Effect of pentoxifylline on histopathological changes in steroid-induced osteonecrosis of femoral head: experimental study in chicken

Abstract

Purpose Pentoxifylline (PTX) is a derivative of methylxanthine and is used in peripheral vascular and cerebrovascular diseases for its effect on the regulation of blood circulation. We investigated whether PTX could be beneficial for femoral head osteonecrosis associated with steroid through these effects. Methods Sixty mature Leghorn type chickens were chosen and divided into three groups. The 25 chickens in group A were given a weekly dose of 3 mg/kg/week methylprednisolone acetate intramuscularly. Four chickens in group B died after the first drug injection and were excluded from the study. Therefore, the remaining 21 chickens in group B were additionally given 25 mg/kg/day pentoxifylline intramuscularly, along with the steroid medication as given in group A. The ten chickens in group C were not given any injections, as they were accepted as the control group. After the sacrifice of the animals at week 14, both femoral heads were taken from each animal. The animals which died along the course of the study also underwent pathological examination but were not a part of the statistical analysis. Results In this study, steroid induced femoral head osteonecrosis has been experimentally observed in chickens after high doses of corticosteroid therapy. The chickens were given pentoxifylline in order to prevent the effects of steroid on bones and bone marrow. The results showed that chickens are suitable osteonecrosis models, and that steroid causes adipogenesis and necrosis in the bone marrow and the death of the subchondral bone. Conclusions The results of this study hint at the assumption that PTX may have a positive benefit on ONFH. PTX seems to minimise the effects of the steroid and reduce the incidence of ONFH.

Mechanism of chlorogenic acid treatment on femoral head necrosis and its protection of osteoblasts

“…The present study is based on this type of metabolism. Osteoblasts, common in the growth of bone tissue, gather in the newly formed bone surface, and have an important role in the process of bone tissue development, bone metabolism and bone mass balance maintenance and damage repair (7)(8)(9). Femoral head necrosis is a common intractable clinical orthopedic disease, and previous studies found that it may be closely associated with the dysfunction of osteoblasts and bone marrow stromal cells (10)(11)(12).…”

Development of non-traumatic osteonecrosis of the femoral head requires toll-like receptor 7 and 9 stimulations and is boosted by repression on nuclear factor kappa B in rats

“…27 Further, it was reported that corticosteroids alone led to the development of ONFH in Leghorn chickens. 28 Histopathological examination of specimens in this model showed that the subchondral bone trabeculae in the femoral head had disappeared. 28 The diminution of the bone trabeculae was similar in appearance to micro-CT images of an osteoporosis animal model, 29 but it was not clear whether it resulted from osteonecrosis.…”

“…28 Histopathological examination of specimens in this model showed that the subchondral bone trabeculae in the femoral head had disappeared. 28 The diminution of the bone trabeculae was similar in appearance to micro-CT images of an osteoporosis animal model, 29 but it was not clear whether it resulted from osteonecrosis. In addition, Yamamoto et al 30 reported an osteonecrosis rabbit model in 1997.…”

MicroRNA-34a alleviates steroid-induced avascular necrosis of femoral head by targeting Tgif2 through OPG/RANK/RANKL signaling pathway

“…2 Clinically, SANFH is characterized by hip discomfort, pain, activity limitation, limp and shortening of lower limbs. 3 Already proposed direct and indirect pathological mechanisms include apoptosis, inhibit formation of osteoblast and their precursors, vascular endothelial dysfunction, enhanced activity of coagulation, enhance production of ROS, inhibition of angiogenesis and increase adipocytes.…”