Expression of 11β-HSD in steroid-induced avascular necrosis of the femoral head

Wang,Lin; Luo,Deng-Ke; Pan,Zhen-Yu

doi:10.3892/mmr.2013.1401

Expression of 11β-HSD in steroid-induced avascular necrosis of the femoral head

Authors:
- Lin Wang
- Deng-Ke Luo
- Zhen-Yu Pan
View Affiliations

Affiliations: Department of Orthopaedic Microsurgery and Hand Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
Published online on: March 28, 2013 https://doi.org/10.3892/mmr.2013.1401
Pages: 1482-1486

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to investigate the association between glucocorticoid receptors and steroid‑induced avascular necrosis of the femoral head (SANFH). Healthy New Zealand rabbits were randomly divided into 3 groups (n=16/group); the normal (no treatment), control (horse serum injections) and treatment (horse serum and methylprednisolone injections) groups. Methylprednisolone and horse serum injections were used to establish a SANFH model in rabbits; magnetic resonance imaging (MRI) and histopathological analysis were used to evaluate the SANFH rabbit model. Total cholesterol and triglyceride contents in the blood of SANFH rabbits were determined. The protein expression levels of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) and type 2 (11β-HSD2) were determined using western blotting. The total cholesterol and triglyceride levels in the blood of methylprednisolone‑treated rabbits were significantly increased compared with the control and normal groups, which provides evidence in support of the metabolic disorder theory. Based on the results obtained from western blotting, the expression levels of 11β-HSD1 protein were increased, whereas the expression levels of 11β-HSD2 protein were decreased following injection. The results of the present study indicate that 11β-HSDs are important in the development of SANFH. Furthermore, 11β-HSDs may be important targets for preventing the development of ANFH in patients treated with steroids, which has a significant reference value for the use of steroids in clinical practice.

