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1.
Cells ; 10(9)2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34571892

RESUMO

An important objective of vascularized tissue regeneration is to develop agents for osteonecrosis. We aimed to identify the pro-angiogenic and osteogenic efficacy of adipose tissue-derived (AD) pericytes combined with Nel-like protein-1 (NELL-1) to investigate the therapeutic effects on osteonecrosis. Tube formation and cell migration were assessed to determine the pro-angiogenic efficacy. Vessel formation was evaluated in vivo using the chorioallantoic membrane assay. A mouse model with a 2.5 mm necrotic bone fragment in the femoral shaft was used as a substitute for osteonecrosis in humans. Bone formation was assessed radiographically (plain radiographs, three-dimensional images, and quantitative analyses), and histomorphometric analyses were performed. To identify factors related to the effects of NELL-1, analysis using microarrays, qRT-PCR, and Western blotting was performed. The results for pro-angiogenic efficacy evaluation identified synergistic effects of pericytes and NELL-1 on tube formation, cell migration, and vessel formation. For osteogenic efficacy analysis, the mouse model for osteonecrosis was treated in combination with pericytes and NELL-1, and the results showed maximum bone formation using radiographic images and quantitative analyses, compared with other treatment groups and showed robust bone and vessel formation using histomorphometric analysis. We identified an association between FGF2 and the effects of NELL-1 using array-based analysis. Thus, combinatorial therapy using AD pericytes and NELL-1 may have potential as a novel treatment for osteonecrosis.


Assuntos
Tecido Adiposo/citologia , Proteínas de Ligação ao Cálcio/metabolismo , Neovascularização Fisiológica , Osteogênese , Osteonecrose/terapia , Pericitos/citologia , Tecido Adiposo/metabolismo , Idoso , Idoso de 80 Anos ou mais , Animais , Apoptose , Proteínas de Ligação ao Cálcio/genética , Movimento Celular , Proliferação de Células , Células Cultivadas , Embrião de Mamíferos/irrigação sanguínea , Embrião de Mamíferos/citologia , Embrião de Mamíferos/metabolismo , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Osteonecrose/etiologia , Osteonecrose/metabolismo , Osteonecrose/patologia , Pericitos/metabolismo
2.
Biomed Res Int ; 2021: 1433684, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34462719

RESUMO

Background: The number of articles of clinical and basic research for osteonecrosis of the femoral head (ONFH) is increasing, yet, to our knowledge, there is still a lack of bibliometric analysis on ONFH articles. The purpose of this study was to identify the top 100 cited (T100) articles related to ONFH research and to analyze the characteristics and qualities of these articles. Methods: The T100 articles on ONFH were retrieved from the Web of Science database. The information about each article including citations, titles, authors, journals, countries, institutions, and keywords was recorded for bibliometric analysis. Results: The T100 articles related to ONFH were mainly published from 1991 to 2010 (n = 70) and were originated from 24 countries. The USA, China, and Japan were the most productive countries in this regard. The most prolific institution was the University of Pennsylvania from the USA with 6 publications and 742 citations. The most cited article was published in 1995 by Professor Steinberg ME. The five most frequently occurring keywords were "femoral head," "osteonecrosis," "core decompression," "total hip arthroplasty," and "follow up." The keywords like "bone tissue engineering" and "extracorporeal shock wave" have emerged in recent years. Conclusions: The USA, China, and Japan contributed greatly in terms of the T100 articles. The outcomes of core decompression and total hip arthroplasty gathered the most research interests. In recent years, bone tissue engineering and extracorporeal shock wave have become new trends. However, the mechanism of ONFH is still unclear.


Assuntos
Cabeça do Fêmur/patologia , Osteonecrose/patologia , Osteonecrose/terapia , Publicações Periódicas como Assunto/estatística & dados numéricos , Publicações/estatística & dados numéricos , Bibliometria , China , Humanos , Japão , Estados Unidos
3.
Sci Rep ; 11(1): 13647, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34211025

RESUMO

This study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. Twenty-five patients with stage III Kümmell disease who received bone cement-augmented pedicle screw fixation at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2009 and December 2015 were enrolled. All patients were females with a history of osteoporosis. The vertebral Cobb angle (V-Cobb angle), the fixed segment Cobb Angle (S-Cobb angle), pelvic parameters, visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI) were assessed preoperatively, postoperatively and at the final follow-up. Complications, loosening rate, operation time, and intraoperative bleeding were recorded. The average lumbar vertebral density T-value was - 3.68 ± 0.71 SD, and the average age was 71.84 ± 5.39. The V-Cobb angle, S-Cobb angle, and Sagittal Vertical Axis (SVA) were significantly smaller postoperatively compared to the preoperative values. The VAS and ODI at 1 month after surgery were 3.60 ± 1.00 and 36.04 ± 6.12%, respectively, which were both significantly lower than before surgery (VAS: 8.56 ± 1.04, ODI: 77.80 ± 6.57%). Bone cement-augmented pedicle screw fixation is a safe and effective treatment for stage III Kümmell disease. It can effectively correct kyphosis, restore and maintain sagittal balance, and maintain spinal stability.


