Advances in the mechanism for steroid-induced osteonecrosis of the femoral head

Runze Zhou , Yixin Bian , Xuejie Cai , Hanyang Sun , Zehui Lv , Yiming Xu , Yingjie Wang , Han Wang , Wei Zhu , Bin Feng , Xisheng Weng

Bone Research ›› 2026, Vol. 14 ›› Issue (1) : 23

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Bone Research ›› 2026, Vol. 14 ›› Issue (1) :23 DOI: 10.1038/s41413-025-00477-2
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Advances in the mechanism for steroid-induced osteonecrosis of the femoral head

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Abstract

Steroid-induced osteonecrosis of the femoral head (SONFH) is a debilitating condition resulting from the use of glucocorticoids, commonly prescribed for immune-related and inflammatory diseases. Understanding the mechanisms driving SONFH remains a significant challenge, complicating efforts to prevent and treat the condition. While genetic predispositions, impaired blood supply, and metabolic changes are recognized contributors, the complex interplay between these factors is not yet fully understood. Recent research has shed light on the pathogenesis of SONFH, exploring it from multiple perspectives, including tissue-level damage, cellular dysfunction, and molecular pathways. This review summarizes these recent advancements, providing an integrated understanding of the onset and progression of the condition. Additionally, it highlights emerging therapeutic strategies that potentially pave the way for more effective treatments in the future.

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Runze Zhou, Yixin Bian, Xuejie Cai, Hanyang Sun, Zehui Lv, Yiming Xu, Yingjie Wang, Han Wang, Wei Zhu, Bin Feng, Xisheng Weng. Advances in the mechanism for steroid-induced osteonecrosis of the femoral head. Bone Research, 2026, 14(1): 23 DOI:10.1038/s41413-025-00477-2

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References

[1]

Guerado E, Caso E. The physiopathology of avascular necrosis of the femoral head: an update. Injury, 2016, 47: S16-S26

[2]

Zhao Det al.. Guidelines for clinical diagnosis and treatment of osteonecrosis of the femoral head in adults (2019 version). J. Orthop. Transl., 2020, 21: 100-110

[3]

Bullough PG, DiCarlo EF. Subchondral avascular necrosis: a common cause of arthritis. Ann. Rheum. Dis., 1990, 49: 412-420

[4]

Buddhiraju Aet al.. Epidemiology, management, and systematic review of surgical trends for patients who have osteonecrosis of the femoral head. J. Arthroplasty, 2025, 40: S112-S119

[5]

Ikeuchi Ket al.. Epidemiology of nontraumatic osteonecrosis of the femoral head in Japan. Mod. Rheumatol., 2015, 25: 278-281

[6]

Seamon J, Keller T, Saleh J, Cui Q. The pathogenesis of nontraumatic osteonecrosis. Arthritis, 2012, 2012: 601763

[7]

Che Zet al.. Emerging roles of growth factors in osteonecrosis of the femoral head. Front. Genet., 2022, 13: 1037190

[8]

Yu Het al.. Decreased angiogenic and increased apoptotic activities of bone microvascular endothelial cells in patients with glucocorticoid-induced osteonecrosis of the femoral head. BMC Musculoskelet. Disord., 2020, 21 277

[9]

Huang C, Wen Z, Niu J, Lin S, Wang W. Steroid-induced osteonecrosis of the femoral head: novel insight into the roles of bone endothelial cells in pathogenesis and treatment. Front. Cell Dev. Biol., 2021, 9: 777697

[10]

Migliorini Fet al.. Failure and progression to total hip arthroplasty among the treatments for femoral head osteonecrosis: a Bayesian network meta-analysis. Br. Med. Bull., 2021, 138: 112-125

[11]

Swarup Iet al.. Implant survival and patient-reported outcomes after total hip arthroplasty in young patients. J. Arthroplasty, 2018, 33: 2893-2898

[12]

Evans RM. The steroid and thyroid hormone receptor superfamily. Science, 1988, 240: 889-895

[13]

Pratt WB, Toft DO. Steroid receptor interactions with heat shock protein and immunophilin chaperones. Endocr. Rev., 1997, 18: 306-360

[14]

Pratt WB, Toft DO. Regulation of signaling protein function and trafficking by the hsp90/hsp70-based chaperone machinery. Exp. Biol. Med., 2003, 228: 111-133

[15]

Grad, I. & Picard, D. The glucocorticoid responses are shaped by molecular chaperones. Mol. Cell. Endocrinol.275 (2007).

[16]

George, G. & Lane, J. M. Osteonecrosis of the femoral head. J. Am. Acad. Orthop. Surg. Glob. Res. Rev.6 (2022).

[17]

Konarski, W. et al. Osteonecrosis related to steroid and alcohol use-an update on pathogenesis. Healthcare11, 1846 (2023).

[18]

Maestro-Paramio L, García-Rey E, Bensiamar F, Saldaña L. Osteoblast function in patients with idiopathic osteonecrosis of the femoral head : implications for a possible novel therapy. Bone Jt. Res., 2021, 10: 619-628

[19]

Liao Zet al.. Single-cell transcriptome analysis reveals aberrant stromal cells and heterogeneous endothelial cells in alcohol-induced osteonecrosis of the femoral head. Commun. Biol., 2022, 5: 324

[20]

Feng Set al.. Abnormal spatial patterns of intrinsic brain activity in osteonecrosis of the femoral head: a resting-state functional magnetic resonance imaging study. Front. Hum. Neurosci., 2020, 14: 551470

[21]

Sakamoto Yet al.. Genome-wide association study of idiopathic osteonecrosis of the femoral head. Sci. Rep., 2017, 7 15035

[22]

Xing X-Xet al.. High-order brain networks abnormalities in osteonecrosis of the femoral head patients: an independent component analysis of resting-state fMRI. Pain Physician, 2022, 25: E1475-E1484

[23]

Zlotorowicz M, Czubak J, Caban A, Kozinski P, Boguslawska-Walecka R. The blood supply to the femoral head after posterior fracture/dislocation of the hip, assessed by CT angiography. Bone Jt. J., 2013, 95-B: 1453-1457

[24]

Zheng G-S, Qiu X, Wang B-J, Zhao D-W. Relationship between blood flow and collapse of nontraumatic osteonecrosis of the femoral head. J. Bone Jt. Surg. Am., 2022, 104: 13-18

[25]

Boss JH, Misselevich I. Osteonecrosis of the femoral head of laboratory animals: the lessons learned from a comparative study of osteonecrosis in man and experimental animals. Vet. Pathol., 2003, 40: 345-354

[26]

Li Pet al.. Quantitative analysis of local microcirculation changes in early osteonecrosis of femoral head: DCE-MRI findings. Front. Surg., 2022, 9: 1003879

[27]

Drescher Wet al.. Selective reduction of bone blood flow by short-term treatment with high-dose methylprednisolone. An experimental study in pigs. J. Bone Jt. Surg. Br., 2001, 83: 274-277

[28]

Wu, R.-W. et al. S100 calcium binding protein A9 represses angiogenic activity and aggravates osteonecrosis of the femoral head. Int. J. Mol. Sci. 20, 5768 (2019).

