Ibuprofen impairs fracture healing by disrupting neutrophil-mediated tissue repair

Ibuprofen treatment in adult zebrafish increases fracture non-union incidence by disrupting neutrophil recruitment and NET-mediated early matrix remodeling, delaying osteoblast differentiation and mineralisation.

• Why it matters: Neutrophils are rapidly recruited to fractures, but how they shape the early repair microenvironment—and how NSAIDs like ibuprofen affect this—remains unclear.
• What they did: Using dynamic live imaging plus genetic and pharmacological perturbations in adult zebrafish, the study tracked neutrophil accumulation, NET release, and gene programs linked to matrix remodelling.
• The result: Neutrophil recruitment impairment, including ibuprofen, increased non-union and altered callus architecture by delaying osteoblast differentiation and impairing mineralisation, consistent with neutrophils templating a provisional emergency fracture matrix.