Assuntos
Cimentos Ósseos/uso terapêutico , Fixação Interna de Fraturas , Osteonecrose/cirurgia , Parafusos Pediculares , Doenças da Coluna Vertebral/cirurgia , Idoso , Cimentos Ósseos/efeitos adversos , Feminino , Fixação Interna de Fraturas/efeitos adversos , Humanos , Masculino , Osteonecrose/patologia , Parafusos Pediculares/efeitos adversos , Doenças da Coluna Vertebral/patologia , Resultado do Tratamento
4.
J Korean Med Sci ; 36(24): e177, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34155839

RESUMO

Non-traumatic osteonecrosis of the femoral head (ONFH) usually affects adults younger than 50 years and frequently leads to femoral head collapse and subsequent arthritis of the hip. It is becoming more prevalent along with increasing use of corticosteroids for the adjuvant therapy of leukemia and other myelogenous diseases as well as management of organ transplantation. This review updated knowledge on the pathogenesis, classification criteria, staging system, and treatment of ONFH.


Assuntos
Necrose da Cabeça do Fêmur/classificação , Necrose da Cabeça do Fêmur/patologia , Cabeça do Fêmur/patologia , Glucocorticoides/efeitos adversos , Quadril/patologia , Osteonecrose/terapia , Humanos , Osteonecrose/patologia , Prednisolona/efeitos adversos
5.
J Cell Mol Med ; 25(11): 5164-5176, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33939272

RESUMO

Glucocorticoid-induced osteonecrosis of the femoral head (GIONFH) is a common orthopaedic disease. GIONFH primarily manifests clinically as hip pain in the early stages, followed by the collapse of the femoral head, narrowing of the hip joint space and damage to the acetabulum, resulting in severely impaired mobility. However, the pathogenesis of GIONFH is not clearly understood. Recently, biomechanical forces and non-coding RNAs have been suggested to play important roles in the pathogenesis of GIONFH. This study aimed to evaluate the role of biomechanical forced and non-coding RNAs in GIONFH. We utilized an in vivo, rat model of GIONFH and used MRI, µCT, GIONFH-TST (tail suspension test), GIONFH-treadmill, haematoxylin and eosin staining, qRT-PCR and Western blot analysis to analyse the roles of biomechanical forces and non-coding RNAs in GIONFH. We used RAW264.7 cells and MC3T3E1 cells to verify the role of MALAT1/miR-329-5p/PRIP signalling using a dual luciferase reporter assay, qRT-PCR and Western blot analysis. The results demonstrated that MALAT1 and PRIP were up-regulated in the femoral head tissues of GIONFH rats, RAW264.7 cells, and MC3T3E1 cells exposed to dexamethasone (Dex). Knockdown of MALAT1 decreased PRIP expression in rats and cultured cells and rescued glucocorticoid-induced osteonecrosis of femoral head in rats. The dual luciferase reporter gene assay revealed a targeting relationship for MALAT1/miR-329-5p and miR-329-5p/PRIP in MC3T3E1 and RAW264.7 cells. In conclusion, MALAT1 played a vital role in the pathogenesis of GIONFH by binding to ('sponging') miR-329-5p to up-regulate PRIP. Also, biomechanical forces aggravated the pathogenesis of GIONFH through MALAT1/miR-329-5p/PRIP signalling.


Assuntos
Cabeça do Fêmur/patologia , Regulação da Expressão Gênica , Glucocorticoides/toxicidade , MicroRNAs/genética , Coativadores de Receptor Nuclear/metabolismo , Osteonecrose/patologia , RNA Longo não Codificante/genética , Animais , Fenômenos Biomecânicos , Células Cultivadas , Cabeça do Fêmur/efeitos dos fármacos , Cabeça do Fêmur/metabolismo , Masculino , Coativadores de Receptor Nuclear/genética , Osteonecrose/induzido quimicamente , Osteonecrose/genética , Osteonecrose/metabolismo , Ratos , Ratos Sprague-Dawley
6.
Drug Des Devel Ther ; 15: 1717-1724, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33935494

RESUMO

Background: Osteonecrosis of the femoral head (ONFH) seriously affects the quality of life and labor ability of patients. It is urgent and vital to find the methods for necrosis clinical treatment. Objective: This study aims to study the potential protective effects of Alendronate in the early stage of femur head necrosis. Methods: Ten clinal ONFH tissue samples were employed. H&E staining was employed for the observation of the pathological characteristics of ONFH. The rat model (n=12) was established by the treatment of liquid nitrogen and then treated with Alendronate. The protein expression of BMP2, EIF2AK3, EIF2A and ATF4 were detected via Western blotting and IHC. Results: Fibrin and necrotizing granulation tissue were observed in ONFH tissues with lymphocytes and plasma cells infiltrating in the necrotic area, exhibiting the inflammatory muscle with abnormal shape and color. In the Model group, the BMP2 and ATF4 were mainly distributed in the cell boundaries. The relative protein expression of BMP2, EIF2AK3, EIF2A, ATF4 was decreased in the Model group, compared to the NC group, which was partially recovered by the Alendronate application. Conclusion: Alendronate application partially reversed the suppression of expression of BMP2, EIF2AK3, EIF2A, ATF4 caused by liquid nitrogen. Alendronate could be a promising strategy of curing ONFH via targeting BMP2/EIF2AK3/EIF2A/ATF4 pathway.


