Positive Correlation Between OPN And The Osteonecrosis Of The Femoral Head

Objective: Osteonecrosis of femoral head(ONFH)Is a kind of common bone disease, its main feature is the femoral head blood supply was damaged, caused the subchondral bone degeneration and necrosis, which led to the collapse of the femoral head, deformation of the structure of joint inflammation, eventually causing dysfunction. There are many causes of the disease, But there are two major classes, One is caused by trauma, Such as traumatic hip joint dislocation,fracture of neck of femur, hip joint sprain etc. Another is caused by non-traumatic causes, as a result of bronchitis, asthma, rheumatoid arthritis, diabetes, skin diseases, long-term use of hormone drugs, a large number of drinking, high blood lipid, osteoporosis, coxa plana, abnormal bone marrow hyperplasia etc. The pathogenesis of the disease complex, pathogenesis has not been clarified, But several studies have found that, there is a closely linked between bone metabolism and its development process[1].Osteopontin(OPN) is a secreted protein, its biological role is reflected in the following aspects, such as induction of cell adhesion and cell recruitment, cytokine expression, signal transduction, tumorigenesis and metastasis, mineralization, cellular immunity, participate in tissue reconstruction, like bone absorption, accelerate angiogenesism, even with atherosclerosis, autoimmune diseases and other inflammatory diseases. Osteopontin expression in the bone marrow, bone, liver, lung, kidney, pancreas tissues, cartilage in the body cells, nerve cells, epithelial cells, osteoblasts, osteoclasts, endothelialcells, bone cells, activated T cells can also express OPN, the existence of OPN in the fluid milk, serum, bile normal, it can be made by human atherosclerotic aorta endothelial cells, macrophages, it is in the atherosclerotic plaques significantly expression. There is a high concentration of OPN between bone line and periosteal plate in the bone remodeling process, It also takes part in the initiation of osteoporosis.As a result of osteopontin and bone metabolism are closely linked, the incidence of it with avascular necrosis of the femoral head may have a certain relationship. The purpose of this experiment is to study the correlation of serum and necrotic tissue osteopontin in the development of osteonecrosis of the femoral head. To provide a theoretical basis for the pathogenesis of avascular necrosis of femoral head.Method: 1.From February 2014 to August 2014, 31 patients with osteonecrosis of the femoral head were selected from Department of Orthopedics, the Third Hospital of Hebei Medical University(Diagnosis standard reference ARCO stages).There were 17 male cases, 10 female cases, the median age is 49.1. ARCO Ⅱ 11 cases, ARCO Ⅲ 10 cases, ARCO Ⅳ 10 cases. Inclusion criteria: ① Conform to the diagnosis standard. ②The Han nationality. Exclusion criteria: Suffer from medical history such as high blood pressure, heart disease, diabetes and so on. Select ten cases of health people at outpatient service physical examination as control group(remove the patients who were taken adrenal cortical hormone and cholesterol-lowering drugs recently). These 2 groups were extracted emptiness peripheral venous blood 4ml, after separat serum, placed in the refrigerator with-80℃ to test. The serum osteopontin level of two goups were detectived with enzyme-linked immunosorbent assay(ELISA). The results were analysised with statistical comparison. 2. From March 2014 to July 2014, 57 patients with osteonecrosis of the femoral head were selected from Department of Orthopedics, the Third Hospital of Hebei Medical University(Diagnosis standard reference ARCO stages).There were 43 male cases, 14 female cases, the median age is 45.0. ARCO Ⅱ 28 cases, ARCO Ⅲ 9 cases, ARCO Ⅳ 20 cases. Inclusion criteria: ① Conform to the diagnosis standard. ②The Han nationality. ③The need for bone transplantation through fenestration over the femoral head or total hip arthroplasty. Exclusion criteria: Suffer from medical history such as high blood pressure, heart disease, diabetes and so on. Randomly selected 5 patients from these 57 patients, which need for bone transplantation through fenestration over the femoral head and will take the intraoperative iliac bone specimens as normal control group. Taken in the operation of femoral head necrosis tissue and normal tissue as a specimen ofilium, after decalcification, dehydration, embedding and paraffin section, the osteopontin level of two goups were detectived with immunohistochemistry.Result: ① In osteonecrosis of the femoral head group, the levels of serum osteopontin(11.47±4.13)were significantly higher than that in healthy adults group(3.34±0.29), the difference were significant(P<0.05). ② In osteonecrosis of the femoral head group of ARCO Ⅱ, ARCO Ⅲ and ARCO Ⅳ, the levels of serum osteopontin were significantly higher than that in healthy adults group, the difference were significant(P<0.05). The levels of serum osteopontin were significantly difference between ARCO Ⅱ and ARCO Ⅳ(P<0.05). The levels of serum osteopontin were no statistical significance in ARCO Ⅱ and ARCO Ⅲ, ARCO Ⅲ and ARCO Ⅳ(P>0.05). ③The levels of osteopontin of the femoral head necrosis tissue were significantly higher than that in normal tissue.Conclusion: ① The serum osteopontin levels were elevated in patients of ONFH, maybe it plays a role in the process of the disease. ② The levels of osteopontin of the femoral head necrosis tissue were significantly higher than that in normal tissue, maybe it has close contact with the development process of the femoral head.