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[1]沈瑩姍,何敏聰,莊至坤,等.激素性股骨頭壞死和酒精性股骨頭壞死的病理學(xué)差異及其分子機(jī)制研究[J].中醫(yī)正骨,2023,35(05):1-7.
　SHEN Yingshan,HE Mincong,ZHUANG Zhikun,et al.Pathological differences between steroid-induced and alcohol-induced osteonecrosis of the femoral head and their molecular mechanisms[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(05):1-7.
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激素性股骨頭壞死和酒精性股骨頭壞死的病理學(xué)差異及其分子機(jī)制研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年05期
頁碼:
1-7
欄目:
基礎(chǔ)研究
出版日期:
2023-05-20

文章信息/Info

Title:
Pathological differences between steroid-induced and alcohol-induced osteonecrosis of the femoral head and their molecular mechanisms
作者:
沈瑩姍1; 何敏聰2; 莊至坤3; 何曉銘2; 李子祺2; 鄭越生4; 何偉2; 魏秋實2
(1.廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院,廣東 廣州 510405; 2.廣州中醫(yī)藥大學(xué)第三附屬醫(yī)院,廣東 廣州 510240; 3.泉州市正骨醫(yī)院,福建 泉州 362000; 4.廣州中醫(yī)藥大學(xué)金沙洲醫(yī)院,廣東 廣州 510168)
Author(s):
SHEN Yingshan1; HE Mincong2; ZHUANG Zhikun3; HE Xiaoming2; LI Ziqi2; ZHENG Yuesheng4; HE Wei2; WEI Qiushi2
1.The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China 2.The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510240,Guangdong,China 3.Quanzhou Orthopedic-Traumatological Hospital,Quanzhou 362000,Fujian,China 4.Jinshazhou Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510168,Guangdong,China
關(guān)鍵詞:
股骨頭壞死;  激素類;  飲酒;  病理學(xué)特點;  顯微鏡檢查; 電子; 掃描;  印跡法; 蛋白質(zhì)
Keywords:
femur head necrosis;  hormones;  alcohol drinking;  pathological characteristics microscopy; electron; scanning;  Blotting; Western
摘要:
目的:探討激素性股骨頭壞死(osteonecrosis of the femoral head,ONFH)和酒精性O(shè)NFH的病理學(xué)差異及其分子機(jī)制。方法:納入接受人工全髖關(guān)節(jié)置換術(shù)治療的ONFH患者的股骨頭60個,根據(jù)患者發(fā)生ONFH的病因,將股骨頭分為激素性O(shè)NFH組和酒精性O(shè)NFH組。將股骨頭做冠狀面逐層切片后,觀察2組股骨頭的分區(qū)情況及病理特點; 于股骨頭正中切片上分別取壞死區(qū)、硬化區(qū)、正常區(qū)的骨組織,處理后采用掃描電鏡觀察2組股骨頭不同區(qū)域骨組織的結(jié)構(gòu)特點; 分離股骨頭壞死區(qū)、硬化區(qū)、正常區(qū)的骨組織,采用蛋白印跡法檢測2組股骨頭各區(qū)骨組織中血小板-內(nèi)皮細(xì)胞粘附分子-1(platelet endothelial cell adhesion molecule-1,PECAM-1)、內(nèi)皮粘蛋白(endomucin,EMCN)、血小板衍生生長因子(platelet derived growth factor,PDGF)-BB、表皮生長因子樣結(jié)構(gòu)域8(epidermal growth factor-like domain 8,EGFL8)及骨形態(tài)發(fā)生蛋白-2(bone morphogenetic protein-2,BMP-2)的表達(dá)量。結(jié)果:股骨頭切片顯示,激素性O(shè)NFH組股骨頭壞死區(qū)與硬化區(qū)交界處有新鮮肉芽組織,酒精性O(shè)NFH組股骨頭壞死區(qū)與硬化區(qū)交界處無新鮮肉芽組織,有纖維組織填充。掃描電鏡圖像顯示,激素性O(shè)NFH組股骨頭的壞死區(qū)骨細(xì)胞胞體呈現(xiàn)粗糙、溶解樣,周圍有樹突包裹,有骨小管分布; 硬化區(qū)骨細(xì)胞胞體較正常骨細(xì)胞略小,樹突縮短、數(shù)量減少,有骨小管分布; 正常區(qū)有豐富的骨小管分布。酒精性O(shè)NFH組股骨頭的壞死區(qū)骨細(xì)胞萎縮,甚至消失,未見樹突與骨小管分布; 硬化區(qū)骨細(xì)胞萎縮、體積較小,樹突稀疏,骨小管小、數(shù)量少; 正常區(qū)骨小管較小、數(shù)量較少。