[29]

Guo M, Zhang J. Vitamin B2 prevents glucocorticoid-caused damage of blood vessels in osteonecrosis of the femoral head. Biomed. Res. Int., 2022, 2022: 4006184

[30]

Fraitzl CR, Kappe T, Brugger A, Billich C, Reichel H. Reduced head-neck offset in nontraumatic osteonecrosis of the femoral head. Arch. Orthop. Trauma Surg., 2013, 133: 1055-1060

[31]

Karasuyama Ket al.. The role of sclerotic changes in the starting mechanisms of collapse: a histomorphometric and FEM study on the femoral head of osteonecrosis. Bone, 2015, 81: 644-648

[32]

Tingart Met al.. Influence of factors regulating bone formation and remodeling on bone quality in osteonecrosis of the femoral head. Calcif. Tissue Int., 2008, 82: 300-308

[33]

Wang L, You X, Zhang L, Zhang C, Zou W. Mechanical regulation of bone remodeling. Bone Res., 2022, 10: 16

[34]

Du Get al.. Roles of TRPV4 and piezo channels in stretch-evoked Ca2+ response in chondrocytes. Exp. Biol. Med., 2020, 245: 180-189

[35]

Qin Let al.. Roles of mechanosensitive channel Piezo1/2 proteins in skeleton and other tissues. Bone Res., 2021, 9: 44

[36]

Xu, X. et al. Piezo channels: awesome mechanosensitive structures in cellular mechanotransduction and their role in bone. Int. J. Mol. Sci. 22, 6429 (2021).

[37]

Wan Q-Qet al.. Crosstalk between bone and nerves within bone. Adv. Sci., 2021, 8: 2003390

[38]

Jia Set al.. Calcitonin gene-related peptide enhances osteogenic differentiation and recruitment of bone marrow mesenchymal stem cells in rats. Exp. Ther. Med., 2019, 18: 1039-1046

[39]

Liu Xet al.. Postmenopausal osteoporosis is associated with the regulation of SP, CGRP, VIP, and NPY. Biomed. Pharmacother., 2018, 104: 742-750

[40]

Juhász T, Helgadottir SL, Tamás A, Reglődi D, Zákány R. PACAP and VIP signaling in chondrogenesis and osteogenesis. Peptides, 2015, 66: 51-57

[41]

Sousa DMet al.. Ablation of Y1 receptor impairs osteoclast bone-resorbing activity. Sci. Rep., 2016, 6 33470

[42]

Adamus MA, Dabrowski ZJ. Effect of the neuropeptide substance P on the rat bone marrow-derived osteogenic cells in vitro. J. Cell. Biochem., 2001, 81: 499-506

[43]

Wang L, Wang N, Li M, Wang K. To investigate the role of the nervous system of bone in steroid-induced osteonecrosis in rabbits. Osteoporos. Int., 2010, 21: 2057-2066

[44]

Lv X, Gao F, Cao X. Skeletal interoception in bone homeostasis and pain. Cell Metab., 2022, 34: 1914-1931

[45]

Chen Het al.. Prostaglandin E2 mediates sensory nerve regulation of bone homeostasis. Nat. Commun., 2019, 10 181

[46]

Hu Bet al.. Sensory nerves regulate mesenchymal stromal cell lineage commitment by tuning sympathetic tones. J. Clin. Invest., 2020, 130: 3483-3498

[47]

Lv, X. et al. Skeleton interoception regulates bone and fat metabolism through hypothalamic neuroendocrine NPY. eLife10, e70324 (2021)

[48]

Stefanakis Ket al.. Leptin physiology and pathophysiology in energy homeostasis, immune function, neuroendocrine regulation and bone health. Metabolism, 2024, 161: 156056

[49]

Canalis E, Mazziotti G, Giustina A, Bilezikian JP. Glucocorticoid-induced osteoporosis: pathophysiology and therapy. Osteoporos. Int., 2007, 18: 1319-1328

[50]

Zhang, L. et al. Bidirectional control of parathyroid hormone and bone mass by subfornical organ. Neuron111, 1914–1932 (2023).

[51]

Zhang Yet al.. Role of RASA1 in cancer: a review and update (review). Oncol. Rep., 2020, 44: 2386-2396

[52]

Yue JAet al.. Effect of glucocorticoids on miRNA expression spectrum of rat femoral head microcirculation endothelial cells. Gene, 2018, 651: 126-133

[53]

Kusumbe AP, Ramasamy SK, Adams RH. Coupling of angiogenesis and osteogenesis by a specific vessel subtype in bone. Nature, 2014, 507: 323-328

[54]

Patel J, Donovan P, Khosrotehrani K. Concise review: functional definition of endothelial progenitor cells: a molecular perspective. Stem Cells Transl. Med., 2016, 5: 1302-1306

[55]

Rehman J, Li J, Orschell CM, March KL. Peripheral blood “endothelial progenitor cells” are derived from monocyte/macrophages and secrete angiogenic growth factors. Circulation, 2003, 107: 1164-1169

[56]

Madonna R, De Caterina R. Circulating endothelial progenitor cells: do they live up to their name?. Vasc. Pharmacol., 2015, 67-69: 2-5

[57]

Dimova Iet al.. SDF-1/CXCR4 signalling is involved in blood vessel growth and remodelling by intussusception. J. Cell. Mol. Med., 2019, 23: 3916-3926

[58]

Chen Cet al.. Impairment of two types of circulating endothelial progenitor cells in patients with glucocorticoid-induced avascular osteonecrosis of the femoral head. Jt. Bone Spine, 2013, 80: 70-76

[59]

Wan Wet al.. TGF-β1 promotes osteogenesis of mesenchymal stem cells via integrin mediated mechanical positive autoregulation. iScience, 2024, 27: 110262

[60]

Tsukasaki M, Takayanagi H. Osteoimmunology: evolving concepts in bone-immune interactions in health and disease. Nat. Rev. Immunol., 2019, 19: 626-642

[61]

Ma Met al.. Osteoimmunology and osteonecrosis of the femoral head. Bone Jt. Res., 2022, 11: 26-28

[62]

Jiang Cet al.. Astragaloside IV ameliorates steroid-induced osteonecrosis of the femoral head by repolarizing the phenotype of pro-inflammatory macrophages. Int. Immunopharmacol., 2021, 93: 107345

[63]

Zhang Q, Sun W, Li T, Liu F. Polarization behavior of bone macrophage as well as associated osteoimmunity in glucocorticoid-induced osteonecrosis of the femoral head. J. Inflamm. Res., 2023, 16: 879-894

[64]

Adapala NS, Yamaguchi R, Phipps M, Aruwajoye O, Kim HKW. Necrotic bone stimulates proinflammatory responses in macrophages through the activation of toll-like receptor 4. Am. J. Pathol., 2016, 186: 2987-2999

[65]

Vandewalle J, Luypaert A, De Bosscher K, Libert C. Therapeutic mechanisms of glucocorticoids. Trends Endocrinol. Metab., 2018, 29: 42-54

[66]

Luvanda, M. K. et al. Dexamethasone promotes Aspergillus fumigatus growth in macrophages by triggering M2 repolarization via targeting PKM2. J. Fungi7, 70 (2021).