Assuntos
Fator 4 Ativador da Transcrição/metabolismo , Alendronato/farmacologia , Proteína Morfogenética Óssea 2/metabolismo , Necrose da Cabeça do Fêmur/tratamento farmacológico , Regulação para Cima/efeitos dos fármacos , eIF-2 Quinase/metabolismo , Fator 4 Ativador da Transcrição/antagonistas & inibidores , Fator 4 Ativador da Transcrição/genética , Animais , Proteína Morfogenética Óssea 2/antagonistas & inibidores , Proteína Morfogenética Óssea 2/genética , Feminino , Necrose da Cabeça do Fêmur/metabolismo , Necrose da Cabeça do Fêmur/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Nitrogênio/farmacologia , Osteonecrose/tratamento farmacológico , Osteonecrose/metabolismo , Osteonecrose/patologia , Ratos , Ratos Sprague-Dawley , eIF-2 Quinase/antagonistas & inibidores , eIF-2 Quinase/genética
7.
PLoS One ; 16(4): e0250334, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33930040

RESUMO

PURPOSE: To evaluate the osseous anatomy of the proximal femur extracted from a 3D-MRI volumetric interpolated breath-hold (VIBE) sequence using either a Dixon or water excitation (WE) fat suppression method, and to measure the overall difference using CT as a reference standard. MATERIAL AND METHODS: This retrospective study reviewed imaging of adult patients with hip pain who underwent 3D hip MRI and CT. A semi-automatically segmented CT model served as the reference standard, and MRI segmentation was performed manually for each unilateral hip joint. The differences between Dixon-VIBE-3D-MRI vs. CT, and WE-VIBE-3D-MRI vs. CT, were measured. Equivalence tests between Dixon-VIBE and WE-VIBE models were performed with a threshold of 0.1 mm. Bland-Altman plots and Lin's concordance-correlation coefficient were used to analyze the agreement between WE and Dixon sequences. Subgroup analyses were performed for the femoral head/neck, intertrochanteric, and femoral shaft areas. RESULTS: The mean and maximum differences between Dixon-VIBE-3D-MRI vs. CT were 0.2917 and 3.4908 mm, respectively, whereas for WE-VIBE-3D-MRI vs. CT they were 0.3162 and 3.1599 mm. The mean differences of the WE and Dixon methods were equivalent (P = 0.0292). However, the maximum difference was not equivalent between the two methods and it was higher in WE method. Lin's concordance-correlation coefficient showed poor agreement between Dixon and WE methods. The mean differences between the CT and 3D-MRI models were significantly higher in the femoral shaft area (P = 0.0004 for WE and P = 0.0015 for Dixon) than in the other areas. The maximum difference was greatest in the intertrochanteric area for both techniques. CONCLUSION: The difference between 3D-MR and CT models were acceptable with a maximal difference below 3.5mm. WE and Dixon fat suppression methods were equivalent. The mean difference was highest at the femoral shaft area, which was off-center from the magnetization field.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico por imagem , Fêmur/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Osteonecrose/diagnóstico por imagem , Adulto , Neoplasias Ósseas/patologia , Feminino , Fêmur/patologia , Articulação do Quadril/patologia , Humanos , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osteonecrose/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
8.
Front Immunol ; 12: 606043, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33717086

RESUMO

Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious adverse drug effect. There are multiple hypotheses to explain the development of MRONJ. Reduced bone remodeling and infection or inflammation are considered central to the pathogenesis of MRONJ. In recent years, increasing evidence has shown that bisphosphonates (BPs)-mediated immunity dysfunction is associated with the pathophysiology of MRONJ. In a healthy state, mucosal immunity provides the first line of protection against pathogens and oral mucosal immune cells defense against potentially invading pathogens by mediating the generation of protective immunoinflammatory responses. In addition, the immune system takes part in the process of bone remodeling and tissue repair. However, the treatment of BPs disturbs the mucosal and osteo immune homeostasis and thus impairs the body's ability to resist infection and repair from injury, thereby adding to the development of MRONJ. Here, we present the current knowledge about immunity dysfunction to shed light on the role of local immune disorder in the development of MRONJ.


