Preventive Effects of Puerarin on Alcohol-induced Osteonecrosis

Abstract

Alcohol can induce adipogenesis by bone marrow stromal cells and may cause osteonecrosis of the femoral head. Currently, there are no medications available to prevent alcohol-induced osteonecrosis. We hypothesized puerarin, a Chinese herbal medicine with antioxidative and antithrombotic effects, can prevent alcohol-induced adipogenesis and osteonecrosis. Both bone marrow stromal cells (in vitro) and mice (in vivo) were treated either with ethanol or with ethanol and puerarin, with an untreated group serving as a control. In the in vitro study, the number of adipocytes, contents of triglycerides, and levels of PPARc mRNA expression were decreased and alkaline phosphatase activity, contents of osteocalcin, and levels of osteocalcin mRNA expression were increased in cells treated with both alcohol and puerarin, compared with cells treated with alcohol only. In the in vivo study, marrow necrosis, fat cell hypertrophy and proliferation, thinner and sparse trabeculae, diminished hematopoiesis, and increased empty osteocyte lacunae in the subchondral region of the femoral head were observed in mice treated with alcohol. However, no such changes were seen in femoral heads of mice treated with alcohol and puerarin. The data suggest puerarin can inhibit adipogenic differentiation by bone marrow stromal cells both in vitro and in vivo and prevents alcohol-induced osteonecrosis in this model.

Low-intensity Pulsed Ultrasound Enhances Bone Repair in a Rabbit Model of Steroid-associated Osteonecrosis

“…Two pathologists (JL, LX) examined the sections from each sample, in a blinded fashion, for each staining procedure. Five fields in the subchondral area of the femoral head on each section were chosen [33]. The first field was located at the approximate center of the femoral head and the remaining four fields were located on both sides of the first field with two fields on each side.…”

“…The mean of the two sections from each sample was taken as the value of that sample. The following parameters were assessed: (1) 200 osteocyte lacunae were counted in each established field at 9 200 magnification and then the percentage of the empty osteocyte lacunae was determined [33]; (2) the average diameter of the fat cells was measured in each field and the average diameter for fat cells of each animal was determined [26,33]; (3) the number and diameter of blood vessels were measured and averaged for each sample based on the a-SMA staining slides [3]. The number of blood vessels was expressed per area of tissue (/mm 2 ); (4) the mineralizing surface and bone surface and mineral apposition rate (lm/day) were calculated as described in previous studies [6,35].…”

“…Different fields per slice were converted to digital pictures and quantitative analysis was performed using Image-Pro 1 Plus 6.0 (Media Cybernetics Inc, Rockville, MD, USA). Histologically, the femoral head was considered necrotic when at least one of the following three signs was present: bone marrow cell necrosis, empty osteocyte lacunae, or any evidence of repair, such as the presence of granulation tissue, fibrosis, or appositional bone formation [33,37].…”

Factors Associated with Aseptic Osteonecrosis in Hospital Settings in Yaounde, Cameroon

“…In many studies, aseptic osteonecrosis of femoral head is a frequent complication of fracture femoral neck and hip luxation; the occurrence of osteonecrosis is explained by the rupture of the round ligament and affection of retinacula arteries [2] [7] [14] [15]. Unlike different studies, alcoholism, described to be the second major cause of osteonecrosis non associated to a trauma [10] [19], was less associated to osteonecrosis in this series. In Burkina Faso, alcoholism was more frequent in adult patients with aseptic osteonecrosis [7].…”

“…The latter increases the risk of occurrence of aseptic osteonecrosis by 100 times when compared to a normal healthy general population [6]. Other factors like steroid treatment and alcoholism are also incriminated in the genesis of avascular bone necrosis [7] [9] [10].…”