[67]

Song H-Met al.. Effects of Wenyangbushen formula on the expression of VEGF, OPG, RANK and RANKL in rabbits with steroid-induced femoral head avascular necrosis. Mol. Med. Rep., 2015, 12: 8155-8161

[68]

Conaway HH, Henning P, Lie A, Tuckermann J, Lerner UH. Activation of dimeric glucocorticoid receptors in osteoclast progenitors potentiates RANKL induced mature osteoclast bone resorbing activity. Bone, 2016, 93: 43-54

[69]

Dong Het al.. Excessive glucocorticoids combined with RANKL promote the differentiation of bone marrow macrophages (BMM) into osteoclasts and accelerate the progression of osteoporosis by activating the SYK/SHP2/NF-κB signaling pathway. Aging, 2024, 16: 12263-12276

[70]

Shi Jet al.. Glucocorticoids: dose-related effects on osteoclast formation and function via reactive oxygen species and autophagy. Bone, 2015, 79: 222-232

[71]

Sun Yet al.. Macrophage-osteoclast associations: origin, polarization, and subgroups. Front. Immunol., 2021, 12: 778078

[72]

Zou Det al.. Th17 and IL-17 exhibit higher levels in osteonecrosis of the femoral head and have a positive correlation with severity of pain. Endokrynol. Pol., 2018, 69: 283-290

[73]

Ren G-Wet al.. Network-based pharmacology and bioinformatics study on the mechanism of action of Gujiansan in the treatment of steroid-induced avascular necrosis of the femoral head. Biomed. Res. Int., 2022, 2022: 8080679

[74]

Geng W, Zhang W, Ma J. IL-9 exhibits elevated expression in osteonecrosis of femoral head patients and promotes cartilage degradation through activation of JAK-STAT signaling in vitro. Int. Immunopharmacol., 2018, 60: 228-234

[75]

Beriou Get al.. TGF-beta induces IL-9 production from human Th17 cells. J. Immunol., 2010, 185: 46-54

[76]

Wang Tet al.. Osteonecrosis of the femoral head: genetic basis. Int. Orthop., 2019, 43: 519-530

[77]

Ma Met al.. Infographic: osteoimmunology mechanism of osteonecrosis of the femoral head. Bone Jt. Res., 2022, 11: 29-31

[78]

Ma Jet al.. The role of immune regulatory cells in nontraumatic osteonecrosis of the femoral head: a retrospective clinical study. Biomed. Res. Int., 2019, 2019: 1302015

[79]

Zhao J, Zhang X, Guan J, Su Y, Jiang J. Identification of key biomarkers in steroid-induced osteonecrosis of the femoral head and their correlation with immune infiltration by bioinformatics analysis. BMC Musculoskelet. Disord., 2022, 23 67

[80]

Zhang, H. et al. A higher frequency of peripheral blood activated B cells in patients with non-traumatic osteonecrosis of the femoral head. Int. Immunopharmacol.20, 95–100 (2014).

[81]

Wang, Y. et al. Accumulation of fat not responsible for femoral head necrosis, revealed by single-cell RNA sequencing: a preliminary study. Biomolecules13, 171 (2023)

[82]

Fuchs TA, Brill A, Wagner DD. Neutrophil extracellular trap (NET) impact on deep vein thrombosis. Arterioscler. Thromb. Vasc. Biol., 2012, 32: 1777-1783

[83]

Han Let al.. The shift in the balance between osteoblastogenesis and adipogenesis of mesenchymal stem cells mediated by glucocorticoid receptor. Stem Cell Res. Ther., 2019, 10: 377

[84]

Cao Z, Umek RM, McKnight SL. Regulated expression of three C/EBP isoforms during adipose conversion of 3T3-L1 cells. Genes Dev., 1991, 5: 1538-1552

[85]

Kim J, Ko J. A novel PPARγ2 modulator sLZIP controls the balance between adipogenesis and osteogenesis during mesenchymal stem cell differentiation. Cell Death Differ., 2014, 21: 1642-1655

[86]

Koromila Tet al.. Glucocorticoids antagonize RUNX2 during osteoblast differentiation in cultures of ST2 pluripotent mesenchymal cells. J. Cell. Biochem., 2014, 115: 27-33

[87]

Song Met al.. The effect of electromagnetic fields on the proliferation and the osteogenic or adipogenic differentiation of mesenchymal stem cells modulated by dexamethasone. Bioelectromagnetics, 2014, 35: 479-490

[88]

Xiao Y, Peperzak V, van Rijn L, Borst J, de Bruijn JD. Dexamethasone treatment during the expansion phase maintains stemness of bone marrow mesenchymal stem cells. J. Tissue Eng. Regen. Med., 2010, 4: 374-386

[89]

Li Jet al.. Dexamethasone shifts bone marrow stromal cells from osteoblasts to adipocytes by C/EBPalpha promoter methylation. Cell Death Dis., 2013, 4 e832

[90]

Park HWet al.. Alternative Wnt signaling activates YAP/TAZ. Cell, 2015, 162: 780-794

[91]

Yuan Zet al.. PPARγ and Wnt signaling in adipogenic and osteogenic differentiation of mesenchymal stem cells. Curr. Stem Cell Res. Ther., 2016, 11: 216-225

[92]

Butler JSet al.. Silencing Dkk1 expression rescues dexamethasone-induced suppression of primary human osteoblast differentiation. BMC Musculoskelet. Disord., 2010, 11 210

[93]

Zanotti S, Canalis E. Notch signaling and the skeleton. Endocr. Rev., 2016, 37: 223-253

[94]

Pereira RMR, Delany AM, Durant D, Canalis E. Cortisol regulates the expression of Notch in osteoblasts. J. Cell. Biochem., 2002, 85: 252-258

[95]

Nobta Met al.. Critical regulation of bone morphogenetic protein-induced osteoblastic differentiation by Delta1/Jagged1-activated Notch1 signaling. J. Biol. Chem., 2005, 280: 15842-15848

[96]

Deregowski V, Gazzerro E, Priest L, Rydziel S, Canalis E. Notch 1 overexpression inhibits osteoblastogenesis by suppressing Wnt/beta-catenin but not bone morphogenetic protein signaling. J. Biol. Chem., 2006, 281: 6203-6210

[97]

Kerachian MA, Séguin C, Harvey EJ. Glucocorticoids in osteonecrosis of the femoral head: a new understanding of the mechanisms of action. J. Steroid Biochem. Mol. Biol., 2009, 114: 121-128

[98]

Kerachian MA, Harvey EJ, Cournoyer D, Chow TYK, Séguin C. Avascular necrosis of the femoral head: vascular hypotheses. Endothelium, 2006, 13: 237-244

[99]

Youm Y-S, Lee S-Y, Lee S-H. Apoptosis in the osteonecrosis of the femoral head. Clin. Orthop. Surg., 2010, 2: 250-255

[100]

Kothapalli R, Aya-ay JP, Bian H, Garces A, Kim HKW. Ischaemic injury to femoral head induces apoptotic and oncotic cell death. Pathology, 2007, 39: 241-246

[101]

Zhu Z-H, Gao Y-S, Zeng B-F, Zhang C-Q. The effect of dexamethasone and hypoxic stress on MC3T3-E1 cells. Front. Biosci., 2011, 16: 2747-2755

[102]

Zuo W, Guo W-S, Yu H-C, Liu P, Zhang Q-D. Role of junction-mediating and regulatory protein in the pathogenesis of glucocorticoid-induced endothelial cell lesions. Orthop. Surg., 2020, 12: 964-973

[103]

Zhang Fet al.. FAR591 promotes the pathogenesis and progression of SONFH by regulating Fos expression to mediate the apoptosis of bone microvascular endothelial cells. Bone Res., 2023, 11: 27

[104]

Zheng L-Wet al.. TNF-α regulates the early development of avascular necrosis of the femoral head by mediating osteoblast autophagy and apoptosis via the p38 MAPK/NF-κB signaling pathway. Cell Biol. Int., 2020, 44: 1881-1889

[105]

Zhu Jet al.. Dexamethasone promotes osteoblast apoptosis through the Chk2/p53 signaling pathway. Adv. Clin. Exp. Med., 2022, 31: 1365-1374

[106]

Chen, N., Meng, Y., Zhan, H. & Li, G. Identification and validation of potential ferroptosis-related genes in glucocorticoid-induced osteonecrosis of the femoral head. Medicina59, 297 (2023).