Assuntos
Suscetibilidade a Doenças/imunologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Arcada Osseodentária/efeitos dos fármacos , Arcada Osseodentária/patologia , Osteonecrose/etiologia , Animais , Biomarcadores , Conservadores da Densidade Óssea/efeitos adversos , Citocinas/biossíntese , Difosfonatos/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/metabolismo , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Humanos , Imunidade nas Mucosas , Mediadores da Inflamação/metabolismo , Membrana Mucosa/efeitos dos fármacos , Membrana Mucosa/metabolismo , Membrana Mucosa/microbiologia , Membrana Mucosa/patologia , Osteogênese , Osteonecrose/metabolismo , Osteonecrose/patologia , Transdução de Sinais , Cicatrização
9.
Mol Med Rep ; 23(5)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33760114

RESUMO

Steroid­induced avascular necrosis of the femoral head (SANFH) is a common orthopaedic disease that is difficult to treat. The present study investigated the effects of total flavonoids of Rhizoma drynariae (TFRD) on SANFH and explored its underlying mechanisms. The SANFH rat model was induced by intramuscular injection of lipopolysaccharides and methylprednisolone. Osteoblasts were isolated from the calvariae of neonatal rats and then cultured with dexamethasone (Dex). TFRD was used in vitro and in vivo, respectively. Haematoxylin and eosin staining was used to assess the pathological changes in the femoral head. Terminal deoxynucleotidyl transferase­mediated deoxyuridine triphosphate nick end labelling assay and flow cytometry were conducted to detect apoptosis of osteoblasts. The 2',7'­dichlorofluorescein­diacetate staining method was used to detect reactive oxygen species (ROS) levels in osteoblasts and the 3­(4,5­dimethylthiazol­2­yl)­2,5­diphenyltetrazolium bromide assay was used to detect osteoblast proliferation. The expression of caspase­3, Bax, Bcl­2, VEGF, runt­related transcription factor 2 (RUNX2), osteoprotegerin (OPG), osteocalcin (OCN), receptor activator of nuclear factor κB ligand (RANKL) and phosphoinositide 3­kinase (PI3K)/AKT pathway related­proteins were detected via western blotting. It was found that TFRD reduced the pathological changes, inhibited apoptosis, increased the expression of VEGF, RUNX2, OPG and OCN, decreased RANKL expression and activated the PI3K/AKT pathway in SANFH rats. TFRD promoted proliferation, inhibited apoptosis and reduced ROS levels by activating the PI3K/AKT pathway in osteoblasts. In conclusion, TFRD protected against SANFH in a rat model. In addition, TFRD protected osteoblasts from Dex­induced damage through the PI3K/AKT pathway. The findings of the present study may contribute to find an effective treatment for the management of SANFH.


Assuntos
Flavonoides/farmacologia , Osteonecrose/tratamento farmacológico , Extratos Vegetais/farmacologia , Polypodiaceae/química , Animais , Proliferação de Células/efeitos dos fármacos , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Modelos Animais de Doenças , Cabeça do Fêmur/patologia , Flavonoides/química , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Osteoblastos/efeitos dos fármacos , Osteogênese por Distração/métodos , Osteonecrose/induzido quimicamente , Osteonecrose/patologia , Osteoprotegerina/genética , Fosfatidilinositol 3-Quinases/genética , Extratos Vegetais/química , Proteínas Proto-Oncogênicas c-akt/genética , Ligante RANK/genética , Ratos , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Esteroides/efeitos adversos
10.
Otolaryngol Head Neck Surg ; 165(5): 636-646, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33618563

RESUMO

OBJECTIVE: Review long-term clinical and quality-of-life outcomes following free flap reconstruction for osteonecrosis. STUDY DESIGN: Retrospective multi-institutional review. SETTING: Tertiary care centers. METHODS: Patients included those undergoing free flap reconstructions for osteonecrosis of the head and neck (N = 232). Data included demographics, defect, donor site, radiation history, perioperative management, diet status, recurrence rates, and long-term quality-of-life outcomes. Quality-of-life outcomes were measured using the University of Washington Quality of Life (UW-QOL) survey. RESULTS: Overall flap success rate was 91% (n = 212). Relative to preoperative diet, 15% reported improved diet function at 3 months following reconstruction and 26% at 5 years. Osteonecrosis recurred in 14% of patients (32/232); median time to onset was 11 months. Cancer recurrence occurred in 13% of patients (29/232); median time to onset was 34 months. Results from the UW-QOL questionnaire were as follows: no pain (45%), minor or no change in appearance (69%), return to baseline endurance level (37%), no limitations in recreation (40%), no changes in swallowing following reconstruction (28%), minor or no limitations in mastication (29%), minor or no speech difficulties (93%), no changes in shoulder function (84%), normal taste function (19%), normal saliva production (27%), generally excellent mood (44%), and no or minimal anxiety about cancer (94%). CONCLUSION: The majority of patients maintained or had advancement in diet following reconstruction, with low rates of osteonecrosis or cancer recurrence and above-average scores on UW-QOL survey suggesting good return of function and quality of life.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Retalhos de Tecido Biológico/irrigação sanguínea , Doenças Maxilomandibulares/etiologia , Doenças Maxilomandibulares/cirurgia , Osteonecrose/cirurgia , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Osteonecrose/etiologia , Osteonecrose/patologia , Radioterapia/efeitos adversos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Centros de Atenção Terciária
11.
Int J Med Sci ; 18(6): 1375-1381, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33628093

