Correlation of serum and local CXCL13 levels with disease severity in patients with non-traumatic osteonecrosis of femoral head.

OBJECTIVE: The primary aim of the present study was to explore the potential correlation of serum / local CXCL13 expressions and disease severity in non-traumatic osteonecrosis of the femoral head (NT-ONFH). METHODS: In total, NT-ONFH patients (n = 130) together with healthy controls (HCs, n = 130) were included in this investigation. Radiographic progression was evaluated based on the imaging criteria outlined in the ARCO classification system. To assess the diagnostic value of serum CXCL13 in relation to radiographic progression, Receiver operating characteristic (ROC) curve analysis was conducted. Serum CXCL13 levels were quantified utilizing ELISA in all participants. Furthermore, local protein/mRNA expressions of CXCL13 were examined employing immunohistochemistry, western blot, as well as RT-PCR techniques. Clinical severity was appraised using the visual analogue scale (VAS), Harris Hip Score (HHS), and Western Ontario as well as McMaster Universities Osteoarthritis Index (WOMAC). RESULTS: The findings revealed a significant reduction in serum CXCL13 levels among NT-ONFH patients in contrast with HCs. Moreover, both mRNA and protein expressions of CXCL13 were markedly decreased in the necrotic area (NA) than the non-necrotic area (NNA) as well as the healthy femoral head tissues. Additionally, serum CXCL13 levels were substantially lower among patients classified as ARCO stage 4 than those at ARCO stage 3. The concentrations of CXCL13 in stage 3 patients were notably diminished relative to those at ARCO stage 2. Notably, serum CXCL13 levels demonstrated a negative association with ARCO grade. Furthermore, these levels were also inversely linked to VAS scores as well as WOMAC scores while displaying a positive association with HHS scores. The findings of ROC curve suggested that reduced serum CXCL13 levels could be an underlying indicator for ARCO stage. CONCLUSIONS: The reduced levels of either serum CXCL13 or local CXCL13 were intricately linked to disease severity for patients with NT-ONFH.

Attenuated serum vasoactive intestinal peptide concentrations are correlated with disease severity of non-traumatic osteonecrosis of femoral head.

BACKGROUND AND OBJECTIVE: The neuropeptide vasoactive intestinal peptide is a 28-amino acid neuropeptide that has been shown to stimulate bone repair and angiogenesis. The purpose of this study was to explore the potential role of serum VIP concentration in osteonecrosis of femoral trauma (ONFH). METHODS: One hundred five patients diagnosed with non-traumatic ONFH and 103 healthy individuals were enrolled in our study. Serum VIP, tumor necrosis factor-α (TNF-α), interluekin-1 beta (IL-1ß), and macrophage colony-stimulating factor (M-CSF) levels also were detected using the commercial ELISA kit. Radiographic progression was evaluated using FICAT classification. The clinical severity of ONFH was assessed by visual analog score (VAS) and Harris Hip Score (HHS). Receiver-operating characteristic (ROC) curve was performed to test the potential diagnostic value of VIP in radiographic progression. RESULTS: The serum VIP level of patients with non-traumatic ONFH was significantly lower than that of healthy controls. There was no significant difference between the alcohol group, the steroid-induction group, and the idiopathic group. Serum VIP levels were significantly higher in ONFH patients with femoral head pre-collapse stage than collapse stage. Serum VIP levels were significantly lower. FICAT 4 non-traumatic ONFH patients had significantly lower serum concentrations of VIP when compared with FICAT 3 and FICAT 2. Moreover, serum VIP levels were significantly lower in ONFH patients with FICAT 3 than FICAT 2. Serum VIP levels were negatively related to FICAT stage. In addition, serum VIP levels were negatively associated with VAS score and positively associated with HHS score. Last, we found serum VIP levels were negatively associated with serum TNF-α and IL-1ß levels. ROC curve analysis indicated that decreased serum VIP could serve as a decent biomarker with regard to the diagnosis of radiographic progression. CONCLUSION: Attenuated serum VIP concentrations are correlated with disease severity of non-traumatic ONFH. Decreased serum VIP may serve as a potential indicator of non-traumatic ONFH.

