不同病因股骨头坏死样本成骨与成血管相关指标蛋白表达的差异

Difference in osteogenesis-and angiogenesis-related protein expression in femoral head samples from patients with femoral head necrosis of different etiologies

背景:股骨头坏死病因与发病机制尚不明确,急待开展深入研究加以探索。目的:检测全髋关节置换后坏死股骨头样本中坏死区骨组织Hedgehog信号通路、成骨与成血管相关标志物的蛋白表达情况,尝试探究酒精、激素与创伤等不同因素致病的机制,为后续临床对股骨头坏死的防治提供理论支持。方法:收集山东中医药大学附属医院在2017年12月至2019年12月接受全髋关节置换后的股骨头坏死与股骨颈骨折患者的股骨头样本,挑选符合纳入标准的股骨头按病因分别归入对照组、特发组、酒精组、激素组以及创伤术后组,采用Western blot法检测不同病因坏死骨组织中Hedgehog信号通路、成骨与成血管相关指标的蛋白表达情况。结果与结论:(1)通过观察各组股骨头样本的大致形态与冠状面,发现不同病因股骨头坏死患者股骨头样本在大致形态与剖面具有较为相似的病理表现,同时有相似的坏死和修复的组织学特征;(2)Western blot结果示,在不同病因股骨头坏死患者股骨头样本中成骨相关指标碱性磷酸酶、Ⅰ型胶原蛋白、骨桥蛋白及RUNX2,成血管相关指标CD31、血管内皮生长因子A与激酶插入域受体、血管性血友病因子,以及Hedgehog信号通路指标刺猬蛋白、锌指蛋白1、锌指蛋白2的蛋白表达水平相较于对照组均出现了不同程度的改变;(3)结果证明股骨头坏死的发生发展与成骨、成血管以及Hedgehog信号通路之间或存在着密切关联,而更深层机制则有待进一步研究。

BACKGROUND:The etiology and pathogenesis of femoral head necrosis are still unclear,and in-depth research is urgently needed.OBJECTIVE:To detect the protein expression of Hedgehog signaling pathway-,osteogenesis-and angiogenesis-related indicators in the necrotic femoral head samples after total hip arthroplasty,and attempt to explore the pathogenic mechanisms of different factors such as alcohol,hormones,and trauma,providing theoretical support for the subsequent clinical prevention and treatment of femoral head necrosis.METHODS:The femoral head samples were collected from patients with femoral head necrosis who underwent total hip arthroplasty in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from December 2017 to December 2019.The femoral head samples meeting the inclusion criteria were selected and classified into control group,idiopathic group,alcohol group,hormone group and post-traumatic group according to the etiology.The expression of Hedgehog signaling pathway-,osteogenesis-and angiogenesis-related indicators in necrotic bone tissues of different etiologies were detected by western blot.RESULTS AND CONCLUSION:By observing the general morphology and coronal plane of the femoral head samples in each group,it was found that the femoral head samples of patients with femoral head necrosis of different etiologies had similar pathological manifestations in general morphology and section,and had similar histological characteristics of necrosis and repair.Western blot results showed that the protein expression levels of osteogenesis-related indicators(alkaline phosphatase,type I collagen,osteopontin and RUNX2),angiogenesis-related indicators(CD31,vascular endothelial growth factor A,kinase insertion domain receptor,and von Willebrand factor),and Hedgehog signaling pathway indicators(hedgehog,zinc finger protein 1,and zinc finger protein 2)in the femoral head samples of patients with femoral head necrosis of different etiologies changed to different extents as compared with the control group.As the occurrence and development of femoral head necrosis may be closely related to osteogenesis,angiogenesis,and Hedgehog signaling pathway,further research is needed.