Chinese Journal of Tissue Engineering Research ›› 2024, Vol. 28 ›› Issue (2): 200-207.doi: 10.12307/2023.830

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Mechanism of compound Shengmai Chenggu capsule in the repair of steroid-induced osteonecrosis of the femoral head

Lin Tianye1, 2, Wu Zhiming3, Zhang Wensheng1, 2, He Xiaoming1, 2, He Mincong1, 2, Zhang Qingwen1, 2, He Wei1, 2, Wei Qiushi1, 2, Li Ziqi1, 2   

  1. 1Guangdong Institute of Traditional Chinese Medicine for Bone Trauma, Guangzhou 510405, Guangdong Province, China; 2The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 3The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510080, Guangdong Province, China
  • Received:2022-10-08 Accepted:2022-11-17 Online:2024-01-18 Published:2023-06-30
  • Contact: Li Ziqi, Master, Attending physician, Guangdong Institute of Traditional Chinese Medicine for Bone Trauma, Guangzhou 510405, Guangdong Province, China; The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • About author:Lin Tianye, MD, Attending physician, Guangdong Institute of Traditional Chinese Medicine for Bone Trauma, Guangzhou 510405, Guangdong Province, China; The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:
    National Natural Science Foundation of China (Youth Project), No. 81904226 (to LZQ); National Natural Science Foundation of China (General Project), No. 81873327 (to HW); Guangdong Provincial Administration of Traditional Chinese Medicine Project, No. 20223012 (to ZQW); Guangdong Institute of Traditional Chinese Medicine for Bone Trauma Development Project, No. GYY202102-03 (to ZQW)

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Abstract: BACKGROUND: Compound Shengmai Chenggu capsule has good therapeutic effects on early steroid-induced osteonecrosis of the femoral head, but the exact mechanism of treatment is not fully understood.
OBJECTIVE: To observe the effect of compound Shengmai Chenggu capsule on fucosyltransferase 8, osteogenic gene and Wnt/β-catenin in bone tissue of rats with steroid-induced osteonecrosis of the femoral head.
METHODS: Sixty Sprague-Dawley rats were randomized into blank group, model group, low-, middle-, and high-dose drug groups (n=12 per group). In the latter four groups, animal models of steroid-induced osteonecrosis of the femoral head were established by subcutaneous injection of imiquimod (once every 2 weeks, 2 times in total) and gluteal muscle injection of methylprednisolone (once a week, 4 times in total). The low-, middle- and high-dose drug groups were given 1.89, 3.78 and 7.56 g/kg per day compound Shengmai Chenggu capsule solution by gavage respectively on the second day after the last modeling. The same amount of saline was given by gavage to the model group. Administration lasted 8 weeks. After the administration, micro-CT scan, histological staining, compression test, RT-qPCR and western blot were performed on the femoral head.
RESULTS AND CONCLUSION: Micro-CT scan results showed that compared with the blank group, trabecular volume fraction, trabecular number and trabecular thickness were significantly decreased (P < 0.05), while trabecular separation was increased in the model group (P < 0.05). Compared with the model group, the compound Shengmai Chenggu capsule could increase trabecular volume fraction, trabecular number and trabecular thickness (P < 0.05), and decrease trabecular separation (P < 0.05) in a dose-dependent manner. Hematoxylin-eosin staining results showed that compared with the model group, the rate of empty bone lacunae was reduced in a dose-dependent group in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups 
(P < 0.05). Immunohistochemical staining results showed that compared with the blank group, the protein expression of fucosyltransferase 8, Runx2 and bone morphogenetic protein 2 was reduced in the model group (P < 0.05); compared with the model group, the compound Shengmai Chenggu capsule increased the protein expression of fucosyltransferase 8, Runx2 and bone morphogenetic protein 2 in a dose-dependent manner (P < 0.05). Results from the compression test showed that there was a dose-dependent increase in the maximum load and elastic modulus of the femoral head in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups compared with the model group (P < 0.05). RT-qPCR and western blot results showed that the mRNA and protein expressions of fucosyltransferase 8, Runx2, alkaline phosphatase, osteocalcin, osteoblast-specific transcription factor and bone morphogenetic protein 2 were decreased in the model group compared with the blank group (P < 0.05); compared with the model group, there was a dose-dependent increase in the mRNA and protein expressions of the above indicators in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups compared with the model group (P < 0.05). Compared with the blank group, the mRNA and protein expression of Wnt2, low-density lipoprotein receptor-related protein 5 and β-catenin were decreased (P < 0.05) and the mRNA and protein expressions of glycogen synthase kinase 3β were increased (P < 0.05) in the model group; compared with the model group, there was a dose-dependent increase in the mRNA and protein expressions of Wnt2, low-density lipoprotein receptor-related protein 5 and β-catenin (P < 0.05) but a dose-dependent decrease in the mRNA and protein expressions of lycogen synthase kinase 3β (P < 0.05) in the low-, middle-, and high-dose compound Shengmai Chenggu capsule groups. To conclude, the mechanism by which the compound Shengmai Chenggu capsule treats steroid-induced osteonecrosis of the femoral head may activate the Wnt/β-catenin signaling pathway through the up-regulation of fucosyltransferase 8, thereby promoting bone formation.

Key words: steroid-induced osteonecrosis of the femoral head, compound Shengmai Chenggu capsule, fucosyltransferase 8, osteogenesis, core fucosylation

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