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Osteonecrosis of the femoral head (ONFH) is a common refractory orthopedic disease, which is one of the common causes of hip pain and dysfunction. ONFH has a very high disability rate, which is associated with a heavy burden to patients, families, and society. The pathogenesis of ONFH is not completely clear. At present, it is believed that it mainly includes coagulation dysfunction, abnormal lipid metabolism, an imbalance of osteogenic/adipogenic differentiation, and poor vascularization repair. The prevention and treatment of ONFH has always been a great challenge for clinical orthopedic surgeons. However, recent studies have emphasized that the use of mesenchymal stem cells (MSCs) to treat steroid-induced ONFH (SONFH) is a promising therapy. This review focuses on the role and molecular mechanism of epigenetic regulation in the progress of MSCs in the treatment of SONFH, and discusses the significance of the latest research in the treatment of SONFH from the perspective of epigenetics.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10813482 | PMC |
http://dx.doi.org/10.3390/biom14010004 | DOI Listing |
Zhongguo Gu Shang
August 2025
Department of Joint and Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, Gansu, China.
Steroid-induced osteonecrosis of the femoral head (SONFH) is avascular necrosis of the femoral head caused by long-erm use of corticosteroids, and its pathogenesis is complex and affected by changes in the dynamic balance of the bone microenvironment. With the deepening of research, the role of bone microenvironment in the pathogenesis of SONFH has been gradually revealed. In the case of excessive use of glucocorticoids (GCs), the bone microenvironment changes significantly, causing imbalance in bone lipid metabolism, microcirculation disorders and disorders of immune regulation, which promotes the increase of the number and activity of osteoclasts, and interferes with the differentiation of osteoblasts and adipoblasts.
View Article and Find Full Text PDFFront Immunol
August 2025
Department of Orthopedic, The First Hospital of Lanzhou University Gansu, Lanzhou, China.
Steroid-induced osteonecrosis of the femoral head (SONFH) represents a prevalent and complex orthopedic condition, intricately linked to multifaceted dysregulation of the immune system. Prolonged administration of high doses of GCs (GCs) represents a major cause of non-traumatic osteonecrosis of the femoral head (ONFH), with its pathogenesis rooted in the interaction between immune cell dysfunction and imbalances in bone metabolism. This review systematically explores the molecular mechanisms through which GCs induce osteonecrosis via immunological pathways, with emphasis on the impact of macrophage polarization imbalance on the disruption of the bone immune microenvironment.
View Article and Find Full Text PDFJ Orthop Surg Res
August 2025
College of Sports Medicine and Rehabilitation, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, Shandong, China.
Background: Osteonecrosis of the femoral head (ONFH) is a progressive, debilitating orthopedic condition that primarily results from compromised vascular supply. Chronic alcohol intake is a well-established non-traumatic etiological factor in ONFH. Despite the increasing global research on ONFH, a bibliometric analysis using explicit literature searches in Web of Science reveals that no studies have specifically focused on alcohol-induced osteonecrosis of the femoral head (AONFH).
View Article and Find Full Text PDFReports (MDPI)
May 2025
Traumatology Department, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia.
Osteonecrosis of the femoral head (ONFH) is a disease of the epiphysis caused by the death of osteocytes and osteoblasts, resulting in debilitating pain. ONFH can be traumatic or nontraumatic, with prolonged glucocorticoid use being the leading cause of nontraumatic ONFH. Atopic dermatitis (AD) is a chronic inflammatory skin condition typically treated with topical corticosteroids.
View Article and Find Full Text PDFBiochem Pharmacol
September 2025
Department of Orthopedics, China-Japan Friendship Hospital, Beijing 100029, China. Electronic address:
Osteonecrosis of the femoral head (ONFH) is a debilitating condition often linked to glucocorticoid use. This research aims to explore the influence of mammalian sterile 20-like kinase 1 (Mst1) on glucocorticoid-induced ONFH, particularly its effects on bone microvascular endothelial cells (BMECs). Methylprednisolone (MPS) was applied to induce BMECs injury in vitro, with or without Mst1 inhibition via shRNA.
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