ABSTRACT
BACKGROUND: In recent years, the incidence of non-traumatic femoral head necrosis has increased gradually. It has the characteristics of insidious onset, rapid development of disease and high disability rate, bringing a great burden to patients, their families and society. Confirming its pathogenesis is of great significance for the early effective treatment of non-traumatic femoral head necrosis. OBJECTIVE: To review the relevant literature worldwide and to summarize the research progress of osteogenic signaling pathways in the pathogenesis of non-traumatic femoral head necrosis. METHODS: PubMed, Embase, Medline, CNKI, VIP and WanFang databases were retrieved with the keywords of “non-traumatic osteonecrosis of femoral head, osteogenesis, signaling pathways, pathogenesis, Wnt/β-catenin, PPARy, TGF-β/Smad, PI3K/AKT, MAPK, Notch” in English and Chinese, respectively. The articles concerning mechanism and application of osteogenic signaling pathways associated with avascular necrosis of the femoral head were included. RESULTS AND CONCLUSION: Recently, the role of osteogenic signaling pathways in non-traumatic femoral head necrosis has received increasing attentions. The abnormal differentiation of bone marrow mesenchymal stem cells in the development of non-traumatic femoral head necrosis has also become an issue of concern. Abnormal differentiation of bone marrow mesenchymal stem cells, inhibition of osteogenic differentiation, increased bone destruction, and imbalance of bone metabolism may be the main cause of non-traumatic femoral head necrosis, and Wnt/β-catenin, PPARy, TGF-β/Smad, PI3K/AKT, MAPK, Notch and other osteogenic signaling pathways may be a viable approach to intervention for non-traumatic femoral head necrosis. Although a large number of in vitro and animal studies have confirmed that osteogenic signaling pathway may have the potential to regulate bone marrow mesenchymal stem cell differentiation and reverse femoral head necrosis, its specific mechanism of action remains unclear and little is reported on its clinical applications. Therefore, exploring the mechanism of signaling pathways and accelerating its clinical use are the directions of the future research.
ABSTRACT
Objective The scope of this study was aimed to explore the relationship between serum Ghrelin levels and disease severity in non-traumatic ONFH patients. Methods 84 non-traumatic ONFH patients and 84 healthy controls were enrolled for this study in our hospital. The radiographic progression was determined by FICAT grading system. The clinical severity was evaluated by visual analogue scale(VAS),Harris hip scores(HSS). The serum APN concentrations were examined by enzyme-linked immunosorbent assay(ELISA).Serum adiponectin and IL-33 levels were also examined. The relationship between serum Ghrelin levels and radiographic severity,clinical severity and biochemical indices were investigated. Results Serum Ghrelin levels were significantly lower in ONFH patients than in healthy controls. Serum Ghrelin levels were negatively correlated with FICAT grading system. In addition,Serum Ghrelin levels were also negatively related to VAS scores and positively associated with HSS scores ,Last ,Serum Ghrelin levels were positively with adiponectin levels and negatively correlated with IL-33 levels. Conclusion Serum Ghrelin levels in non-traumatic ONFH patients were negatively associated with the disease severity. Decreased serum Ghrelin levels may reflect disease severity of non-traumatic ONFH.