Corticosteroid-induced osteoporosis and osteonecrosis: Role of oxidative stress

Abstract

Glucocorticoids (GC) play a significant role in body metabolism. In the last few years, advances and highlights have been made to understand the role of oxidative stress induced by corticosteroids in the pathogenesis of osteonecrosis (ON) and osteoporosis (OP) and the door for digging in GC mechanistic has been opened by the newly detection of high-affinity receptors for glucocorticoids and calcitriol in bones. The harmful free radicals produced by corticosteroid administration are strong emitters of many regulatory cytokines such as tumor necrosis factor (TNF), nuclear factor kappa β (NF-kB) and interleukins. For this, a great attention has been directed toward the possibility of using a novel free radical scavenger like natural antioxidant, e.g. ginseng, that can be helpful in the management of ON and OP. The use of antioxidants for the management of osteoporosis characterized by many improvements in the way of control the incidence rate of ON and OP. Many antioxidants have an anti-osteoporotic effect, with an overall redox state maintenance. Also, the lipid peroxides are alleviated and the intraosseous vascular integrity within the bone marrow are repaired. Moreover, the oxidative damage of DNA is contoured. The objective of this review is to highlight the role of oxidative stress in the pathogenesis of corticosteroid-induced osteonecrosis (ON) and osteoporosis (OP) and studying the possibility of using a novel free radical scavenger, a natural antioxidant, e.g. Ginseng, that can be helpful in the management of OP & ON.