Relationship of α2-Macroglobulin with Steroid-Induced Femoral Head Necrosis: A Chinese Population-Based Association Study in Southeast China

Abstract

Objective: The present study aimed to identify the relationship of α-2-macroglobulin and microvascular vessel pathology with steroid-induced femoral head necrosis in the Southeast Chinese population. Methods: This study enrolled 40 patients diagnosed with steroid-induced necrosis of the femoral head. Patients had various stages of femoral head necrosis. The differential expression of serum proteins and mRNA from patients with steroid-induced necrosis of the femoral head (SINFH) and healthy volunteers was analyzed by western blot and quantitative polymerase chain reaction (QT-PCR). The pathological change in osteocyte necrosis was indicated by hematoxylin and eosin stain and immunohistochemistry. Results: Hematoxylin and eosin stain showed histopathology changes in the necrotic area of patients with steroid-induced INFH: bone trabeculae were fewer and thinner, became broken, fragmented and structurally disordered; intraosseous adipose cells became enlarged; the arrangement of the osteoblasts became irregular; and vacant bone lacunae increased. QT-PCR showed significantly lower levels of α-2-macroglobulin in the serum of patients with SINFH than in controls (P < 0.05). Immunohistochemical staining and western blotting demonstrated that the expression of α-2-macroglobulin was significantly decreased in the necrotic area of SINFH patients (P < 0.05). Conclusion: The α-2-macroglobulin may be associated with the pathology of SINFH. The multiple pathological reactions occur in SINFH and α-2-macroglobulin may serve as a potential biomarker for the diagnosis of SINFH or a promising therapeutic target.