RESUMO

Introduction: Recently, the efficacy of mesenchymal stem cells (MSCs) mediated by their tissue repair and anti-inflammatory actions in the prevention and therapy of various disorders has been reported. In this research, our attention was focused specifically on the prevention and therapy of glucocorticoid-induced osteonecrosis. We investigated the stress resistance of MSC against glucocorticoid administration and hypoxic stress, which are factors known to induce osteocytic cell death. Materials and Methods: Mouse bone cells (MLO-Y4) and bone-marrow derived mouse MSCs were exposed to dexamethasone (Dex), hypoxia of 1% oxygen or both in vitro. Mitochondrial membrane potentials were estimated by mitochondria labeling with a cell-permeant probe (Mito tracker red); expression of these apoptosis-inducing molecules, oxidative stress marker (8-hydroxy-2'-deoxyguanosine), caspase-3, -9, and two apoptosis-inhibiting molecules, energy-producing ATP synthase (ATP5A) and X-linked inhibitor of apoptosis protein (XIAP), were analyzed by both immunofluorescence and western blot. Results: With exposure to either dexamethasone or hypoxia, MLO-Y4 showed reduced mitochondrial membrane potential, ATP5A and upregulation of 8-OHdG, cleaved caspases and XIAP. Those changes were significantly enhanced by treatment with dexamethasone plus hypoxia. In MSCs, however, mitochondrial membrane potentials were preserved, while no significant changes in the pro-apoptosis or anti-apoptosis molecules analyzed were found even with exposure to both dexamethasone and hypoxia. No such effects induced by treatment with dexamethasone, hypoxia, or both were demonstrated in MSCs at all. Discussion: In osteocyte cells subjected to the double stresses of glucocorticoid administration and a hypoxic environment osteocytic cell death was mediated via mitochondria. In contrast, MSC subjected to the same stressors showed preservation of mitochondrial function and reduced oxidative stress. Accordingly, even under conditions sufficiently stressful to cause the osteocytic cell death in vivo, it was thought that the function of MSC could be preserved, suggesting that in the case of osteonecrosis preventative and therapeutic strategies incorporating their intraosseous implantation may be promising.


Assuntos
Glucocorticoides/efeitos adversos , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/efeitos dos fármacos , Osteócitos/efeitos dos fármacos , Osteonecrose/terapia , Animais , Apoptose/efeitos dos fármacos , Hipóxia Celular/efeitos dos fármacos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Dexametasona/efeitos adversos , Modelos Animais de Doenças , Humanos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Células-Tronco Mesenquimais/patologia , Camundongos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/patologia , Osteócitos/patologia , Osteonecrose/induzido quimicamente , Osteonecrose/patologia
12.
Medicine (Baltimore) ; 100(2): e24031, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33466148

RESUMO

RATIONALE: Osteonecrosis (ON) is a devastating illness that leads to bone ischemia and potential joint destruction. Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease, with multi-system involvement which is closely associated with occurrence of ON. Multifocal ON, with an estimated morbidity of 3% in SLE patients, is extremely rare in juvenile subjects. PATIENT CONCERNS: A 13.3-year-old female SLE patient was admitted to hospital 20 months following the SLE diagnosis because of a sudden aggravation of sore knees. She suffered from double knee joint pain and her left knee joint showed typical signs of inflammation including redness, swelling, heat, and pain. DIAGNOSES: The SLE patient was diagnosed with multifocal ON of her knee joint based on magnetic resonance imaging findings of bone destruction and osteoproliferation at the bilateral distal femur and proximal tibia. INTERVENTIONS: The patient received high-dose methylprednisolone and intravenous cyclophosphamide pulse therapies for controlling active lupus and nephritis. Oral calcitriol and dipyridamole were administered to alleviate knee pain and inhibit thrombi formation, thereby suppressing ON progress. OUTCOMES: Three weeks following the treatment, the swelling in patient's left knee subsided. Her self-reporting pain score decreased from 9 to 4 and walking time increased from 45minutes to 90minutes per day. Nearly 5 weeks later, the pain in bilateral knee joints disappeared and the patient could walk without difficulties. LESSONS: This patient is the youngest SLE patient who developed multifocal ON based on the reported literature. It suggests that ON can occur in young SLE patients. A combination of internal and external risk factors can promote the development of ON. The balanced approach to the application of corticosteroids and immunosuppressors in the treatment of SLE and prevention of ON is a challenging problem that deserves further exploration.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Osteonecrose/complicações , Adolescente , Conservadores da Densidade Óssea/uso terapêutico , Calcitriol/uso terapêutico , Ciclofosfamida/uso terapêutico , Dipiridamol/uso terapêutico , Feminino , Humanos , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/patologia , Metilprednisolona/uso terapêutico , Osteonecrose/tratamento farmacológico , Osteonecrose/patologia , Inibidores da Agregação Plaquetária/uso terapêutico
13.
Medicine (Baltimore) ; 100(1): e23705, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429739

