Steroid-induced osteonecrosis

Motta, Francesca; Timilsina, Suraj; Gershwin, M. Eric; Selmi, Carlo

doi:10.1016/j.jtauto.2022.100168

Cited by 15 publications

(9 citation statements)

References 59 publications

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“…However, the pathogenesis of SIONFH remains to be elucidated at the molecular level. The ultimate mechanism is compromised blood flow with failure to deliver nutrients to the affected bone, favoured by numerous preexisting factors [ 37 ]. This study suggests that 4-HNE may be related to the progression of SIONFH.…”

Section: Discussionmentioning

confidence: 99%

Decreased serum 4-Hydroxynonenal level as a biomarker for the progression of steroid-induced osteonecrosis of the femoral head

Xiao,

Wei,

Xiao

et al. 2023

J Orthop Surg Res

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Background Osteonecrosis of the femoral head (ONFH) is becoming a prevalent global health problem. 4-Hydroxynonenal (4-HNE) serves as a common marker of oxidative stress. This study aims to study the potential role of 4-HNE in the progression of steroid-induced osteonecrosis of the femoral head (SIONFH). Method Between April 2021 and December 2021, 64 subjects were enrolled in this cross-sectional case‒control study. Thirty-six patients were grouped based on the Association Research Circulation Osseous (ARCO) classification, and 28 healthy volunteers without hip pain or any lesions shown in anteroposterior and frog-leg lateral pelvic radiographs served as the normal control group. Bone hematoxylin–eosin (HE) staining, microcomputed tomography (micro-CT), immunohistochemistry, and levels of plasma 4-HNE were evaluated. Results The 4-HNE level was higher in the SIONFH group than in the normal control group (P < 0.001), and 4-HNE levels were significantly higher in SIONFH patients in the early stage of disease (stage II). The 4-HNE level was negatively correlated with ARCO stage (r = − 0.6875, P < 0.001). Immunohistochemistry revealed the presence of 4-HNE in the trabecular bone, osteocytes, and bone marrow. Conclusion The 4-HNE level is negatively associated with ARCO stages. Lower levels of 4-HNE may serve as a critical biomarker for the progression of SIONFH.

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Section: Discussionmentioning

confidence: 99%

Decreased serum 4-Hydroxynonenal level as a biomarker for the progression of steroid-induced osteonecrosis of the femoral head

Xiao,

Wei,

Xiao

et al. 2023

J Orthop Surg Res

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“…In 2011, a prospective study containing 1199 hips and knees from 302 participants who received hormonal therapy for at least one year reported the incidence of osteonecrosis was 37 percent of patients with systemic lupus erythematosus (SLE), but only 21% in patients without SLE [19]. However, the pathogenesis of SIONFH remains to be elucidated at the molecular level but the ultimate mechanism is compromised blood flow with failure to deliver nutrients to the affected bone, favored by numerous preexisting factors [20]. This study found that 4-HNE plays a critical role in the progression of SIONFH, and this may be beneficial to the choice of early treatment for the disease.…”

Section: Discussionmentioning

confidence: 99%

Decreased serum 4-Hydroxynonenal level as a biomarker for the progression of steroid-induced osteonecrosis of the femoral head

Xiao

Wei

Tian

et al. 2023

Preprint

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Background: 4-hydroxynonenal (4-HNE) is a common marker of oxidative stress. this study aim to study the potential role of 4-HNE in the progression of steroid-induced osteonecrosis of the femoral head (SIONFH). Method: Between April 2021 and December 2021, 64 subjects were enrolled in this cross-sectional case-control study. 36 patients were grouped based on the Association Research Circulation Osseous (ARCO) classification. Bone HE staining, micro-ct, immunohistochemistry, and level of plasma 4-HNE were evaluated. Immunohistochemistry presented that 4-HNE was detected in the trabecular bone, osteocytes, and bone marrow. Results: Plasma 4-HNE levels were significantly higher in SIONFH patients in the early stage of disease stages (Stage II) , and the 4-HNE level was higher in the SIONFH group than those in the normal control group (P<0.001). The 4-HNE level was negatively associated with ARCO stages (r =- 0.6875, P<0.001). Conclusion:The level of 4-HNE is negatively associated with ARCO stages. The reduced 4-HNE may be a critical biomarker of the progression of SIONFH.

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“…The mechanisms underlying osteonecrosis remain incompletely understood with interruption of vascular supply to the bone postulated to occur due to mechanical disruption, injury, thrombosis or embolism 11 . Additionally, direct osteocyte damage secondary to toxic exposure may also play a role 12 . Subchondral insufficiency fractures may also be an inciting event 7 .…”

Section: Discussionmentioning

confidence: 99%

“…11 Additionally, direct osteocyte damage secondary to toxic exposure may also play a role. 12 Subchondral insufficiency fractures may also be an inciting event. 7 The final resultant histological and radiological appearances are stereotypical consisting of medullary infarcts and structural collapse.…”

Section: Osteonecrosismentioning

confidence: 99%

Paraquat ingestion in an adult with cystic fibrosis (CF): Diagnostic and management dilemmas

Evans,

Kumar,

France

et al. 2023

Respirology Case Reports

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N,N'‐dimethyl‐4,4'bipyridinium dichloride (Paraquat) is a potent herbicide used widely in agriculture. We report the effects of an ingestion of paraquat by a 28 year old male with cystic fibrosis and the diagnostic and management challenges this posed in both the acute and longer term setting. We describe the effects of direct paraquat toxicity on the lung tissue secondary to aspiration and review the long‐term sequelae of paraquat, namely osteonecrosis. Our case is the first to describe osteonecrosis of the knee in the context of paraquat toxicity. Survival following ingestion remains poor with a high associated mortality. However, timely treatment with NAC and immunosuppression may impact on survival. In those patients who do survive the acute phase post ingestion, follow‐up over years may be required to detect the long‐term effects of paraquat on bone health.

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Steroid-induced osteonecrosis

Cited by 15 publications

References 59 publications

Decreased serum 4-Hydroxynonenal level as a biomarker for the progression of steroid-induced osteonecrosis of the femoral head

Decreased serum 4-Hydroxynonenal level as a biomarker for the progression of steroid-induced osteonecrosis of the femoral head

Decreased serum 4-Hydroxynonenal level as a biomarker for the progression of steroid-induced osteonecrosis of the femoral head

Paraquat ingestion in an adult with cystic fibrosis (CF): Diagnostic and management dilemmas

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