Role of coagulopathy in glucocorticoid-induced osteonecrosis of the femoral head

Zhang, Qiankun; Liu, Jin; Jin, Lie

doi:10.1177/0300060517700299

Cited by 51 publications

(44 citation statements)

References 76 publications

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“…Glucocorticoid (GC) use and alcoholism are associated with avascular necrosis (AVN) of the femoral head, 50% of which leads to collapse and joint destruction within 3 years of diagnosis . The common pathway for ONFH involves interruption of blood supply to the bone, resulting in osteocyte apoptosis and loss of structural integrity, ultimately leading to femoral head collapse . The transplantation of mesenchymal stromal cells (MSCs) and biomechanical support can often enhance the reparative reaction at the pre‐collapse stages of ONFH in patients and animal models .…”

Section: Discussionmentioning

confidence: 99%

Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap‐Shaped Separated Cartilage Defect

Ying

Wang

Ding

et al. 2019

Journal Orthopaedic Research

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A combination treatment with porous tantalum rod implantation and intra-arterial infusion of peripheral blood stem cells (PBSCs) provides a promise for treating early and intermediate stages of osteonecrosis of the femoral head (ONFH). However, its clinical indications and application restrictions remain unclear. This study aims to determine the clinical, histological, and radiological outcomes of a combination treatment using mechanical support and a targeted intra-arterial infusion of PBSCs for painful ONFH with a capshaped separation (CSS) cartilage defect. Compared with the standard pain management (control group), this combination treatment did not improve the Harris Hip Score (HHS) at 36 months. Micro-CT and histologic analyses showed severe focal destruction in all CSS-ONFH femoral heads in both the combination and control groups. Femoral heads showed a higher percentage of bone lesions in the combination treatment group than in the control group. There was no significant difference in osteoclast number in the subchondral bone areas between the two groups. A high level of expression of inflammatory cytokines, including tumor necrosis factor-α and interleukin-1β, was detected in blood vessels around the subchondral bone in both groups. The RANKL/OPG (receptor activator of the nuclear factor-kB ligand/osteoprotegerin) ratio was also similar between the control and combination treatment groups. Our results indicate that this combination treatment is not an effective method for the treatment of patients with painful CSS-ONFH. Moreover, this combination treatment did not inhibit inflammatory osteoclastogenesis in patients with more advanced disease.

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Section: Discussionmentioning

confidence: 99%

Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap‐Shaped Separated Cartilage Defect

Ying

Wang

Ding

et al. 2019

Journal Orthopaedic Research

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“…Fat embolism and coagulation disorders are two of the most common causes of interrupted blood supply. GCs could directly or indirectly lead to hypofibrinolysis and thrombophilia, dysfunction and apoptosis of endothelial cells, lipid metabolism alterations, and platelet activation, which are followed by poor blood flow, ischemia, and eventually, osteonecrosis [30][31][32][33]. Nevertheless, the effectiveness of GCs differs among individuals owing to varied GC sensitivity [34].…”

Section: Discussionmentioning

confidence: 99%

Expression Profile Analysis of Differentially Expressed Circular RNAs in Steroid-Induced Osteonecrosis of the Femoral Head

Zhu

et al. 2019

Disease Markers

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Background. A growing number of studies have suggested that circular RNAs (circRNAs) serve as potential diagnostic biomarkers in many diseases. However, the role of circRNAs in steroid-induced osteonecrosis of the femoral head (SONFH) has not been reported. Methods. Secondary sequencing was performed to profile circRNA expression in peripheral blood samples from three SONFH patients and three healthy individuals. We confirmed our preliminary findings by qRT-PCR. Bioinformatics analysis was conducted to predict their functions. Results. The result showed 345 dysregulated circRNAs. qRT-PCR of eight selected circRNAs preliminarily confirmed the results, which were consistent with RNA sequencing. Bioinformatics analyses were performed to predict the functions of circRNAs to target the genes of miRNAs and the networks of circRNA-miRNA-mRNA interactions. Conclusions. This study provides a new and fundamental circRNA profile of SONFH and a theoretical basis for further studies on the functions of circRNAs in SONFH.

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“…endothelial cell damage, intravascular coagulation and disordered angiogenesis lead to ischemia, which is considered to be one of the core pathological results of onFH (20,22). Endothelial cell tube formation is the first step in neovascularization (65), and blood vessels are critical in bone remodeling because they supply nutrients (66).…”

Section: Circrnas and Vascular Endothelial Cellsmentioning

confidence: 99%

“…The mechanism by which onFH develops remains unclear (19). The majority of experts agree that a lack of blood supply to the femoral head and bone marrow causes death of osteocytes, as explained by the microvascular injury theory, osteoporosis theory, apoptosis theory, osteogenic enhancement and adipogenic weakening theory of bone marrow mesenchymal stem cells (20)(21)(22)(23)(24). it has previously been reported that numerous circrnas are associated with onFH, which suggested that they may have a critical role in the development and progression of onFH (25).…”

Section: Introductionmentioning

confidence: 99%

The potential roles of circular RNAs in osteonecrosis of the femoral head (Review)

Zhao

Wang

et al. 2019

Mol Med Report

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circular rnas (circrnas) are categorized as non-coding rnas that, unlike widely known canonical linear rnas, form a covalently closed continuous loop without 5' or 3' polarities, which enables them to resist digestion by rna exonucleases. although the functions of circrnas remain largely unknown, accumulated evidence has demonstrated that circrnas can act as microrna sponges, which allows them to regulate numerous biological processes and disease mechanisms, including apoptosis, angiogenesis, invasion, metastasis and stem cell differentiation. although research into circRNAs is in its infancy, studies have identified critical roles for circrnas in the initiation and progression of disease. The present study delineated the characteristics and functions of circrnas, and focused on the potential relationship between circrnas and osteonecrosis of the femoral head (onFH). circrnas represent a novel avenue for studying the mechanisms underlying onFH as well as possible treatments.

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Role of coagulopathy in glucocorticoid-induced osteonecrosis of the femoral head

Cited by 51 publications

References 76 publications

Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap‐Shaped Separated Cartilage Defect

Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap‐Shaped Separated Cartilage Defect

Expression Profile Analysis of Differentially Expressed Circular RNAs in Steroid-Induced Osteonecrosis of the Femoral Head

The potential roles of circular RNAs in osteonecrosis of the femoral head (Review)

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