Osteonecrosis of the femoral head and glaucoma caused by topical corticosteroid application

Kabata, Tamon; Shimanuki, Keito; Shimanuki, Kiichi; Tsuchiya, Hiroyuki

doi:10.1007/s10165-011-0473-0

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…Steroid treatment is one of the most comment risk factors associated with osteonecrosis [ 6 ]. Prolonged steroid use produces a hyperlipidemic state in most patients and subsequently results in abnormal coagulopathy and bone marrow fat-cell packing, leading to microvascular occlusion and high intraosseous pressure, all of which put them at risk for osteonecrosis [ 29 ]. Therefore, many researchers postulate that a microvascular enhancing agent may prevent the conditions associated with the development of osteonecrosis.…”

Section: Discussionmentioning

confidence: 99%

Tetramethylpyrazine Enhances Vascularization and Prevents Osteonecrosis in Steroid-Treated Rats

Jiang

Chen

Wang

et al. 2015

BioMed Research International

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Steroid-induced osteonecrosis of the femoral head (steroid-induced ONFH) is an avascular necrosis disease of bone. Tetramethylpyrazine (TMP), with significant vascular protective properties, has been widely used for the treatments of ischemic neural disorders and cardiovascular diseases. However, its role in the treatment of steroid-induced ONFH has not been evaluated. In this study, our results showed that TMP significantly decreased the ratio of empty lacuna, adipose tissue area, and adipocyte perimeter in steroid-induced ONFH rats histopathologically. TMP also reduced the levels of serum lipid dramatically by haematological examination. According to the micro-CT quantification, TMP could improve the microstructure of the trabecular bone and increases bone mineral density in steroid-induced ONFH rats. Moreover, TMP significantly increased the vessel volume, vessel surface, percentage of vessel volume, and vessel thickness of the femoral heads by micro-CT. Interestingly, the downregulation of VEGF and FLK1 proteins in the sera and necrotic femoral heads could be reversed by TMP treatment, and this was true for their mRNA expressions in femoral heads. In conclusion, these findings suggest for the first time that TMP may prevent steroid-induced ONFH and also enhance femoral head vascularization by inhibiting the effect of steroid on VEGF/FLK1 signal pathway.

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Section: Discussionmentioning

confidence: 99%

Tetramethylpyrazine Enhances Vascularization and Prevents Osteonecrosis in Steroid-Treated Rats

Jiang

Chen

Wang

et al. 2015

BioMed Research International

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“…6 Two main mechanisms have been proposed in the pathogenesis of TCS and ocular disease, namely via systemic absorption and secondly through seepage over the eyelid or absorption by the eyeball through the palpebral fissure. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] The main questions arising from this search include: (i) can the periorbital application of topical steroids induce glaucoma and cataracts and, if so, what quantities are required; (ii) are individuals with known ocular disease at risk of exacerbating their condition by using TCS and (iii) can topical steroids applied on other areas of the body lead to ocular complications? 9 Glaucoma may be caused by direct contact of the TCS with the conjunctiva or through the eyelids.…”

Section: Introductionmentioning

confidence: 99%

Ocular side–effects of topical corticosteroids: what a dermatologist needs to know

Daniel

Orchard

2015

Aust J Dermatology

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Topical corticosteroids are used frequently in dermatology and atopic dermatitis without significant adverse effects. Though ocular diseases such as glaucoma and cataracts are known complications of systemic corticosteroids, the role of topical corticosteroids is limited to case reports. This review assesses the literature regarding topical steroids and their role in ocular diseases. There is evidence of harm to vision when potent topical corticosteroids are inappropriately used for prolonged periods to periorbital sites. There is no evidence to date that weak TCS to the face or potent TCS to areas other than the eyes results in ocular complications. Further research trials are required in this area.

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Pathological mechanisms and related markers of steroid-induced osteonecrosis of the femoral head

Li,

Zhao,

Leng

et al. 2024

Annals of Medicine

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Background Osteonecrosis of the femoral head (ONFH) is a refractory orthopedic disease with a high disability rate. Long-term administration of steroids is the most common pathogenic factor for non-traumatic ONFH. Early diagnosis of steroid-induced osteonecrosis of the femoral head (SONFH) is difficult and mainly depends on imaging. Objectives The objectives of this review were to examine the pathological mechanisms of SONFH, summarize related markers of SONFH, and identify areas for future studies. Methods We reviewed studies on pathological mechanisms and related markers of SONFH and discussed the relationship between them, as well as clinical applications and the outlook of potential markers. Results The pathological mechanisms of SONFH included decreased osteogenesis, lipid accumulation, increased intraosseous pressure, and microcirculation disruption. Differential proteomics and genomics play crucial roles in the occurrence, progression, and outcome of SONFH, providing novel insights into SONFH. Additionally, the biological functions of mesenchymal stem cells (MSCs) and exosomes (Exos) in SONFH have attracted increasing attention. Conclusions The pathological mechanisms of SONFH are complex. The related markers mentioned in the current review can predict the occurrence and progression of SONFH, which will help provide effective early clinical prevention and treatment strategies for SONFH.

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Osteonecrosis of the femoral head and glaucoma caused by topical corticosteroid application

Cited by 5 publications

References 12 publications

Tetramethylpyrazine Enhances Vascularization and Prevents Osteonecrosis in Steroid-Treated Rats

Tetramethylpyrazine Enhances Vascularization and Prevents Osteonecrosis in Steroid-Treated Rats

Ocular side–effects of topical corticosteroids: what a dermatologist needs to know

Pathological mechanisms and related markers of steroid-induced osteonecrosis of the femoral head

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