[107]

Sun F, Zhou JL, Liu ZL, Jiang ZW, Peng H. Dexamethasone induces ferroptosis via P53/SLC7A11/GPX4 pathway in glucocorticoid-induced osteonecrosis of the femoral head. Biochem. Biophys. Res. Commun., 2022, 602: 149-155

[108]

Xu Xet al.. Luteolin ameliorates necroptosis in glucocorticoid-induced osteonecrosis of the femoral head via RIPK1/RIPK3/MLKL pathway based on network pharmacology analysis. Biochem. Biophys. Res. Commun., 2023, 661: 108-118

[109]

Fan Xet al.. The protective effect of DNA aptamer on osteonecrosis of the femoral head by alleviating TNF-α-mediated necroptosis via RIP1/RIP3/MLKL pathway. J. Orthop. Transl., 2022, 36: 44-51

[110]

Aguirre JI, Castillo EJ, Kimmel DB. Biologic and pathologic aspects of osteocytes in the setting of medication-related osteonecrosis of the jaw (MRONJ). Bone, 2021, 153: 116168

[111]

Feng Met al.. Administration of necrostatin-1 ameliorates glucocorticoid-induced osteonecrosis of the femoral head in rats. J. Mol. Histol., 2023, 54: 207-216

[112]

Ermine K, Yu J, Zhang L. Role of receptor interacting protein (RIP) kinases in cancer. Genes Dis., 2022, 9: 1579-1593

[113]

Liang X-Zet al.. Identification of potential autophagy-related genes in steroid-induced osteonecrosis of the femoral head via bioinformatics analysis and experimental verification. J. Orthop. Surg. Res., 2022, 17: 86

[114]

Zhu Let al.. Parathyroid hormone (PTH) induces autophagy to protect osteocyte cell survival from dexamethasone damage. Med. Sci. Monit., 2017, 23: 4034-4040

[115]

Huang Get al.. Microarray‑based screening of differentially expressed genes in glucocorticoid‑induced avascular necrosis. Mol. Med. Rep., 2017, 15: 3583-3590

[116]

Yu X, Zhang S, Zhang B, Dai M. Relationship of idiopathic femoral head necrosis with blood lipid metabolism and coagulation function: A propensity score-based analysis. Front. Surg., 2022, 9: 938565

[117]

Mei Ret al.. Metabolic profiling analysis of the effect and mechanism of gushiling capsule in rabbits with glucocorticoid-induced osteonecrosis of the femoral head. Front. Pharmacol., 2022, 13: 845856

[118]

Li Let al.. Pathological mechanisms and related markers of steroid-induced osteonecrosis of the femoral head. Ann. Med., 2024, 56: 2416070

[119]

Wang GJ, Sweet DE, Reger SI, Thompson RC. Fat-cell changes as a mechanism of avascular necrosis of the femoral head in cortisone-treated rabbits. J. Bone Jt. Surg. Am., 1977, 59: 729-735

[120]

Wang Tet al.. Role of mesenchymal stem cells on differentiation in steroid-induced avascular necrosis of the femoral head. Exp. Ther. Med., 2017, 13: 669-675

[121]

Yan Yet al.. Plasma lipidomics analysis reveals altered lipids signature in patients with osteonecrosis of the femoral head. Metabolomics, 2022, 18 14

[122]

Gillet Cet al.. Osteonecrosis of the femoral head: lipotoxicity exacerbation in MSC and modifications of the bone marrow fluid. Endocrinology, 2017, 158: 490-502

[123]

Qiang H, Liu H, Ling M, Wang K, Zhang C. Early steroid-induced osteonecrosis of rabbit femoral head and panax notoginseng saponins: mechanism and protective effects. Evid. Based Complement Altern. Med., 2015, 2015: 719370

[124]

Chen Ket al.. Steroid-induced osteonecrosis of the femoral head reveals enhanced reactive oxygen species and hyperactive osteoclasts. Int. J. Biol. Sci., 2020, 16: 1888-1900

[125]

Xu Het al.. Glucocorticoid-induced activation of NOX/ROS/NF-κB signaling in MSCs contributes to the development of GONFH. Apoptosis, 2023, 28: 1332-1345

[126]

Circu ML, Aw TY. Reactive oxygen species, cellular redox systems, and apoptosis. Free Radic. Biol. Med., 2010, 48: 749-762

[127]

Malhotra JD, Kaufman RJ. The endoplasmic reticulum and the unfolded protein response. Semin. Cell Dev. Biol., 2007, 18: 716-731

[128]

Bai S-Cet al.. NADPH oxidase isoforms are involved in glucocorticoid-induced preosteoblast apoptosis. Oxid. Med. Cell. Longev., 2019, 2019: 9192413

[129]

Fan Z-Qet al.. Oxidative stress induced osteocyte apoptosis in steroid-induced femoral head necrosis. Orthop. Surg., 2021, 13: 2145-2152

[130]

Chen Let al.. Therapeutic effect of SIRT3 on glucocorticoid-induced osteonecrosis of the femoral head via intracellular oxidative suppression. Free Radic. Biol. Med., 2021, 176: 228-240

[131]

Fang, L. et al. SIRT6 prevents glucocorticoid-induced osteonecrosis of the femoral head in rats. Oxid. Med. Cell. Longev. 2022, 6360133 (2022).

[132]

Kömürcü, E. et al. Preventive effects of coenzyme Q10 (CoQ10) on steroid-induced osteonecrosis in rats. Acta Orthop. Traumatol. Turc. 48, 217–222 (2014).

[133]

Fan S, Pan H, Huang J, Lei Z, Liu J. Hyperoside exerts osteoprotective effect on dexamethasone-induced osteoblasts by targeting NADPH Oxidase 4 (NOX4) to inhibit the reactive oxygen species (ROS) accumulation and activate c-Jun N-terminal kinase (JNK) pathway. Bioengineered, 2022, 13: 8657-8666

[134]

Yang Net al.. Inhibition of MAGL activates the Keap1/Nrf2 pathway to attenuate glucocorticoid-induced osteonecrosis of the femoral head. Clin. Transl. Med., 2021, 11 e447

[135]

Lin, R. L. C. et al. Decreased Ankyrin Expression Is Associated with Repressed eNOS Signaling, Cell Proliferation, and Osteogenic Differentiation in Osteonecrosis of the Femoral Head. J. Bone Jt. Surg. Am. 104, 2–12 (2022).

