apoptotic pathways.
 
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paymanz

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i think the authors havent provided enough info about their cell culture to have a accurate calculation but any help/suggestion to convert in vitro dosage in this study to in vivo dosage is appreciated.

My own estimation is that a person need to ingest several grams of pure lidocaine per day to reach that 2mM level.especially with short half life of lidocaine....


Dosage like that is very toxic and lethal.
 
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I’m curious what the transdermal equivalent would be, e.g. with Aspercreme.
 
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