Wang Jianzhong, Gao Hongyan, Wang Kunzheng, Li Wei, Shi Zhibin, Zhang Mingyu
Department of Orthopaedics, 2nd Affiliated Hospital, Xi'an Jiaotong University, Xi'an Shaanxi, 710004, P.R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Jul;23(7):777-80.
To investigate the expression levels of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL) mRNAs in BMSCs in patients suffering glucocorticoid-induced necrosis of the femoral head (GNFH), and to discuss the relationship between OPG/RANKL system and GNFH.
The bone tissue and BMSCs of femoral head were collected from 35 patients suffering GNFH (experimental group) and from 21 patients suffering fracture of femoral neck (control group). The ratio of men to women was 4:3 in two groups, aged 41 to 70 years (mean 55.34 years in the experimental group and mean 55.33 years in the control group). The patients of experimental group received over 3 weeks' glucocorticoid treatment or more than 1 week's high-dose glucocorticoid therapy in recent 2 years, but patients of the control group did not receive more than 1 week's hormone therapy. In 2 groups, the microstructure of bone tissue of femoral head was detected by HE staining. The BMSCs were isolated and cultured by adherent-wall method; the expression levels of OPG and RANKL mRNAs were examined by real-time quantitative polymerase chain reaction and the ratio of OPG mRNA to RANKL mRNA was calculated.
Bone trabeculae and bone units were replaced by interrupted bone fragments, which were surrounded by inflammation and granulation tissue and few osteocytes were seen in bone lacunae in the experimental group. In control group, bone trabeculae and bone units were made by complete lamellar bone which surrounded blood vessels and osteocytes were seen in lacunae. The expression levels of OPG mRNA in the experimental group (0.37 +/- 0.12) was significantly lower than that in the control group (0.47 +/- 0.13), and the levels of RANKL mRNA in the experimental group (1.12 +/- 0.39) was significantly higher than that in the control group (0.84 +/- 0.24), showing statistically significant difference (P < 0.05). The ratio of OPG mRNA to RANKL mRNA in the experimental group (0.37 +/- 0.17) was significantly lower than that in the control group (0.61 +/- 0.26, P < 0.05).
The GNFH may be related to the expression levels of OPG mRNA and RANKL mRNA in BMSCs.
探讨糖皮质激素性股骨头坏死（GNFH）患者骨髓间充质干细胞（BMSCs）中骨保护素（OPG）和核因子κB受体活化因子配体（RANKL）mRNA的表达水平，并探讨OPG/RANKL系统与GNFH的关系。
收集35例GNFH患者（实验组）和21例股骨颈骨折患者（对照组）的股骨头骨组织及BMSCs。两组男女比例均为4:3，年龄41～70岁（实验组平均55.34岁，对照组平均55.33岁）。实验组患者在近2年内接受过3周以上糖皮质激素治疗或1周以上大剂量糖皮质激素治疗，而对照组患者未接受过1周以上激素治疗。两组均采用苏木精-伊红（HE）染色检测股骨头骨组织的微观结构。采用贴壁法分离培养BMSCs；采用实时定量聚合酶链反应检测OPG和RANKL mRNA的表达水平，并计算OPG mRNA与RANKL mRNA的比值。
实验组骨小梁和骨单位被中断的骨碎片取代，周围有炎症和肉芽组织，骨陷窝内可见少量骨细胞。对照组骨小梁和骨单位由完整的板层骨构成，包绕血管，陷窝内可见骨细胞。实验组OPG mRNA表达水平（0.37±0.12）明显低于对照组（0.47±0.13），实验组RANKL mRNA水平（1.12±0.39）明显高于对照组（0.84±0.24），差异均有统计学意义（P<0.05）。实验组OPG mRNA与RANKL mRNA的比值（0.37±0.17）明显低于对照组（0.61±0.26，P<0.05）。
GNFH可能与BMSCs中OPG mRNA和RANKL mRNA的表达水平有关。
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