RESUMO

RATIONALE: Osteonecrosis of the femoral head is a common orthopedic disease. Some studies have shown that osteonecrosis of the femoral head is related to susceptibility genes, but there are few reports of familial osteonecrosis of the femoral head. Here, we reported two first-degree relatives with osteonecrosis of the femoral head. PATIENT CONCERNS: A 27-year-old man with bilateral hip pain was diagnosed with osteonecrosis of the femoral head. The patient's mother also had a history of this disease. DIAGNOSES: Whole exome sequencing revealed the same mutation (c.15+3G>A) in the insulin-like growth factor 1 (IGF1) gene of the proband and his mother but not in his elder sister. INTERVENTIONS: The patient underwent bilateral total hip arthroplast. OUTCOMES: The patient recovered well, and was discharged. LESSONS: We found a heterozygous mutation (c.15+3G>A) in IGF1 in this family, which could be related to osteonecrosis of the femoral head. Early genetic counseling and gene locus detection could, thus, prove helpful for early diagnosis of osteonecrosis of the femoral head.


Assuntos
Cabeça do Fêmur/anormalidades , Fator de Crescimento Insulin-Like I/análise , Osteonecrose/genética , Adulto , Artroplastia de Quadril/métodos , Cabeça do Fêmur/patologia , Humanos , Fator de Crescimento Insulin-Like I/genética , Masculino , Osteonecrose/patologia
14.
Surg Radiol Anat ; 43(7): 1107-1115, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33486573

RESUMO

PURPOSE: The application of the anatomical parameters of the contralateral hip joint to guide the preoperative template of the affected side relies on the bilateral hip symmetry. We investigated the bilateral hip symmetry and range of anatomical variations by measurement and comparison of bilateral hip anatomical parameters. METHODS: This study included 224 patients (448 hips) who were diagnosed with osteoarthritis (OA) and avascular necrosis (AVN) of the femur head, and underwent bilateral primary total hip arthroplasty (THA) in our hospital from January 2012 to August 2020. Imaging data included 224 patients X-ray and 30 CT data at the end of the cohort. Anatomical parameters, including the acetabular abduction angle and trochanteric height, were measured using the Noble method. Postoperative measurements included stem size, difference of leg length and offset. RESULTS: Except for the isthmus width, there were no significant differences in the anatomical morphology of the hip joint. Among the demographic factors, there was a correlation between body weight and NSA. Among various anatomical parameters, a correlation was present between medullary cavity widths of T + 20, T, and T - 20. The difference in the use of stem size is not due to the morphological difference of bilateral medullary cavity, but due to the different of 1- or 2-stage surgery. CONCLUSION: Bilateral symmetry was present among the patients with normal morphology of the hip medullary cavity, theoretically confirming the feasibility of structural reconstruction of the hip joint using the hip joint on the uninjured side. Additionally, the difference in the morphology of the hip medullary cavity is not present in a single plane but is synergistically affected by multiple adjacent planes.


Assuntos
Acetábulo/anatomia & histologia , Artroplastia de Quadril/métodos , Cabeça do Fêmur/anatomia & histologia , Articulação do Quadril/anatomia & histologia , Planejamento de Assistência ao Paciente , Acetábulo/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/patologia , Cabeça do Fêmur/cirurgia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/cirurgia , Osteonecrose/patologia , Osteonecrose/cirurgia , Período Pré-Operatório , Tomografia Computadorizada por Raios X , Adulto Jovem
15.
Mol Biol Rep ; 48(1): 969-974, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33289909

RESUMO

Haemophilic arthropathy (HA), caused by intra-articular haemorrhage, is one of the most common complications in patients with haemophilia. Factor replacement therapy provides missing coagulation factors to prevent children with haemophilia from joint bleeding and decreases their risk for HA. However, haemophilia patients in developing countries are still suffering from HA due to insufficient replacement therapy. Symptoms such as pain and activity limitations caused by HA seriously affect the functional abilities and quality of life of patients with HA, causing a high disability rate in the haemophilia cohort. The pathological mechanism of HA is complicated because the whole pathological mainly involves hypertrophic synovitis, osteopenia, cartilage and bone destruction, and these pathological changes occur in parallel and interact with each other. Inflammation plays an important role in the whole complex pathological process, and iron, cytokines, growth factors and other factors are involved. This review summarizes the pathological mechanism of HA to provide background for clinical and basic research.


