Glucocorticoids-induced osteonecrosis of the femoral head: adipogenic differentiation and treatment progress

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Abstract

BACKGROUND:

Glucocorticoids may induce local bone trabecular and bone marrow necrosis, femoral head collapse and deformation, thus resulting in hip dysfunction. However the pathological mechanisms and treatment of glucocorticoids-induced osteonecrosis of the femoral head remain unclear, and the pathogenesis mechanisms are controversial. The current studies focus on the understanding of the pathological mechanisms.

OBJECTIVE:

To summary the research progress of adipogenic differentiation theory of glucocorticoids-induced osteonecrosis of the femoral head and the treatment.

METHODS:

The first author searched literature from CNKI and PubMed database from 1988 to 2010, by using the key words is “Glucocorticoids, osteonecrosis of femoral head, bone marrow stromal stem cells, adipogenic differentiation, differentiation factors, treatment, choices” in English, and “glucocorticoids induced osteonecrosis of femoral head, adipogenic differentiation, treatment, research progress” in Chinese. Articles regarding the adipogenic differentiation theory of glucocorticoids-induced osteonecrosis of the femoral head and the treatment were included.

RESULTS AND CONCLUSION:

A total of 112 literatures were screened out, according to inclusion and exclusion criteria for literature screening, 54 articles were included. Modern researches emphasize the cell and molecular biology level, and show that the biological base of glucocorticoids-induced osteonecrosis of the femoral head is abnormal adipogenic differentiation of bone cells, glucocorticoids cause the variations of adipogenic differentiation factors, leading to adipogenic differentiation of bone marrow stromal cells. But glucocorticoids affects multiple differentiation factors, it may cause great error in the evaluation of the pathogenesis of glucocorticoids-induced osteonecrosis of the femoral head purely from one factor. The abuse of glucocorticoids is the leading cause for the osteonecrosis of femoral head. Further studies are needed to investigate the pathogenesis of osteonecrosis of the femoral head and treatment programs.

Subject headings:

hormones; femur head necrosis; bone marrow; adipogenesis

Funding:

the National Natural Science Foundation of China, No. 81373660; a grant from Shandong Province TCM Science and Research Program, No. 2013ZDZK-038; the Natural Science Foundation of Shandong Province, No. 2009ZRB14263

Funding:

Liu B, Li G, Xu B, Liu GY. Glucocorticoids-induced osteonecrosis of the femoral head: adipogenic differentiation and treatment progress. Zhongguo Zuzhi Gongcheng Yanjiu. 2014;18(29):4730-4735.

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