[136]

Calder JDF, Buttery L, Revell PA, Pearse M, Polak JM. Apoptosis-a significant cause of bone cell death in osteonecrosis of the femoral head. J. Bone Jt. Surg. Br., 2004, 86: 1209-1213

[137]

Lu Yet al.. Effect of glucocorticoids on the function of microvascular endothelial cells in the human femoral head bone. Adv. Clin. Exp. Med., 2020, 29: 345-353

[138]

Gao Y-S, Wang H-F, Ding H, Zhang C-Q. A novel rat model of osteonecrosis of the femoral head induced by periarticular injection of vascular endothelial growth factor receptor 2 antibody. J. Surg. Res., 2013, 183: e1-e5

[139]

de Campos Pessoa AL, de Oliveira Araújo VHV, Rosa Nascimento AL, Elias N, de Carvalho JJ. Phosphodiesterase-5 inhibition improves bone regeneration at the early stages of ischemic osteonecrosis of the femoral head in rats. J. Orthop. Res., 2021, 39: 2077-2082

[140]

Pan FYet al.. Effect of strontium ranelate on rabbits with steroid-induced osteonecrosis of femoral head through TGF-β1/BMP2 pathway. Eur. Rev. Med. Pharmacol. Sci., 2020, 24: 1000-1006

[141]

Song Het al.. Effect of bone mesenchymal stem cells transplantation on the micro-environment of early osteonecrosis of the femoral head. Int. J. Clin. Exp. Pathol., 2015, 8: 14528-14534

[142]

Zhang Y, Yin J, Ding H, Zhang C, Gao Y-S. Vitamin K2 ameliorates damage of blood vessels by glucocorticoid: a potential mechanism for its protective effects in glucocorticoid-induced osteonecrosis of the femoral head in a rat model. Int. J. Biol. Sci., 2016, 12: 776-785

[143]

Zhang Y-Let al.. Vitamin K2 prevents glucocorticoid-induced osteonecrosis of the femoral head in rats. Int. J. Biol. Sci., 2016, 12: 347-358

[144]

Zhang Cet al.. Hypoxia-inducible factor-1 is a positive regulator of Sox9 activity in femoral head osteonecrosis. Bone, 2011, 48: 507-513

[145]

Chen, W. et al. HIF-1α regulates bone homeostasis and angiogenesis, participating in the occurrence of bone metabolic diseases. Cells11, 3552 (2022).

[146]

Antebi Bet al.. Short-term physiological hypoxia potentiates the therapeutic function of mesenchymal stem cells. Stem Cell Res. Ther., 2018, 9: 265

[147]

Wang Let al.. Human type H vessels are a sensitive biomarker of bone mass. Cell Death Dis., 2017, 8 e2760

[148]

Jiang L, Sheng K, Wang C, Xue D, Pan Z. The effect of MMP-2 inhibitor 1 on osteogenesis and angiogenesis during bone regeneration. Front. Cell Dev. Biol., 2020, 8: 596783

[149]

Xu W-N, Zheng H-L, Yang R-Z, Jiang L-S, Jiang S-D. HIF-1α regulates glucocorticoid-induced osteoporosis through PDK1/AKT/mTOR signaling pathway. Front. Endocrinol., 2019, 10: 922

[150]

Xu Ket al.. Overexpression of HIF-1α enhances the protective effect of mitophagy on steroid-induced osteocytes apoptosis. Environ. Toxicol., 2021, 36: 2123-2137

[151]

Yamaguchi R, Kamiya N, Adapala NS, Drissi H, Kim HKW. HIF-1-dependent IL-6 activation in articular chondrocytes initiating synovitis in femoral head ischemic osteonecrosis. J. Bone Jt. Surg. Am., 2016, 98: 1122-1131

[152]

Arnett TRet al.. Hypoxia is a major stimulator of osteoclast formation and bone resorption. J. Cell. Physiol., 2003, 196: 2-8

[153]

Zhu Jet al.. HIF-1α facilitates osteocyte-mediated osteoclastogenesis by activating JAK2/STAT3 pathway in vitro. J. Cell. Physiol., 2019, 234: 21182-21192

[154]

Song Xet al.. HIF-1α induces hypoxic apoptosis of MLO-Y4 osteocytes via JNK/caspase-3 pathway and the apoptotic-osteocyte-mediated osteoclastogenesis in vitro. Tissue Cell, 2020, 67: 101402

[155]

Simion Cet al.. Use of glucocorticoids and risk of venous thromboembolism: a narrative review. Semin. Thromb. Hemost., 2021, 47: 654-661

[156]

Zalavras, C. G., Vartholomatos, G., Dokou, E. & Malizos, K. N. Genetic background of osteonecrosis: associated with thrombophilic mutations? Clin. Orthop. Relat. Res. 422, 251–255 (2004).

[157]

Hawker H, Neilson H, Hayes RJ, Serjeant GR. Haematological factors associated with avascular necrosis of the femoral head in homozygous sickle cell disease. Br. J. Haematol., 1982, 50: 29-34

[158]

Akinyoola AL, Adediran IA, Asaleye CM, Bolarinwa AR. Risk factors for osteonecrosis of the femoral head in patients with sickle cell disease. Int. Orthop., 2009, 33: 923-926

[159]

Crane JL, Cao X. Bone marrow mesenchymal stem cells and TGF-β signaling in bone remodeling. J. Clin. Invest., 2014, 124: 466-472

[160]

Li Yet al.. Neutralization of excessive levels of active TGF-β1 reduces MSC recruitment and differentiation to mitigate peritendinous adhesion. Bone Res., 2023, 11: 24

[161]

Wang Xet al.. Inhibition of overactive TGF-β attenuates progression of heterotopic ossification in mice. Nat. Commun., 2018, 9 551

[162]

Li, X. et al. Excess glucocorticoids inhibit murine bone turnover via modulating the immunometabolism of the skeletal microenvironment. J. Clin. Invest.134, e166795 (2024).

[163]

Steinmetz OM, Stahl RAK. A new partnership between TGF-beta1 and glucocorticoids in the network of inflammation. Kidney Int., 2003, 63: 2317-2318

[164]

Zhao Xet al.. Glucocorticoid enhanced the expression of ski in osteonecrosis of femoral head: the effect on adipogenesis of rabbit BMSCs. Calcif. Tissue Int., 2019, 105: 506-517

[165]

Lu Z, Han K. SMAD4 transcriptionally activates GCN5 to inhibit apoptosis and promote osteogenic differentiation in dexamethasone-induced human bone marrow mesenchymal stem cells. Steroids, 2022, 179: 108969

[166]

Elsafadi Met al.. Convergence of TGFβ and BMP signaling in regulating human bone marrow stromal cell differentiation. Sci. Rep., 2019, 9 4977

[167]

Okada M, Kim JH, Hutton WC, Yoon ST. Upregulation of intervertebral disc-cell matrix synthesis by pulsed electromagnetic field is mediated by bone morphogenetic proteins. J. Spinal Disord. Tech., 2013, 26: 167-173

[168]

Hao Yet al.. CircPVT1 up-regulation attenuates steroid-induced osteonecrosis of the femoral head through regulating miR-21-5p-mediated Smad7/TGFβ signalling pathway. J. Cell. Mol. Med., 2021, 25: 4608-4622

[169]

Cui Het al.. Macrophage-derived miRNA-containing exosomes induce peritendinous fibrosis after tendon injury through the miR-21-5p/Smad7 pathway. Mol. Ther. Nucleic Acids, 2019, 14: 114-130

[170]

Zhen Get al.. Inhibition of TGF-β signaling00000 in mesenchymal stem cells of subchondral bone attenuates osteoarthritis. Nat. Med., 2013, 19: 704-712

[171]

Liu Jet al.. Wnt/β-catenin signalling: function, biological mechanisms, and therapeutic opportunities. Signal Transduct. Target. Ther., 2022, 7: 3

[172]

Baron R, Kneissel M. WNT signaling in bone homeostasis and disease: from human mutations to treatments. Nat. Med., 2013, 19: 179-192

[173]

Meszaros, K. & Patocs, A. Glucocorticoids influencing Wnt/β-catenin pathway; multiple sites, heterogeneous effects. Molecules25, 1489 (2020).

