RESUMEN
BACKGROUND@#Accumulating evidence suggests that lithium influences mesenchymal stem cell (MSC) proliferation and osteogenic differentiation. As decreased bone formation in femoral heads is induced by glucocorticoids (GCs), we hypothesized that lithium has a protective effect on GC-induced osteonecrosis of femoral heads (ONFH).@*METHODS@#A rat ONFH model was induced by methylprednisolone (MP) and the effect of lithium chloride on the models was evaluated. Micro-computed tomography (CT)-based angiography and bone scanning were performed to analyze the vessels and bone structure in the femoral heads. Hematoxylin and eosin and immunohistochemical staining were performed to evaluate the trabecular structure and osteocalcin (OCN) expression, respectively. Bone marrow-derived MSCs were isolated from the models, and their proliferative and osteogenic ability was evaluated. Western blotting and quantitative real-time polymerase chain reaction were performed to detect osteogenic-related proteins including Runx2, alkaline phosphatase, and Collagen I.@*RESULTS@#Micro-CT analysis showed a high degree of osteonecrotic changes in the rats that received only MP injection. Treatment with lithium reduced this significantly in rats that received lithium (MP + Li group); while 18/20 of the femoral heads in the MP showed severe osteonecrosis, only 5/20 in the MP + Li showed mild osteonecrotic changes. The MP + Li group also displayed a higher vessel volume than the MP group (0.2193 mm3vs. 0.0811 mm3, P < 0.05), shown by micro-CT-based angiography. Furthermore, histological analysis showed better trabecular structures and more OCN expression in the femoral heads of the MP + Li group compared with the MP group. The ex vivo investigation indicated higher proliferative and osteogenic ability and upregulated osteogenic-related proteins in MSCs extracted from rats in the MP + Li group than that in the MP group.@*CONCLUSIONS@#We concluded that lithium chloride has a significant protective effect on GC-induced ONFH in rats and that lithium also enhances MSC proliferation and osteogenic differentiation in rats after GC administration.
Asunto(s)
Animales , Ratas , Diferenciación Celular , Cabeza Femoral , Necrosis de la Cabeza Femoral/tratamiento farmacológico , Glucocorticoides , Cloruro de Litio , Células Madre Mesenquimatosas , Osteogénesis , Ratas Sprague-Dawley , Microtomografía por Rayos XRESUMEN
Se estudiaron 38 pacientes con diagnóstico de enfermedad de Perthes. Los resultados se expresan sobre la base de 48 caderas afectadas. Se informa el momento de curación de las caderas clasificadas dentro de los diferentes grupos de Catterall. Se propone el tratamiento medicamentoso y fisioterapéutico dirigido a la mielodisplasia, el cual acorta la evolución natural de la enfermedad de Perthes. Se plantea la aplicación del mismo asociado con el tratamiento habitual y se indica que éste debe iniciarse preferentemente en la etapa de necrosis