激素性O(shè)NFH組股骨頭壞死區(qū)、硬化區(qū)、正常區(qū)骨組織中PECAM-1、EMCN、EGFL8,壞死區(qū)、硬化區(qū)骨組織中PDGF-BB,硬化區(qū)骨組織中BMP-2的蛋白表達(dá)量均高于酒精性O(shè)NFH組(PECAM-1:1.970±0.053,0.493±0.076,t=0.453,P=0.000; 0.797±0.047,0.467±0.025,t=1.910,P=0.000; 2.207±0.045,1.443±0.118,t=4.993,P=0.000; EMCN:1.277±0.038,1.077±0.025,t=1.087,P=0.002; 2.220±0.106,0.270±0.036,t=4.655,P=0.000; 2.400±0.046,0.473±0.126,t=2.494,P=0.000; EGFL8:4.443±0.313,1.043±0.091,t=4.106,P=0.000; 1.833±0.096,0.090±0.030,t=2.969,P=0.000; 0.553±0.110,0.130±0.010,t=8.892,P=0.021; PDGF-BB:1.413±0.040,0.223±0.006,t=4.654,P=0.000; 0.980±0.036,0.193±0.015,t=2.579,P=0.000; BMP-2:0.417±0.023,0.270±0.036,t=0.810,P=0.004),壞死區(qū)骨組織中BMP-2的蛋白表達(dá)量低于酒精性O(shè)NFH組(0.343±0.070,1.160±0.056,t=0.116,P=0.000); 激素性O(shè)NFH組股骨頭正常區(qū)骨組織中PDGF-BB、BMP-2的蛋白表達(dá)量與酒精性O(shè)NFH組比較,組間差異均無統(tǒng)計學(xué)意義(0.250±0.056,0.287±0.031,t=1.062,P=0.374; 0.263±0.025,0.320±0.036,t=0.604,P=0.089)。結(jié)論:與激素性O(shè)NFH相比,酒精性O(shè)NFH的股骨頭壞死區(qū)與硬化區(qū)交界處無新鮮肉芽組織、有纖維組織填充,壞死區(qū)、硬化區(qū)的骨細(xì)胞明顯萎縮,各區(qū)骨小管更小、數(shù)量更少,這種病理學(xué)差異與股骨頭不同區(qū)域骨組織中血管生成蛋白和骨代謝相關(guān)蛋白的表達(dá)有關(guān)。
Abstract:
Objective:To explore the pathological differences between steroid-induced osteonecrosis of the femoral head(ONFH)and alcohol-induced ONFH,and to explore their molecular mechanisms.Methods:Sixty femoral heads from ONFH patients who underwent artificial total hip arthroplasty were enrolled in the study and were divided into steroid-induced ONFH group and alcohol-induced ONFH group according to the etiology of ONFH.The femoral heads were sectioned in coronal plane layer by layer,and their subregion and pathological characteristics were observed.The bone tissues from the necrotic zone,sclerotic zone and normal zone of the femoral head were harvested from the median section of the femoral head,and their structural characteristic were observed in the 2 groups using a scanning electron microscope after processing.The bone tissues from the necrotic zone,sclerotic zone and normal zone were isolated,and the protein expression levels of platelet endothelial cell adhesion molecule-1(PECAM-1),endomucin(EMCN),platelet-derived growth factor(PDGF)-BB,epidermal growth factor-like domain 8(EGFL8)and bone morphogenetic protein-2(BMP-2)in the bone tissues of each zone were detected using Western blot.Results:The femoral head sections showed that there were fresh granulation tissues at the junction of the necrotic zone and sclerotic zone in the steroid-induced ONFH group,while no fresh granulation tissues were observed,but fibrous tissues were found in alcohol-induced ONFH group.The scanning electron microscopy images showed that,in steroid-induced ONFH group,the osteocytes in the necrotic zone displayed as rough,dissolved cell bodies surrounded by dendrites,with distributed bone canaliculi.The osteocytes in the sclerotic zone