[174]

Chen X-Jet al.. Polydatin promotes the osteogenic differentiation of human bone mesenchymal stem cells by activating the BMP2-Wnt/β-catenin signaling pathway. Biomed. Pharmacother., 2019, 112: 108746

[175]

Huang Let al.. High levels of GSK-3β signalling reduce osteogenic differentiation of stem cells in osteonecrosis of femoral head. J. Biochem., 2018, 163: 243-251

[176]

Nie Z, Chen S, Peng H. Glucocorticoid induces osteonecrosis of the femoral head in rats through GSK3β-mediated osteoblast apoptosis. Biochem. Biophys. Res. Commun., 2019, 511: 693-699

[177]

Sun Het al.. Activation of cannabinoid receptor 2 alleviates glucocorticoid-induced osteonecrosis of femoral head with osteogenesis and maintenance of blood supply. Cell Death Dis., 2021, 12 1035

[178]

Cheng, C. H., Chen, L. R. & Chen, K. H. Osteoporosis due to hormone imbalance: an overview of the effects of estrogen deficiency and glucocorticoid overuse on bone turnover. Int. J. Mol. Sci.23, 1376 (2022).

[179]

Fang Bet al.. Involvement of tumor necrosis factor alpha in steroid-associated osteonecrosis of the femoral head: friend or foe?. Stem Cell Res. Ther., 2019, 10: 5

[180]

Han Net al.. P-glycoprotein overexpression in bone marrow-derived multipotent stromal cells decreases the risk of steroid-induced osteonecrosis in the femoral head. J. Cell. Mol. Med., 2016, 20: 2173-2182

[181]

Han Net al.. Effects of p-glycoprotein on steroid-induced osteonecrosis of the femoral head. Calcif. Tissue Int., 2010, 87: 246-253

[182]

Kuribayashi Met al.. Combination analysis of three polymorphisms for predicting the risk for steroid-induced osteonecrosis of the femoral head. J. Orthop. Sci., 2008, 13: 297-303

[183]

Xu Tet al.. Administration of erythropoietin prevents bone loss in osteonecrosis of the femoral head in mice. Mol. Med. Rep., 2017, 16: 8755-8762

[184]

Ye J, Wei D, Peng L, Chang T. Ginsenoside Rb1 prevents steroid‑induced avascular necrosis of the femoral head through the bone morphogenetic protein‑2 and vascular endothelial growth factor pathway. Mol. Med. Rep., 2019, 20: 3175-3181

[185]

Wang, L.-T., Chen, L.-R. & Chen, K.-H. Hormone-related and drug-induced osteoporosis: a cellular and molecular overview. Int. J. Mol. Sci.24, 5814 (2023).

[186]

Duan Pet al.. C/EBPα regulates the fate of bone marrow mesenchymal stem cells and steroid-induced avascular necrosis of the femoral head by targeting the PPARγ signalling pathway. Stem Cell Res. Ther., 2022, 13: 342

[187]

Jiang Yet al.. Pravastatin prevents steroid-induced osteonecrosis in rats by suppressing PPARγ expression and activating Wnt signaling pathway. Exp. Biol. Med., 2014, 239: 347-355

[188]

Liu Yet al.. IKKe in osteoclast inhibits the progression of methylprednisolone-induced osteonecrosis. Int. J. Biol. Sci., 2021, 17: 1353-1360

[189]

Shan Het al.. Effects of astragaloside IV on glucocorticoid-induced avascular necrosis of the femoral head via regulating Akt-related pathways. Cell Prolif., 2023, 56: e13485

[190]

Lu Pet al.. Overexpression of FGF2 delays the progression of osteonecrosis of the femoral head activating the PI3K/Akt signaling pathway. J. Orthop. Surg. Res., 2021, 16: 613

[191]

Larsen Met al.. Augmentation of surgical angiogenesis in vascularized bone allotransplants with host-derived a/v bundle implantation, fibroblast growth factor-2, and vascular endothelial growth factor administration. J. Orthop. Res., 2010, 28: 1015-1021

[192]

Zou Wet al.. Hypoxia enhances glucocorticoid-induced apoptosis and cell cycle arrest via the PI3K/Akt signaling pathway in osteoblastic cells. J. Bone Min. Metab., 2015, 33: 615-624

[193]

Chen Jet al.. Cyclic polypeptide D7 protects bone marrow mesenchymal cells and promotes chondrogenesis during osteonecrosis of the femoral head via growth differentiation factor 15-mediated redox signaling. Oxid. Med. Cell. Longev., 2022, 2022: 3182368

[194]

Li Wet al.. Exogenous melatonin ameliorates steroid-induced osteonecrosis of the femoral head by modulating ferroptosis through GDF15-mediated signaling. Stem Cell Res. Ther., 2023, 14: 171

[195]

Wang Det al.. Induction of PI3K/Akt-mediated apoptosis in osteoclasts is a key approach for Buxue Tongluo pills to treat osteonecrosis of the femoral head. Front. Pharmacol., 2021, 12: 729909

[196]

Wang X-Y, Gong L-J, Huang J-M, Jiang C, Yan Z-Q. Pinocembrin alleviates glucocorticoid-induced apoptosis by activating autophagy via suppressing the PI3K/Akt/mTOR pathway in osteocytes. Eur. J. Pharmacol., 2020, 880: 173212

[197]

Jang B-Yet al.. Methylprednisolone inhibits autophagy of vascular endothelial cells in rat femoral head via PI3K/Akt/mTOR pathway. Orthop. Surg., 2022, 14: 2669-2681

[198]

Zhu Wet al.. CD41-deficient exosomes from non-traumatic femoral head necrosis tissues impair osteogenic differentiation and migration of mesenchymal stem cells. Cell Death Dis., 2020, 11 293

[199]

Xu Yet al.. LINC00473-modified bone marrow mesenchymal stem cells incorporated thermosensitive PLGA hydrogel transplantation for steroid-induced osteonecrosis of femoral head: A detailed mechanistic study and validity evaluation. Bioeng. Transl. Med., 2022, 7: e10275

[200]

Lv, W., Yu, M., Yang, Q., Kong, P. & Yan, B. Total flavonoids of Rhizoma drynariae ameliorate steroid‑induced avascular necrosis of the femoral head via the PI3K/AKT pathway. Mol. Med. Rep.23, 345 (2021).