View Figures

View References

1	Wen Q, Ma L, Chen YP, Yang L, Luo W and Wang XN: A rabbit model of hormone-induced early avascular necrosis of the femoral head. Biomed Environ Sci. 21:398–403. 2008. View Article : Google Scholar : PubMed/NCBI
2	Jones JP Jr: Intravascular coagulation and osteonecrosis. Clin Orthop Relat Res. 277:41–53. 1992.PubMed/NCBI
3	Kawai K, Tamaki A and Hirohata K: Steroid-induced accumulation of lipid in the osteocytes of the rabbit femoral head. A histochemical and electron microscopic study. J Bone Joint Surg Am. 67:755–763. 1985.PubMed/NCBI
4	Nishimura T, Matsumoto T, Nishino M and Tomita K: Histopathologic study of veins in steroid treated rabbits. Clin Orthop Relat Res. 334:37–42. 1997. View Article : Google Scholar : PubMed/NCBI
5	Wang GJ, Lennox DW, Reger SI, et al: Cortisone-induced intrafemoral head pressure change and its response to a drilling decompression method. Clin Orthop Relat Res. 159:274–278. 1981.PubMed/NCBI
6	Arlet J: Nontraumatic avascular necrosis of the femoral head. Past, present, and future. Clin Orthop Relat Res. 277:12–21. 1992.PubMed/NCBI
7	Jones JP Jr: Fat embolism and osteonecrosis. Orthop Clin North Am. 16:595–633. 1985.PubMed/NCBI
8	Mont MA, Jones LC, Einhorn TA, Hungerford DS and Reddi AH: Osteonecrosis of the femoral head. Potential treatment with growth and differentiation factors. Clin Orthop Relat Res. (Suppl 355): S314–S335. 1998.PubMed/NCBI
9	Drescher W, Bünger MH, Weigert K, et al: Methylprednisolone enhances contraction of porcine femoral head epiphyseal arteries. Clin Orthop Relat Res. 423:112–117. 2004. View Article : Google Scholar : PubMed/NCBI
10	Drescher W, Schneider T, Becker C, Hobolth J, Rüther W, Hansen ES and Bünger C: Selective reduction of bone blood flow by short-term treatment with high-dose methylprednisolone: An experimental study in pigs. J Bone Joint Surg Br. 83:274–277. 2001. View Article : Google Scholar : PubMed/NCBI
11	Feng Y, Yang SH, Xiao BJ, Xu WH, Ye SN, Xia T, Zheng D, Liu XZ and Liao YF: Decreased in the number and function of circulation endothelial progenitor cells in patients with avascular necrosis of the femoral head. Bone. 46:32–40. 2010. View Article : Google Scholar : PubMed/NCBI
12	Fujioka M, Kubo T, Nakamura F, Shibatani M, Ueshima K, Hamaguchi H, Inoue S, Sugano N, Sakai T, Torii Y, Hasegawa Y and Hirasawa Y: Initial changes of non-traumatic osteonecrosis of femoral head in fat suppression images: bone marrow edema was not found before the appearance of band patterns. Magn Reson Imaging. 19:985–991. 2001. View Article : Google Scholar : PubMed/NCBI
13	Seckl JR and Walker BR: Minireview: 11beta-hydroxysteroid dehydrogenase type 1- a tissue-specific amplifier of glucocorticoid action. Endocrinology. 142:1371–1376. 2001.PubMed/NCBI
14	Nakano D and Nishiyama A: Programmed 11β-hydroxysteroid dehydrogenase type 2 reduction: a possible cause of adult-onset disease? J Hypertens. 29:201–203. 2011.
15	Kaur K, Hardy R, Ahasan MM, et al: Synergistic induction of local glucocorticoid generation by inflammatory cytokines and glucocorticoids: implications for inflammation associated bone loss. Ann Rheum Dis. 69:1185–1190. 2010. View Article : Google Scholar : PubMed/NCBI
16	Kitajima M, Shigematsu M, Ogawa K, et al: Effects of glucocorticoid on adipocyte size in human bone marrow. Med Mol Morphol. 40:150–156. 2007. View Article : Google Scholar : PubMed/NCBI
17	Kerachian MA, Séguin C and Harvey EJ: Glucocorticoids in osteonecrosis of the femoral head: a new understanding of the mechanisms of action. J Steroid Biochem Mol Biol. 114:121–128. 2009. View Article : Google Scholar : PubMed/NCBI
18	Matsui M, Saito S, Ohzono K, et al: Experimental steroid-induced osteonecrosis in adult rabbits with hypersensivity vasculitis. Clin Orthop Relat Res. 277:61–72. 1992.PubMed/NCBI
19	Shi B, Li G, Wang P, Yin W, Sun G, Wu Q and Yu G: Effect of antler extract on corticosteroid-induced avascular necrosis of the femoral head in rats. J Ethnopharmacol. 127:124–129. 2010. View Article : Google Scholar : PubMed/NCBI
20	Jones LC and Hungerford DS: Osteonecrosis: etiology, diagnosis, and treatment. Curr Opin Rheumatol. 16:443–449. 2004. View Article : Google Scholar : PubMed/NCBI
21	Hungerford DS: Treatment of osteonecrosis of the femoral head: everything’s new. J Arthroplasty. 22(Suppl 1): 91–94. 2007.
22	Beris AE, Payatakes AH, Kostopoulos VK, et al: Non-union of femoral neck fractures with osteonecrosis of the femoral head: treatment with combined free vascularized fibular grafting and subtrochanteric valgus osteotomy. Orthop Clin North Am. 35:335–343. 2004. View Article : Google Scholar : PubMed/NCBI
23	Nelson CL, Garrison RL, Walz BH and McLaren SG: Resurfacing of only the femoral head - treatment for young patients with osteonecrosis of the femoral head with collapse, delamination and significant head involvement. J Ark Med Soc. 100:162–163. 2003.PubMed/NCBI
24	Asano T, Takahashi KA, Fujioka M, et al: ABCB1 C3435T and G2677T/A polymorphism decreased the risk for steroid-induced osteonecrosis of the femoral head after kidney transplantation. Pharmacogenetics. 13:675–682. 2003. View Article : Google Scholar : PubMed/NCBI
25	Jones JP Jr and Sakovich L: Fat embolism of bone. A roentgenographic and histological investigation, with use of intra-arterial lipiodol, in rabbits. J Bone Joint Surg Am. 48:149–164. 1966.PubMed/NCBI
26	Jones JP: Epidemiologlcal risk factors for non-traumatic osteonecrosis. Orthopade. 29:370–379. 2000.(In German).
27	Ichiseki T, Matsumoto T, Nishino M, Kaneuji A and Katsuda S: Oxidative stress and vascular permeability in steroid-induced osteonecrosis model. J Orthop Sci. 9:509–5l. 5:2004.PubMed/NCBI
28	Starklint H, Lausten GS and Arnoldi CC: Microvascular obstruction in avascular necrosis. Immunohistochemistry of l4 femoral heads. Acta Orthop Scand. 66:9–12. 1995. View Article : Google Scholar : PubMed/NCBI