displayed as slightly smaller cell bodies compared with that of normal osteocytes,with shorter and fewer dendrites and distributed bone canaliculi.The abundant bone canaliculi were found in the normal zone.While in alcohol-induced ONFH group,the osteocytes in the necro-tic zone were atrophied or even disappeared,and no dendrites or bone canaliculi were observed.The osteocytes in the sclerotic zone were also atrophied,manifesting as a smaller volume with sparse dendrites and small and few bone canaliculi,meanwhile,smaller and fewer bone canaliculi were found in the normal zone.The PECAM-1,EMCN and EGFL8 in the bone tissues of the necroticzon zone,sclerotic zone and normal zone,and PDGF-BB in the bone tissues of the necrotic zone and sclerotic zone,and BMP-2 in the bone tissues of the sclerotic zone were all highly expressed in the steroid-induced ONFH group compared to alcohol-induced ONFH group(PECAM-1:1.970±0.053 vs 0.493±0.076,t=0.453,P=0.000; 0.797±0.047 vs 0.467±0.025,t=1.910,P=0.000; 2.207±0.045 vs 1.443±0.118,t=4.993,P=0.000; EMCN:1.277±0.038 vs 1.077±0.025,t=1.087,P=0.002; 2.220±0.106 vs 0.270±0.036,t=4.655,P=0.000; 2.400±0.046 vs 0.473±0.126,t=2.494,P=0.000; EGFL8:4.443±0.313 vs 1.043±0.091,t=4.106,P=0.000; 1.833±0.096 vs 0.090±0.030,t=2.969,P=0.000; 0.553±0.110 vs 0.130±0.010,t=8.892,P=0.021; PDGF-BB:1.413±0.040 vs 0.223±0.006,t=4.654,P=0.000; 0.980±0.036 vs 0.193±0.015,t=2.579,P=0.000; BMP-2:0.417±0.023 vs 0.270±0.036,t=0.810,P=0.004),while the BMP-2 in the bone tissues of the necrotic zone was lowly expressed in the steroid-induced ONFH group compared to the alcohol-induced ONFH group(0.343±0.070 vs 1.160±0.056,t=0.116,P=0.000).There was no statistical difference in the protein expression levels of PDGF-BB and BMP-2 in the bone tissues of normal zone between steroid-induced ONFH group and alcohol-induced ONFH group(0.250±0.056 vs 0.287±0.031,t=1.062,P=0.374; 0.263±0.025 vs 0.320±0.036,t=0.604,P=0.089).Conclusion:Compared to steroid-induced ONFH patients,the fibrous tissues can be observed,but the fresh granulation tissues can not be observed at the junction of the necrotic zone and sclerotic zone of the femoral head in alcohol-induced ONFH patients,moreover,the osteocytes in the necrotic zone and sclerotic zone are significantly atrophied and the bone canaliculi in each zone are smaller and fewer.These pathological differences are related to the expression of vascular growth proteins and bone metabolism-related proteins in the bone tissues of different zones of the femoral head.

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備注/Memo

備注/Memo:
基金項目:國家自然科學(xué)基金項目(81873327,81904226); 廣東省自然科學(xué)基金項目(2017A030313698) 通訊作者:魏秋實 E-mail:[email protected]
更新日期/Last Update: 1900-01-01