[201]

Shen Z-Het al.. Activation of AKT signaling via small molecule natural compound prevents against osteoblast apoptosis and osteonecrosis of the femoral head. Am. J. Transl. Res., 2020, 12: 7211-7222

[202]

Xu Y, Jiang Y, Wang Y, Zhao Z, Li T. LINC00473 rescues human bone marrow mesenchymal stem cells from apoptosis induced by dexamethasone through the PEBP1‑mediated Akt/Bad/Bcl‑2 signaling pathway. Int. J. Mol. Med., 2021, 47: 171-182

[203]

Tao S-Cet al.. Exosomes derived from human platelet-rich plasma prevent apoptosis induced by glucocorticoid-associated endoplasmic reticulum stress in rat osteonecrosis of the femoral head via the Akt/Bad/Bcl-2 signal pathway. Theranostics, 2017, 7: 733-750

[204]

Yu Het al.. Chrysophanic acid shifts the differentiation tendency of BMSCs to prevent alcohol-induced osteonecrosis of the femoral head. Cell Prolif., 2020, 53: e12871

[205]

Jiang H-Tet al.. IGF-1 reverses the osteogenic inhibitory effect of dexamethasone on BMP9-induced osteogenic differentiation in mouse embryonic fibroblasts via PI3K/AKT/COX-2 pathway. J. Steroid Biochem. Mol. Biol., 2019, 191: 105363

[206]

Nie Zet al.. Gene expression profiling of osteoblasts subjected to dexamethasone-induced apoptosis with/without GSK3β-shRNA. Biochem. Biophys. Res. Commun., 2018, 506: 41-47

[207]

Deng Set al.. Dexamethasone induces osteoblast apoptosis through ROS-PI3K/AKT/GSK3β signaling pathway. Biomed. Pharmacother., 2019, 110: 602-608

[208]

Ding P, Zhang W, Tan Q, Yao C, Lin S. Impairment of circulating endothelial progenitor cells (EPCs) in patients with glucocorticoid-induced avascular necrosis of the femoral head and changes of EPCs after glucocorticoid treatment in vitro. J. Orthop. Surg. Res., 2019, 14: 226

[209]

Sims NA, Quinn JMW. Osteoimmunology: oncostatin M as a pleiotropic regulator of bone formation and resorption in health and disease. Bonekey Rep., 2014, 3: 527

[210]

Nicolaidou Vet al.. Monocytes induce STAT3 activation in human mesenchymal stem cells to promote osteoblast formation. PLoS ONE, 2012, 7: e39871

[211]

Xing Tet al.. Duhuo Jisheng Decoction inhibits the activity of osteoclasts in osteonecrosis of the femoral head via regulation of the RELA/AKT1 axis. Am. J. Transl. Res., 2022, 14: 3559-3571

[212]

Chen B, Liu Y, Cheng L. IL-21 Enhances the degradation of cartilage through the JAK-STAT signaling pathway during osteonecrosis of femoral head cartilage. Inflammation, 2018, 41: 595-605

[213]

Xin Pet al.. The role of JAK/STAT signaling pathway and its inhibitors in diseases. Int. Immunopharmacol., 2020, 80: 106210

[214]

Paria Net al.. The impact of large-scale genomic methods in orthopaedic disorders: insights from genome-wide association studies. J. Bone Jt. Surg. Am., 2014, 96: e38

[215]

Wyles CCet al.. CORR® ORS Richard A. Brand Award: disruption in peroxisome proliferator-activated receptor-γ (PPARG) Increases osteonecrosis risk through genetic variance and pharmacologic modulation. Clin. Orthop. Relat. Res., 2019, 477: 1800-1812

[216]

Grässel Set al.. Expression profile of matrix metalloproteinase-2 and -9 and their endogenous tissue inhibitors in osteonecrotic femoral heads. Int. J. Mol. Med., 2010, 26: 127-133

[217]

Li G, Ji F, Guo W, Wei B. Decreased serum MMP-9 levels in patients with nontraumatic osteonecrosis of the femoral head. BMC Musculoskelet. Disord., 2023, 24 240

[218]

Tian Yet al.. MMP2 and MMP10 polymorphisms are related to steroid-induced osteonecrosis of the femoral head among Chinese Han population. Biomed. Res. Int., 2019, 2019: 8298193

[219]

Zhao Z, Zhang L, Kang X, Zheng J, Tian B. Association between genetic polymorphisms of CR2 gene and the risk of steroid-induced osteonecrosis of the femoral head in the Chinese Han male population. Genet. Test. Mol. Biomark., 2020, 24: 460-466

[220]

Jin Tet al.. IL-4 gene polymorphisms and their relation to steroid-induced osteonecrosis of the femoral head in Chinese population. Mol. Genet. Genom. Med., 2019, 7: e563

[221]

Herlin M, McGuigan FE, Luthman H, Åkesson K. Polymorphisms in inflammation associated genes ALOX15 and IL-6 are associated with bone properties in young women and fracture in elderly. Bone, 2015, 79: 105-109

[222]

Todhunter CEet al.. Influence of IL-6, COL1A1, and VDR gene polymorphisms on bone mineral density in Crohn’s disease. Gut, 2005, 54: 1579-1584

[223]

Wang R, Li R, Liu R. An intron SNP rs2069837 in IL-6 is associated with osteonecrosis of the femoral head development. BMC Med. Genomics, 2022, 15 5

[224]

O’Rielly DD, Roslin NM, Beyene J, Pope A, Rahman P. TNF-alpha-308 G/A polymorphism and responsiveness to TNF-alpha blockade therapy in moderate to severe rheumatoid arthritis: a systematic review and meta-analysis. Pharmacogenomics J., 2009, 9: 161-167

[225]

Peng Y, Liu Y, Huang D, Huang W, Shao Z. Association of TNF-α-308(G/A) and -238(G/A) polymorphisms with non-traumatic osteonecrosis of the femoral head risks: a meta-analysis. Int. Orthop., 2018, 42: 1711-1721

[226]

Sun Met al.. DNA methylation in the OPG/RANK/RANKL pathway is associated with steroid-induced osteonecrosis of the femoral head. BMC Musculoskelet. Disord., 2021, 22 599

[227]

Zhang, J., Cao, J., Liu, Y. & Zhao, H. Advances in the pathogenesis of steroid-associated osteonecrosis of the femoral head. Biomolecules14, 667 (2024).

[228]

Cheng Cet al.. METTL14 benefits the mesenchymal stem cells in patients with steroid-associated osteonecrosis of the femoral head by regulating the m6A level of PTPN6. Aging, 2021, 13: 25903-25919

[229]

Hu Let al.. Structural insight into substrate preference for TET-mediated oxidation. Nature, 2015, 527: 118-122

[230]

Wang Bet al.. Knockdown of HDAC9 inhibits osteogenic differentiation of human bone marrow mesenchymal stem cells partially by suppressing the MAPK Signaling Pathway. Clin. Inter. Aging, 2022, 17: 777-787

[231]

Meng C-Yet al.. Influence of MicroRNA-141 on inhibition of the proliferation of bone marrow mesenchymal stem cells in steroid-induced osteonecrosis via SOX11. Orthop. Surg., 2020, 12: 277-285

[232]

Xue, F. et al. MicroRNA‑141 inhibits the differentiation of bone marrow‑derived mesenchymal stem cells in steroid‑induced osteonecrosis via E2F3. Mol. Med. Rep.26, 234 (2022).

