Heparanase expression in necrotic bone and peripheral blood after osteonecrosis of the femoral head

doi:10.3969/j.issn.2095-4344.2014.20.021

Abstract

Abstract:

BACKGROUND: Accumulating evidence shows that, low molecular heparin can prevent and treat early osteonecrosis of femoral head, but the mechanism remains unclear. The heparin exhibits a dynamic balance with heparanase in vivo, and inhibits heparanase expression.
OBJECTIVE: To observe the changes of heparanase and tissue factor pathway inhibitor expression level in plasma and femoral head of patients with idiopathic osteonecrosis of femoral head, and investigate the pathophysiological role of heparanase in the progression of idiopathic osteonecrosis of femoral head.
METHODS: A total of 36 patients with idiopathic osteonecrosis of femoral head were randomly divided into four groups according to ARCO I-IV period, with nine patients in each group. Patients with fresh femoral neck fracture for hip arthroplasty were included in the control group. Heparanase and tissue factor pathway inhibitor levels in preoperative venous plasma were measured by ELISA, and in subchondral necrosis bone of ARCO II-IV groups were observed for western blot analysis and hematoxylin-eosin staining.
RESULTS AND CONCLUSION: In plasma, heparanase and tissue factor pathway inhibitor levels were significantly increased along with the development of idiopathic osteonecrosis of femoral head compared with control group, the highest levels were found in ARCO III period, and then slightly decreased in ARCO IV period, showing significant differences. The protein levels of heparanase and tissue factor pathway inhibitor in necrosis bone were increased significantly compared with control group, the highest levels occurred in ARCO III period, no obvious difference was found between ARCO II and IV periods. Heparanase and tissue factor pathway inhibitor levels are gradually increased along with the development of the necrosis, and heparanase plays an important role in idiopathic osteonecrosis of femoral head.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: femur head necrosis, heparin lyase, femoral neck fractures, arthroplasty, replacement, hip

CLC Number:

R318

Tian Kai-xuan, Han Yong-tai. Heparanase expression in necrotic bone and peripheral blood after osteonecrosis of the femoral head[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(20): 3230-3235.

Figures/Tables 1

2.1 参与者数量分析纳入患者特发性股骨头坏死患者36例，股骨颈骨折患者9例，治疗过程无脱落，全部进入结果分析。 2.2 患者术前血浆中乙酰肝素酶与组织因子途径抑制物表达股骨头坏死患者术前血液中乙酰肝素酶与组织因子途径抑制物含量增高，在ARCOⅠ-Ⅲ期中逐渐增加，ARCO Ⅳ期有所降低。在ARCOⅡ、Ⅲ期中含量最多，两组之间差异无显著性意义，均与其他3组之间差异有显著性意义。ARCOⅠ期中含量高于对照组及ARCO Ⅳ期，差异有显著性意义。对照组及ARCO Ⅳ期比较差异无显著性意义，但ARCO Ⅳ期表达趋势较高。见图1。 2.3 两组患者患侧股骨头组织中乙酰肝素酶与组织因子途径抑制物表达股骨头局部中乙酰肝素酶与组织因子途径抑制物表达较对照组增加(图2A)，其表达趋势为ARCOⅡ、Ⅲ期中增高，在ARCO Ⅳ期有所降低，均较对照组高(图2B，C)。乙酰肝素酶的表达在ARCO Ⅱ-Ⅳ期中明显高于对照组，差异有显著性意义。ARCO Ⅲ期表达显著性高于ARCOⅡ期。组织因子途径抑制物表达中ARCO Ⅲ期高于ARCO Ⅱ期及对照组，差异有显著性意义。 2.4 两组患者股骨头组织病理学检查结果对照组：骨小梁完整，排列规则，骨小梁中骨细胞清晰可见，空骨陷窝少见，造血细胞丰富，脂肪细胞相对较少，形态正常。实验组：股骨头坏死组织髓腔组织中脂肪细胞直径增大，大量脂肪细胞堆积，造血组织在髓腔中的比例变小，骨小梁变稀、变细，随着坏死程度加重部分骨小梁断裂，有骨碎片出现，空骨陷窝明显增多，髓腔脂肪细胞肥大，有的相互融合成泡状，至ARCO IV期骨髓腔内造血组织明显减少，骨小梁结构紊乱，广泛地骨小梁断裂、稀疏、纤细，可见大量的空骨陷窝(图3)。"

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