Notable Difference between the Development of Vertebral Fracture and Osteonecrosis of the Femoral Head in Patients Treated with High-dose Glucocorticoids for Systemic Rheumatic Diseases

Kameda, Hideto; Amano, Koichi; Nagasawa, Hayato; Ogawa, Hidenori; Sekiguchi, N.; Takei, Hiroyuki; Suzuki, Katsuya; Takeuchi, Tsutomu

doi:10.2169/internalmedicine.48.2414

Cited by 6 publications

(4 citation statements)

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“…Furthermore, the above theories do not clearly explain the occurrence of osteocyte necrosis as no cell swelling and inflammation accompany the characteristic necrosis of SANFH. Steroidal hormones, such as glucocorticoids, have been demonstrated to induce apoptosis (17). They reduce the number of osteocytes by promoting the apoptosis of osteoblasts and osteocytes, and they also affect the function of osteoblasts, retard osteogenesis and induce cell apoptosis, which results in bone loss.…”

Section: Discussionmentioning

confidence: 99%

Nitric oxide content and apoptosis rate in steroid-induced avascular necrosis of the femoral head

Bai

Liu

Zhao

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to explore the effect on nitric oxide (NO) content and osteocyte apoptosis of steroid-induced avascular necrosis of the femoral head (SANFH) in an animal model of SANFH. A total of 40 Japanese white rabbits, 5 months of age and weighing 2.5±0.5 kg, were randomly divided into groups A (hormone + endotoxin group), B (endotoxin + normal saline group), C (normal saline + hormone group) and D (control group). Following the establishment of the model, a blood sample was taken from the heart of each animal and centrifuged; the levels of NO in the serum were detected. The bilateral femoral heads were conventionally dissected, fixed, decalcified and stained with hematoxylin and eosin. Subsequently, the empty bone lacunae were counted under an optical microscope. Changes in osteocyte morphology were observed using electron microscopy and osteocyte apoptosis was detected with a terminal deoxynucleotidyl transferase dUTP nick end labeling assay. The percentage of empty bone lacunae in group A was significantly higher compared with that in groups B, C and D (P<0.01); however, there was no significant difference in percentage among groups B, C and D. The NO content in group A was significantly higher compared with that in groups B, C and D (P<0.01); however, there was no significant difference in NO content among groups B, C and D. The osteocyte apoptosis index in group A was significantly higher compared with that in the other groups (P<0.01); there was no significant difference among groups B, C and D. NO content was positively correlated with osteocyte apoptosis index (r=0.707). Thus, the present study found that NO content and the osteocyte apoptosis index were increased in SANFH, and that they play an important role in SANFH. The content of NO was positively correlated with the osteocyte apoptosis index, indicating that NO induces apoptosis.

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Section: Discussionmentioning

confidence: 99%

Nitric oxide content and apoptosis rate in steroid-induced avascular necrosis of the femoral head

Bai

Liu

Zhao

et al. 2015

Experimental and Therapeutic Medicine

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“…The comparative study of Kameda et al. presented that the progression of ONFH relied on the response to a high dose of GC therapy and a decrease in the bone mineral density value in the 1st year [ 24 ]. Saito et al.…”

Section: The Etiology and Pathogenesis Of Onfhmentioning

confidence: 99%

Evolutionary course of the femoral head osteonecrosis: Histopathological - radiologic characteristics and clinical staging systems

Chen

Liu

et al. 2022

Journal of Orthopaedic Translation

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“…The comparative study of Kameda et al . [ 6 ] showed that the development of ONFH depended on the response to a high dose of corticosteroid therapy and a decrease in the bone mineral density value in the 1 st year. The prospective study of Shigemura et al .…”

Section: Etection In the E Arlier mentioning

confidence: 99%

Corticosteroid-induced Osteonecrosis of the Femoral Head

Liu

Zhang

Sun

et al. 2017

Chinese Medical Journal

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Objective:This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral head (ONFH) based on a comprehensive analysis of the clinical literature.Data Sources:For the purpose of collecting potentially eligible articles, we searched for articles in the PubMed, Cochrane Library, Embase, and CNKI databases up to February 2017, using the following key words: “corticosteroid”, “osteonecrosis of the femoral head”, “risk factors”, “diagnosis”, “prognosis”, and “treatment”.Study Selection:Articles on relationships between corticosteroid and ONFH were selected for this review. Articles on the diagnosis, prognosis, and intervention of earlier-stage ONFH were also reviewed.Results:The incidence of corticosteroid-induced ONFH was associated with high doses of corticosteroids, and underlying diseases in certain predisposed individuals mainly occurred in the first 3 months of corticosteroid prescription. The enhanced awareness and minimized exposure to the established risk factors and earlier definitive diagnosis are essential for the success of joint preservation. When following up patients with ONFH, treatment should be started if necessary. Surgical treatment yielded better results than conservative therapy in earlier-stage ONFH. The ideal purpose of earlier intervention and treatment is permanent preservation of the femoral head without physical restrictions in daily living.Conclusions:Clinicians should enhance their precaution awareness of corticosteroid-induced ONFH. For high-risk patients, regular follow-up is very important in the 1st year after high-dose prescription of corticosteroids. Patients with suspected ONFH should be referred to orthopedists for diagnosis and treatment in its earlier stage to preserve the joint.

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Notable Difference between the Development of Vertebral Fracture and Osteonecrosis of the Femoral Head in Patients Treated with High-dose Glucocorticoids for Systemic Rheumatic Diseases

Abstract: Objective Vertebral fracture (VF) and osteonecrosis of the femoral head (OFH) are serious concerns in patients with rheumatic diseases treated with high-dose glucocorticoids (GCs

Cited by 6 publications

References 46 publications

Nitric oxide content and apoptosis rate in steroid-induced avascular necrosis of the femoral head

Nitric oxide content and apoptosis rate in steroid-induced avascular necrosis of the femoral head

Evolutionary course of the femoral head osteonecrosis: Histopathological - radiologic characteristics and clinical staging systems

Corticosteroid-induced Osteonecrosis of the Femoral Head

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