Assuntos
Artrite/patologia , Doenças Ósseas Metabólicas/patologia , Hemartrose/patologia , Hemofilia A/patologia , Osteonecrose/patologia , Sinovite/patologia , Adulto , Artrite/genética , Artrite/imunologia , Artrite/metabolismo , Doenças Ósseas Metabólicas/genética , Doenças Ósseas Metabólicas/imunologia , Doenças Ósseas Metabólicas/metabolismo , Criança , Citocinas/genética , Citocinas/imunologia , Fator VIII/uso terapêutico , Regulação da Expressão Gênica , Hemartrose/genética , Hemartrose/imunologia , Hemartrose/metabolismo , Hemofilia A/genética , Hemofilia A/imunologia , Hemofilia A/metabolismo , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/imunologia , Ferro/imunologia , Ferro/metabolismo , Articulações/imunologia , Articulações/metabolismo , Articulações/patologia , Osteonecrose/genética , Osteonecrose/imunologia , Osteonecrose/metabolismo , Qualidade de Vida , Sinovite/genética , Sinovite/imunologia , Sinovite/metabolismo
16.
Orthopedics ; 44(2): e243-e247, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33238013

RESUMO

Although various studies have proposed vascular and mechanical factors, the etiology of Kienböck disease is unknown. Kienböck theorized that lunatomalacia resulted from traumatic disruption of blood supply and bony nutrition to the lunate. Extraosseous supply to the lunate, as far as volar or dorsal vessels are concerned, is still controversial. This study evaluated the extraosseous nutrient foramina from the dorsal and volar aspects of lunate specimens. A total of 913 specimens from the Hamann-Todd Osteological Collection in Cleveland, Ohio, were examined. The nutrient artery foramina on left and right lunate specimens were examined from dorsal and volar aspects. The number of nutrient artery foramen was tabulated. Age, sex, and race data were collected. Specimens were divided into groups according to the number of nutrient artery foramina, and the dorsal and volar foramina were compared. The average number of foramina on the dorsal aspect of the lunate (1.71) was greater than the volar aspect (1.64), except in specimens younger than 35 years. A greater number of specimens had 3 or more foramina on the dorsal side compared with the volar aspect. Based on this study, there was significant contribution of dorsal arterial vessels to the blood supply of lunate specimens older than 35 years, which contrasts with findings in earlier studies. The disruption of dorsal intercarpal and radiocarpal ligaments leading to the disruption of the dorsal arterial arches may contribute to vascular insufficiency of the lunate and should be evaluated further in the etiopathogenesis of Kienböck disease. [Orthopedics. 2021;44(2):e243-e247.].


Assuntos
Osso Semilunar/irrigação sanguínea , Adulto , Artérias/patologia , Artérias/fisiopatologia , Cadáver , Humanos , Ligamentos/patologia , Ligamentos/fisiopatologia , Masculino , Osteonecrose/etiologia , Osteonecrose/patologia , Osteonecrose/fisiopatologia
17.
Sci Rep ; 10(1): 20660, 2020 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-33244062

RESUMO

Although corticosteroids and alcohol are two major risk factors for nontraumatic osteonecrosis of the femoral head (NONFH), the effects of other factors have rarely been studied, thereby making early diagnosis and treatment of NONFH difficult. This study aimed to develop and validate a nomogram to NONFH, but patients with alcohol- and steroid-related NONFH are not at all taken into account in this study. A training cohort of 790 patients (n = 434, NONFH; n = 356, femoral neck fractures [non-NONFH]) diagnosed in our hospital from January 2011 to December 2016 was used for model development. A least absolute shrinkage and selection operator (lasso) regression model was used for date dimension reduction and optimal predictor selection. A predictive model was developed from univariate and multivariate logistic regression analyses. Performance characterisation of the resulting nomogram included calibration, discriminatory ability, and clinical usefulness. After internal validation, the nomogram was further evaluated in a separate cohort of 300 consecutive patients included between January 2017 and December 2018. The simple prediction nomogram included five predictors from univariate and multivariate analyses, including gender, total cholesterol levels, triglyceride levels, white blood cell count, and platelet count. Internal validation showed that the model had good discrimination [area under the receiver operating characteristic curve (AUC) = 0.80] and calibration. Good discrimination (AUC = 0.81) and calibration were preserved in the validation cohort. Decision curve analysis showed that the predictive nomogram was clinically useful. The simple diagnostic nomogram, which combines demographic data and laboratory blood test results, was able to quantify the probability of NONFH in cases of early screening and diagnosis.


Assuntos
Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/patologia , Osteonecrose/diagnóstico , Osteonecrose/patologia , Grupo com Ancestrais do Continente Asiático , Plaquetas/metabolismo , Colesterol/metabolismo , Estudos de Coortes , Feminino , Cabeça do Fêmur/metabolismo , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nomogramas , Osteonecrose/metabolismo , Probabilidade , Curva ROC , Triglicerídeos/metabolismo
18.
J Mater Chem B ; 8(42): 9734-9743, 2020 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-33021308