Reduced serum and local LncRNA MALAT1 expressions are linked with disease severity in patients with non-traumatic osteonecrosis of the femoral head.

OBJECTIVE: This study was performed to illustrate the potential relationship between reduced serum and local LncRNA MALAT1 expressions with disease severity in patients with non-traumatic osteonecrosis of the femoral head (ONFH). METHODS: A total of 104 patients with non-traumatic ONFH and 100 healthy controls were consecutively recruited from our hospital. Serum and local LncRNA MALAT1 expressions were detected using real-time polymerase chain reaction (RT-PCR). Radiographic progression was defined by Ficat classification. Clinical severity was evaluated by Visual Analog Scale (VAS) and Harris Hip Score (HHS). Receiver operating characteristic (ROC) curve was carried out to determine the diagnostic value of MALAT1 in the radiographic progression. RESULTS: Serum LncRNA MALAT1 expressions were significantly lower in non-traumatic ONFH patients than in healthy controls. In addition, local MALAT1 expressions in non-traumatic ONFH tissue were significantly lower in the affected area than in the non-affected area. Ficat grade 4 has significantly lower serum and local LncRNA MALAT1 expressions in comparison with grade 3, and Ficat grade 3 showed markedly decreased serum and local LncRNA MALAT1 expressions compared with grade 2. Serum and local LncRNA MALAT1 expressions were significantly and negatively associated with VAS and positively related to the HHS. Further ROC curve analysis indicated that serum MALAT1 may act as a decent indicator in the diagnosis of non-traumatic ONFH. CONCLUSIONS: Decreased serum and local MALAT1 expressions may reflect disease severity in non-traumatic ONFH patients.

Attenuated serum adiponectin levels are associated with disease severity in patients with non-traumatic osteonecrosis of the femoral head.

OBJECTIVE: Decreased adiponectin (APN) levels have been detected in patients with osteonecrosis of the femoral head (ONFH). The scope of this study was aimed to explore the relationship between serum APN levels and disease severity in nontraumatic ONFH patients. PATIENTS AND METHODS: Ninety two nontraumatic ONFH patients and 92 healthy controls were enrolled for this study following the estimation of sample size. Serum APN concentrations were examined by enzyme-linked immunosorbent assay (ELISA). The radiographic progression was determined by Ficat grading system. The clinical severity was evaluated by visual analog scale (VAS), Harris hip scores (HSSs) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores. RESULTS: Serum APN levels were significantly lower in ONFH patients than in healthy controls. Serum APN levels were significantly lower in patients with Ficat stage 4 ONFH than in patients with stage 3 ONFH, and APN levels in patients with stage 3 were lower compared with stage 2. Serum APN levels were negatively correlated with the Ficat grading system. In addition, serum APN levels were also negatively related to VAS and WOMAC scores and positively associated with HSSs. CONCLUSION: Decreased serum APN levels may reflect disease severity of nontraumatic ONFH.

Associations of TNF-α -238 A/G and IL-10 -1082 G/A Genetic Polymorphisms With the Risk of NONFH in the Chinese Population.

The study aims to explore the roles of common polymorphisms of Tumor Necrosis Factor-α (TNF-α) (-238 A/G and -308 A/G) and IL-10 (-819 T/C and -1082 G/A) genes in the risk of non-traumatic osteonecrosis of the femoral head (NONFH). One hundred and forty-seven NONFH patients and 135 healthy individuals were selected as the case and control groups. qRT-PCR and Western blotting techniques detected mRNA as well as protein expressions of TNF-α and IL-10 of each genotype in both the case and control groups. The GA genotype and the A allele of TNF-α -238 A/G were higher in the case group than in the control group. Compared with the control group, AA, GA, and AG + AA genotypes as well as the A allele of IL-10-1082 G/A were all lower in the case group. In the case groups increased levels of TNF-α as well as decreased levels of IL-10 expression when compared with the control group. TNF-α expression of TNF-α-238 GA genotype was significantly higher than that in patients with GG genotype, while the IL-10 expression of GA and AA genotypes of IL-10-1082 was significantly lower than in that of patients with the GG genotype. TNF-α protein expression in the GA genotype was significantly higher than in the GG genotype. In relation to TNF-α -238, TNF-α protein expression of GA and AA genotypes had significantly reduced more so than the GG genotype in IL-10-1082. TNF-α-238 A/G and IL-10-1082 G/A may be involved as risk factors of NONFH. J. Cell. Biochem. 118: 4872-4880, 2017. © 2017 Wiley Periodicals, Inc.

