Calycosin modulates inflammation via suppressing TLR4/NF‐κB pathway and promotes bone formation to ameliorate glucocorticoid‐induced osteonecrosis of the femoral head in rat

Abstract

modulates inflammation via suppressing TLR4/NF-κB pathway and promotes bone formation to ameliorate glucocorticoidinduced osteonecrosis of the femoral head in rat. Phytotherapy

General recommendation for assessment and management on the risk of glucocorticoid-induced osteonecrosis in patients with COVID-19

“…Finally, 15 articles (Appendix Ref. [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]) were selected for the following meta-analysis. The article selection process was illustrated in Figure A3 a.…”

“…Of the 15 studies, 9 (Appendix Ref. [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] ]) and 6 (Appendix Ref. [ [10] , [11] , [12] , [13] , [14] , [15] ]) were published in Chinese and English, respectively.…”

“…Accumulating clinical studies showed that osteonecrosis more frequently occurs in the femoral head, the incidence of ONFH among convalescent SARS patients was calculated based on 14 studies (Appendix Ref. [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [13] , [14] , [15] ]) in our meta-analysis. The article selection process was illustrated in Figure A4 a. Randomized effect model meta-analysis indicated a combined proportion at 28.8% (95% CI:20.7%–37.0%, Fig.…”

“…Increasing clinical evidence show that glucocorticoid therapy is one of the main therapeutics for severe COVID-19 patients [ 3 ]. However, glucocorticoid exposure may lead to the occurrence of osteonecrosis [ 4 ], which is characterized by the loss of blood supply to the subchondral bone at multiple joints, such as hip, knee, shoulder, and ankle [ 5 ]. Due to joint destruction and disability rapidly caused by osteonecrosis, most patients will undergo long-term medical interventions or repeated surgeries throughout their lifespan [ 6 , 7 ].…”

Osteoimmunology and osteonecrosis of the femoral head

“… 28 , 29 The TLR4/NF-κB pathway may connect the immune response with bone metabolism, and activation of this pathway may disrupt the balance between the two systems, decreasing bone regeneration and increasing bone resorption. 30 Several immune cells, such as B and T cells, participate in the immune response and bone remodelling by expressing receptor activator of nuclear factor kappa-Β ligand (RANKL) and osteoprotegerin (OPG). 8 , 31 The OPG/RANK/RANKL axis controls the differentiation and activity of osteoblasts and osteoclasts, in order to maintain bone homeostasis and prevent bone loss.…”