Department of Micro-Reconstructive Surgery, The First Teaching Hospital of Xinjiang Medical University, Urumqi 830054, PR China.
Med Hypotheses. 2011 Aug;77(2):282-5. doi: 10.1016/j.mehy.2011.04.036. Epub 2011 May 26.
Steroid-induced osteonecrosis of the femoral head (ONFH) is associated with increase of intraosseous pressure caused by elevating of adipogenesis and fat cell hypertrophy in the bone marrow, which subsequently decreases the blood flow in the femoral head and finally resulting in bone ischemia. The early femoral head-preserving method has mainly focused on the conventional core decompression procedure. However, it only achieves a slight decrease in intra-medullary pressure with limited clinical outcome. The crucial point in prevention is to achieve a thorough decompression of intra-medullary pressure and improvement of microcirculation of the femoral head. Bisphenol-A-diglycidyl ether (BADGE), an antagonism of PPAR-γ(Peroxisome proliferator-activated receptor gamma), has been shown to successfully reverse bone marrow adipogenesis and fat cell hypertrophy, enhances proliferation of osteoblasts, inhibit osteoclastogenesis. Therefore, we hypothesized that BADGE administration may be an appropriate novel method for the prevention of early stage steroid-induced ONFH.
激素诱导性股骨头坏死（ONFH）与骨髓内脂肪生成和脂肪细胞肥大导致的骨内压力增加有关，这会降低股骨头的血流量，最终导致骨缺血。早期保股骨头的方法主要集中在传统的核心减压手术上。然而，它只能使髓内压力略有下降，临床效果有限。预防的关键是实现髓内压力的彻底减压和股骨头微循环的改善。双酚 A 二缩水甘油醚（BADGE）是过氧化物酶体增殖物激活受体 γ（PPAR-γ）的拮抗剂，已被证明可以成功逆转骨髓脂肪生成和脂肪细胞肥大，增强成骨细胞的增殖，抑制破骨细胞的形成。因此，我们假设 BADGE 的给药可能是预防早期激素诱导性 ONFH 的一种合适的新方法。
