Li Weizhe, Sakai Takashi, Nishii Takashi, Nakamura Nobuo, Takao Masaki, Yoshikawa Hideki, Sugano Nobuhiko
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
J Orthop Res. 2009 May;27(5):694-700. doi: 10.1002/jor.20802.
Osteogenesis and angiogenesis are closely associated with the reparative process in bone. In osteonecrosis of the femoral head (ONFH), although the progression of bone resorption by osteoclasts is considered to be followed by femoral head collapse, the reparative reaction remains unknown. In order to investigate the reparative reaction in patients with ONFH, the distribution of TRAP- positive cells and expression of HIF-1alpha, VEGF, and FGF-2 were observed in 51 hips in 42 patients. TRAP-positive cells were detected around the teres insertion and retinaculum in the early radiologic stage, and increased around the new trabecular bone throughout the reparative interface zone in the late collapsed stage. HIF-1alpha expression was detected at the fibrosis area and the transitional area, which included the proximal area of the reparative interface zone adjacent to the necrotic zone. VEGF was expressed at the edematous area of the reparative interface zone, while FGF-2 was detected widely in the reparative interface zone and the normal zone. In the late radiologic stages, HIF-1alpha, VEGF, and FGF-2 were not detected in the necrotic zone, and they acted in angiogenesis in the reparative interface zone, while TRAP-positive cells increased around the new bone formation in response to remodeling after the collapse.
骨生成和血管生成与骨的修复过程密切相关。在股骨头坏死（ONFH）中，尽管破骨细胞引起的骨吸收进展被认为会导致股骨头塌陷，但其修复反应仍不清楚。为了研究ONFH患者的修复反应，观察了42例患者51个髋关节中抗酒石酸酸性磷酸酶（TRAP）阳性细胞的分布以及低氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）和碱性成纤维细胞生长因子-2（FGF-2）的表达。在早期放射学阶段，在圆韧带附着处和支持带周围检测到TRAP阳性细胞，在晚期塌陷阶段，整个修复界面区新小梁骨周围的TRAP阳性细胞增多。在纤维化区域和过渡区域检测到HIF-1α表达，过渡区域包括与坏死区相邻的修复界面区近端。VEGF在修复界面区的水肿区域表达，而FGF-2在修复界面区和正常区域广泛检测到。在晚期放射学阶段，坏死区未检测到HIF-1α、VEGF和FGF-2，它们在修复界面区的血管生成中起作用，而TRAP阳性细胞在塌陷后响应重塑在新骨形成周围增多。
