The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage

Abstract Bone marrow edema (BME), a notable manifestation during the progression of osteonecrosis of the femoral head (ONFH), exhibits significant associations with femoral head collapse, pain, and prognosis, howeverits’ pathogenesis remains underexplored. In this study, specimens from patients unde...

Full description

Saved in:
Bibliographic Details
Main Authors: Liang Mo, Zhangzheng Wang, Mengyu Jiang, Chi Zhou, Chao Ma, Yinuo Fan, Wei He, Zhenqiu Chen, Yuhao Liu
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-024-83376-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841544644959141888
author Liang Mo
Zhangzheng Wang
Mengyu Jiang
Chi Zhou
Chao Ma
Yinuo Fan
Wei He
Zhenqiu Chen
Yuhao Liu
author_facet Liang Mo
Zhangzheng Wang
Mengyu Jiang
Chi Zhou
Chao Ma
Yinuo Fan
Wei He
Zhenqiu Chen
Yuhao Liu
author_sort Liang Mo
collection DOAJ
description Abstract Bone marrow edema (BME), a notable manifestation during the progression of osteonecrosis of the femoral head (ONFH), exhibits significant associations with femoral head collapse, pain, and prognosis, howeverits’ pathogenesis remains underexplored. In this study, specimens from patients undergoing total hip arthroplasty (THA) were analyzed. The results revealed significantly higher Visual Analog Scale (VAS) scores and CT low-density area ratio in the BME group compared to the control group. Furthermore, Sirius Red staining exhibited fibrotic tissue in both necrotic and sclerotic areas, with more pronounced effects in the BME group. Meanwhile, data-independent Acquisition (DIA) proteomics technology was utilized to identify differentially expressed proteins (DEPs) within bone tissue. 141, 299 and 852 DEPs were identified in femoral neck, necrotic and sclerotic regions, respectively. Immune responses, inflammatory reactions and oxidative stress were markedly altered in ONFH cases with BME. In bone tissue, the levels of malondialdehyde (MDA) and proteins associated with osteoclast activity were found to be elevated in the BME group. In conclusion, BME in ONFH at pericollapse stage is associated with inflammation, fibrosis, heightened oxidative stress and increased osteoclast activity. These factors collectively elevated the risk of collapse or re-collapse. Targeted interventions aimed at neutralizing these risk factors show potential in slowing down the progression of the disease.
format Article
id doaj-art-219b712b23fb404bb04677117787c598
institution Kabale University
issn 2045-2322
language English
publishDate 2025-01-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-219b712b23fb404bb04677117787c5982025-01-12T12:22:38ZengNature PortfolioScientific Reports2045-23222025-01-0115111510.1038/s41598-024-83376-6The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stageLiang Mo0Zhangzheng Wang1Mengyu Jiang2Chi Zhou3Chao Ma4Yinuo Fan5Wei He6Zhenqiu Chen7Yuhao Liu8The First Affiliated Hospital of Guangzhou University of Chinese Medicine / Guangdong Clinical Research Academy of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese Medicine / Guangdong Clinical Research Academy of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese Medicine / Guangdong Clinical Research Academy of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese Medicine / Guangdong Clinical Research Academy of Chinese MedicineGuangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese Medicine / Guangdong Clinical Research Academy of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese Medicine / Guangdong Clinical Research Academy of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese Medicine / Guangdong Clinical Research Academy of Chinese MedicineAbstract Bone marrow edema (BME), a notable manifestation during the progression of osteonecrosis of the femoral head (ONFH), exhibits significant associations with femoral head collapse, pain, and prognosis, howeverits’ pathogenesis remains underexplored. In this study, specimens from patients undergoing total hip arthroplasty (THA) were analyzed. The results revealed significantly higher Visual Analog Scale (VAS) scores and CT low-density area ratio in the BME group compared to the control group. Furthermore, Sirius Red staining exhibited fibrotic tissue in both necrotic and sclerotic areas, with more pronounced effects in the BME group. Meanwhile, data-independent Acquisition (DIA) proteomics technology was utilized to identify differentially expressed proteins (DEPs) within bone tissue. 141, 299 and 852 DEPs were identified in femoral neck, necrotic and sclerotic regions, respectively. Immune responses, inflammatory reactions and oxidative stress were markedly altered in ONFH cases with BME. In bone tissue, the levels of malondialdehyde (MDA) and proteins associated with osteoclast activity were found to be elevated in the BME group. In conclusion, BME in ONFH at pericollapse stage is associated with inflammation, fibrosis, heightened oxidative stress and increased osteoclast activity. These factors collectively elevated the risk of collapse or re-collapse. Targeted interventions aimed at neutralizing these risk factors show potential in slowing down the progression of the disease.https://doi.org/10.1038/s41598-024-83376-6Osteonecrosis of the femoral headBone marrow edemaOsteoclastInflammationOxidative stress
spellingShingle Liang Mo
Zhangzheng Wang
Mengyu Jiang
Chi Zhou
Chao Ma
Yinuo Fan
Wei He
Zhenqiu Chen
Yuhao Liu
The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage
Scientific Reports
Osteonecrosis of the femoral head
Bone marrow edema
Osteoclast
Inflammation
Oxidative stress
title The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage
title_full The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage
title_fullStr The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage
title_full_unstemmed The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage
title_short The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage
title_sort pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage
topic Osteonecrosis of the femoral head
Bone marrow edema
Osteoclast
Inflammation
Oxidative stress
url https://doi.org/10.1038/s41598-024-83376-6
work_keys_str_mv AT liangmo thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT zhangzhengwang thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT mengyujiang thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT chizhou thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT chaoma thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT yinuofan thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT weihe thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT zhenqiuchen thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT yuhaoliu thepathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT liangmo pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT zhangzhengwang pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT mengyujiang pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT chizhou pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT chaoma pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT yinuofan pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT weihe pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT zhenqiuchen pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage
AT yuhaoliu pathomechanismofbonemarrowedemainthefemoralheadnecrosiswithpericollapsestage