RESUMO

Core decompression of the femoral head is a recommended head-conserving strategy for early-stage osteonecrosis of the femoral head. However, no ideal filling material has been found so far. In this study, we fabricated a "solid core-porous coating" composite scaffold, which is a silk fibroin/hydroxypropyl methylcellulose (SF/HPMC) scaffold, by a "two-step" process. The solid core scaffold possesses a sufficient compression modulus (860 MPa) for support, while the porous coating scaffold with controllable pore size and porosity provides a suitable microenvironment for the osteoblast cell to adhere and proliferate. Moreover, the porous coating scaffold was mineralized by adding different contents of hydroxyapatite crystal to further enhance its osteoinductivity, according to the simulated body fluid (SBF) biomineralization assay. To demonstrate the biocompatibility and osteoinductivity of such composite scaffolds, a series of in vitro experiments were performed, indicating the MC3T3-E1 pre-osteoblast cells grew and differentiated well on the mineralized porous coating scaffolds. The mechanical testing results also proved that the mechanical property of the solid core scaffold varied (230-1600 MPa) with different solid contents of SF/HPMC, as expected. Furthermore, the rabbit femoral head core decompression model was adopted and confirmed the excellent mechanical performance of the solid core scaffolds, as well as the satisfied osteoinductivity of the porous coating scaffold, by inserting the composite scaffolds into the bone tunnel in vivo. All of the preliminary results implied that the novel biodegradable composite scaffold has an outstanding prospective for the clinical use of core decompression of the femoral head.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Cabeça do Fêmur/patologia , Fibroínas/uso terapêutico , Osteonecrose/terapia , Animais , Materiais Biocompatíveis/química , Bombyx/química , Linhagem Celular , Durapatita/química , Durapatita/uso terapêutico , Cabeça do Fêmur/ultraestrutura , Fibroínas/química , Camundongos , Osteonecrose/patologia , Porosidade , Coelhos , Tecidos Suporte/química
19.
Int J Mol Med ; 46(5): 1721-1732, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32901839

RESUMO

Long non­coding RNAs (lncRNAs) are crucial for the occurrence and development of numerous diseases. Although lncRNAs are involved in the biological activities of stem cells and play crucial roles in stem cell differentiation, the expression of specific lncRNAs during human bone marrow­derived mesenchymal stem cell (hBMSC) osteogenic differentiation in osteonecrosis of the femoral head (ONFH) and their regulatory roles have not yet been fully elucidated. To the best of our knowledge, the present study is the first to characterize lncRNA expression profiles during hBMSC osteogenic differentiation in ONFH using microarray analysis and RT­qPCR to confirm the microarray data. A total of 24 downregulated and 24 upregulated lncRNAs were identified and the results of RT­qPCR were found to be consistent with those of microarray analysis. Bioinformatics analyses, using the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases, were conducted to explore the possible mechanisms and identify the signaling pathways that the lncRNAs are involved in. GO analysis revealed significant changes in the intracellular organelle, Ras protein signal transduction and transferase activity. KEGG pathway analysis revealed that the lncRNAs were closely associated with fatty acid metabolism, apoptosis and the TGF­ß signaling pathway. The overexpression of MAPT antisense RNA 1 (MAPT­AS1) was found to promote osteogenesis and inhibit the adipogenesis of hBMSCs at the cellular and mRNA levels. On the whole, the findings of the present study identified the lncRNAs and their roles in hBMSCs undergoing osteogenic differentiation in ONFH and provide a new perspective for the pathogenesis of ONFH.


Assuntos
Células da Medula Óssea/patologia , Diferenciação Celular/genética , Cabeça do Fêmur/patologia , Células-Tronco Mesenquimais/patologia , Osteogênese/genética , Osteonecrose/genética , RNA Longo não Codificante/genética , Adipogenia/genética , Medula Óssea/patologia , Biologia Computacional/métodos , Ácidos Graxos/genética , Perfilação da Expressão Gênica/métodos , Humanos , Osteonecrose/patologia , RNA Mensageiro/genética , Transdução de Sinais/genética , Células-Tronco/patologia , Fator de Crescimento Transformador beta/genética , Regulação para Cima/genética , Proteínas tau/genética
20.
Am J Med Genet A ; 182(12): 2988-2993, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32985097

RESUMO

Gaucher disease, a lysosomal storage disorder and hemophagocytic lymphohistiocytosis (HLH), a disorder of the immune system, have several overlapping clinical features including cytopenias, elevated serum ferritin, and splenomegaly. Prior reports of acute infantile neuronopathic, Type 2 Gaucher disease manifesting with signs of HLH have been published. Here we describe an adult patient who was initially suspected of having HLH, and was treated with a 10-day course of etoposide and a 5-day course alemtuzumab for presumptive HLH, only to later to have his presentation be determined to be due to Type 1 Gaucher disease. HLH chemotherapy treatment appeared to trigger a severe Gaucher acute pain crisis and extensive bony disease including avascular necrosis. Prolonged immunosuppression, and recurrent infections further complicated a lengthy hospitalization. We discuss the clinical overlap between Gaucher and HLH and the iatrogenic consequences of HLH-directed therapy on underlying Type 1 Gaucher disease.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Doença de Gaucher/patologia , Linfo-Histiocitose Hemofagocítica/tratamento farmacológico , Osteonecrose/patologia , Adulto , Alemtuzumab/administração & dosagem , Etoposídeo/administração & dosagem , Doença de Gaucher/induzido quimicamente , Doença de Gaucher/complicações , Humanos , Linfo-Histiocitose Hemofagocítica/complicações , Linfo-Histiocitose Hemofagocítica/patologia , Masculino , Osteonecrose/induzido quimicamente , Prognóstico , Adulto Jovem
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