2023, Vol. 27 ›› Issue (9): 1469-1476

Hormonal osteonecrosis and oxidative stress

Dang Yi1, Du Chengyan2, Yao Honglin2, Yuan Nenghua2, Cao Jin1, Xiong Shan1, Zhang Dingmei1, Wang Xin1

1Department of Orthopedics, 2Operating Room, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China

Received:2021-12-30 Accepted:2022-01-30 Online:2023-03-28 Published:2022-07-02
Contact: Wang Xin, MD, Chief physician, Doctoral supervisor, Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China Zhang Dingmei, MD, Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
About author:Dang Yi, Master candidate, Department of Orthopedics, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China Du Chengyan, Operating Room, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China Dang Yi and Du Chengyan contributed equally to this article.
Supported by:
National Natural Science Foundation of China, No. 31960209, 31760266 (to WX); Basic Research Program of Guizhou Science and Technology Department, No. Guizhou Science and Technology Foundation [2020]1Y093 (to WX); Science and Technology Fund of Guizhou Provincial Health Commission, No. gzwkj2022-108 (to ZDM); Graduate Research Fund of Zunyi Medical University, No. ZYK63 (to CJ); Graduate Research Fund of Zunyi Medical University, No. ZYK57 (to XS)

Abstract: BACKGROUND: The exact mechanism of glucocorticoid induced osteonecrosis is still unclear, and oxidative stress is one of the important mechanisms.
OBJECTIVE: To summarize the relationship between hormonal osteonecrosis and oxidative stress, and to understand the pathogenesis of oxidative stress in hormonal osteonecrosis by reviewing the currently known relevant literature.
METHODS: CNKI, Wanfang, VIP, CBM and PubMed databases were searched for articles regarding research progress of hormonal osteonecrosis and oxidative stress. After preliminarily screened by reading abstracts, a total of 96 articles were finally included for review.
RESULTS AND CONCLUSION: (1) Reactive oxygen species closely links the signal network formed by mesenchymal stem cells, osteocytes, osteoblasts, osteoclasts, and blood vessels to inhibit their osteogenesis and angiogenesis, thus playing an important role in steroid-induced femoral head necrosis. (2) The article explains separately the role of reactive oxygen species in bone metabolism, which mainly regulates cell proliferation, apoptosis and differentiation in bone metabolism through Wnt/β-catenin, MAPK, nuclear factor-κB and PI3K/AKT signaling pathways, thus mediating bone formation and resorption imbalance induced by glucocorticoid. (3) Due to the complex mechanism of hormone osteonecrosis at present, the specific mechanism and process are not clear. In addition, due to the current technical limitations, antioxidant strategies have not had a significant impact on the disease. (4) The mechanism of oxidative stress in steroid-induced osteonecrosis of the femoral head should be further studied based on existing mechanisms. Furthermore, different signaling pathways involved in reactive oxygen species regulation were further analyzed to provide therapeutic targets for clinical treatment of osteonecrosis.
Key words: glucocorticoid, osteonecrosis, oxidative stress, bone metabolism, bone marrow mesenchymal stem cells, osteoblast, osteoclast, blood vessels, signal pathway, review

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