Efficacy of Fu-Yuan Capsule in the Healing of Fractures of the Lower End of the Radius in a Rabbit Model.

OBJECTIVE: The aim of the study was to explore the efficacy of Fu-Yuan Capsule in the healing of fractures of the lower end of the radius in a rabbit model. METHODS: After establishing a rabbit fracture model, all animals were randomly divided into the model group (n = 24), the Fu-Yuan Capsule group (n = 24), and the Shenyang Hongyao group (n = 24). The X-ray was applied to observe the course of fracture healing at 2, 4, 6, and 8 weeks after treatment. Haematoxylin-eosin staining and immunohistochemical staining were used to determine the histological change and the expression of bone morphogenetic protein-2 (BMP-2). Serum alkaline phosphatase (ALP), calcium, and phosphorus levels were detected before and after treatment. RESULTS: X-ray showed that the Fu-Yuan Capsule and Shenyang Hongyao groups exhibited abundant callus shadow areas than the model group in a time-dependent manner. In the model group, the fractures exhibited poor recovery with fibrous callus and obstructed bone marrow cavity. In the Fu-Yuan Capsule and Shenyang Hongyao groups, the fracture showed good recovery and restored normal structure with an effective remodeling of the lamellar bone. Immunohistochemical staining showed that the Fu-Yuan Capsule and Shenyang Hongyao groups had higher expressions of BMP-2 than the model group. Furthermore, serum ALP and calcium-phosphorus product in the Fu-Yuan Capsule and Shenyang Hongyao groups were higher than what they were in the model group. CONCLUSIONS: These results suggest that Fu-Yuan Capsule could promote the fracture healing through upregulating BMP-2 expression and increasing serum ALP and calcium-phosphorus product.

Treatment of osteonecrosis of the femoral head with core decompression and bone grafting.

Osteonecrosis of the femoral head (ONFH) is a disorder that can lead to femoral head collapse. Various procedures have been advocated to avert the need for total hip replacement. These include vascularised and non-vascularised bone grafting procedures. We examined the effect of core decompression combined with an allogeneic, antigen-extracted, autolysed fibular allograft and autologous impacted bone grafting for the treatment of osteonecrosis of the femoral head. The study included 162 patients (223 hips; 61 females, 101 males; mean age 33.5 years, range 19-54 years) with stage II-III avascular necrosis of the femoral head according to the ARCO (Association Research Circulation Osseous) classification. The outcome was determined by changes in the Harris hip score, by progression in radiographic stages, and by the need for hip replacement. The mean follow-up was 24 months (range 7- 42 months). Statistical evaluation included Kaplan-Meier survival analysis. The mean Harris hip score increased from 61 to 85. Excellent and good results were obtained in 93.3% of cases in stage II, and 87% in stages III with a survivorship of 81% in all cases. Core decompression combined with an allogeneic, antigen-extracted, autolysed fibular allograft and autologous impacted bone grafting may be the treatment of choice, particularly in the precollapse stage.

[Advances in researches on genetic predisposition to steroid-induced osteonecrosis of the femoral head].

The pathogenesis of steroid-induced osteonecrosis of the femoral head (SONFH) is not very clear at present. For the past few years researches showed that the SONFH related to genetic predisposing factors. The related research progresses were reviewed in this article to show the correlation between genetic mutation and genetic polymorphism of steroid metabolism and transport, resistance and receptor, coagulation and fibrinolysis, lipid and bone metabolism and susceptibility to SONFH. The article also discussed current problems, countermeasure and future applications.