[233]

Zhang Yet al.. Increased microRNA-93-5p inhibits osteogenic differentiation by targeting bone morphogenetic protein-2. PLoS ONE, 2017, 12: e0182678

[234]

Liu G-Zet al.. Identification of potential miRNA biomarkers for traumatic osteonecrosis of femoral head. J. Cell. Physiol., 2020, 235: 8129-8140

[235]

Zhang Yet al.. MiRNA-320a-5p contributes to the homeostasis of osteogenesis and adipogenesis in bone marrow mesenchymal stem cell. Regen. Ther., 2022, 20: 32-40

[236]

Duan D-Y, Tang J, Tian H-T, Shi Y-Y, Jia J. Adipocyte-secreted microvesicle-derived miR-148a regulates adipogenic and osteogenic differentiation by targeting Wnt5a/Ror2 pathway. Life Sci., 2021, 278: 119548

[237]

Li Pet al.. Differential expression of miR-672-5p and miR-146a-5p in osteoblasts in rats after steroid intervention. Gene, 2016, 591: 69-73

[238]

Zhang Z, Jin A, Yan D. MicroRNA‑206 contributes to the progression of steroid‑induced avascular necrosis of the femoral head by inducing osteoblast apoptosis by suppressing programmed cell death 4. Mol. Med. Rep., 2018, 17: 801-808

[239]

Liu Yet al.. MicroRNA-23b-3p participates in steroid-induced osteonecrosis of the femoral head by suppressing ZNF667 expression. Steroids, 2020, 163: 108709

[240]

Xie Y, Hu JZ, Shi ZY. MiR-181d promotes steroid-induced osteonecrosis of the femoral head by targeting SMAD3 to inhibit osteogenic differentiation of hBMSCs. Eur. Rev. Med. Pharmacol. Sci., 2018, 22: 4053-4062

[241]

Fu L, Liu H, Lei W. MiR-596 inhibits osteoblastic differentiation and cell proliferation by targeting Smad3 in steroid-induced osteonecrosis of femoral head. J. Orthop. Surg. Res., 2020, 15: 173

[242]

Yang Wet al.. Exosomal miR-100-5p inhibits osteogenesis of hBMSCs and angiogenesis of HUVECs by suppressing the BMPR2/Smad1/5/9 signalling pathway. Stem Cell Res. Ther., 2021, 12: 390

[243]

Cao Yet al.. Reciprocal effect of microRNA-224 on osteogenesis and adipogenesis in steroid-induced osteonecrosis of the femoral head. Bone, 2021, 145: 115844

[244]

Zhang Jet al.. Screening of potential biomarkers in the peripheral serum for steroid-induced osteonecrosis of the femoral head based on WGCNA and machine learning algorithms. Dis. Markers, 2022, 2022: 2639470

[245]

Zhang Met al.. Serum exosomal hsa-miR-135b-5p serves as a potential diagnostic biomarker in steroid-induced osteonecrosis of femoral head. Am. J. Transl. Res., 2020, 12: 2136-2154

[246]

Li Set al.. Low miR-182-5p expressing extracellular vesicles derived from human bone marrow stromal cells of subjects with steroid-induced osteonecrosis of the femoral head aggravate disease progression. J. Bone Min. Res., 2023, 38: 976-993

[247]

Wu X, Wang Y, Fan X, Xu X, Sun W. Extracorporeal shockwave relieves endothelial injury and dysfunction in steroid-induced osteonecrosis of the femoral head via miR-135b targeting FOXO1: in vitro and in vivo studies. Aging, 2022, 14: 410-429

[248]

Tang Jet al.. miR-27a promotes osteogenic differentiation in glucocorticoid-treated human bone marrow mesenchymal stem cells by targeting PI3K. J. Mol. Histol., 2021, 52: 279-288

[249]

Li Pet al.. Differential expression of miR-195-5p in collapse of steroid-induced osteonecrosis of the femoral head. Oncotarget, 2017, 8: 42638-42647

[250]

Yin Yet al.. Upregulating MicroRNA-410 or downregulating Wnt-11 increases osteoblasts and reduces osteoclasts to alleviate osteonecrosis of the femoral head. Nanoscale Res. Lett., 2019, 14 383

[251]

Wang B, Yu P, Li T, Bian Y, Weng X. MicroRNA expression in bone marrow mesenchymal stem cells from mice with steroid-induced osteonecrosis of the femoral head. Mol. Med. Rep., 2015, 12: 7447-7454

[252]

Huang Set al.. microRNA-148a-3p in extracellular vesicles derived from bone marrow mesenchymal stem cells suppresses SMURF1 to prevent osteonecrosis of femoral head. J. Cell. Mol. Med., 2020, 24: 11512-11523

[253]

Bai Yet al.. Expression of microRNA‑27a in a rat model of osteonecrosis of the femoral head and its association with TGF‑β/Smad7 signalling in osteoblasts. Int. J. Mol. Med., 2019, 43: 850-860

[254]

Luo Het al.. Microarray analysis of long-noncoding RNAs and mRNA expression profiles in human steroid-induced avascular necrosis of the femoral head. J. Cell. Biochem., 2019, 120: 15800-15813

[255]

Li Zet al.. Emerging roles of long non-coding RNAs in osteonecrosis of the femoral head. Am. J. Transl. Res., 2020, 12: 5984-5991

[256]

Wu Yet al.. lncRNA FGD5-AS1 regulates bone marrow stem cell proliferation and apoptosis by affecting miR-296-5p/STAT3 axis in steroid-induced osteonecrosis of the femoral head. J. Health Eng., 2022, 2022: 9364467

[257]

Wang Tet al.. LncAABR07053481 inhibits bone marrow mesenchymal stem cell apoptosis and promotes repair following steroid-induced avascular necrosis. Commun. Biol., 2023, 6: 365

[258]

Zhang XY, Shan HJ, Zhang P, She C, Zhou XZ. LncRNA EPIC1 protects human osteoblasts from dexamethasone-induced cell death. Biochem. Biophys. Res. Commun., 2018, 503: 2255-2262

[259]

Le G, Lu M, Li L, Luo H. The Lnc-HOTAIR/miR122/PPARγ signaling mediated the occurrence and continuous development of alcohol-induced Osteonecrosis of the femoral head. Toxicol. Lett., 2023, 380: 53-61

[260]

Chen X, Li J, Liang D, Zhang L, Wang Q. LncRNA AWPPH participates in the development of non-traumatic osteonecrosis of femoral head by upregulating Runx2. Exp. Ther. Med., 2020, 19: 153-159

[261]

Zhao X, Liu Y, Yu S. Long noncoding RNA AWPPH promotes hepatocellular carcinoma progression through YBX1 and serves as a prognostic biomarker. Biochim. Biophys. Acta Mol. Basis Dis., 2017, 1863: 1805-1816

[262]

Jin Cet al.. Long non-coding RNA MIAT knockdown promotes osteogenic differentiation of human adipose-derived stem cells. Cell Biol. Int., 2017, 41: 33-41

[263]

Wang Qet al.. LncRNA expression profiling of BMSCs in osteonecrosis of the femoral head associated with increased adipogenic and decreased osteogenic differentiation. Sci. Rep., 2018, 8 9127

[264]

Li Tet al.. Identification of long non‑coding RNAs expressed during the osteogenic differentiation of human bone marrow‑derived mesenchymal stem cells obtained from patients with ONFH. Int. J. Mol. Med., 2020, 46: 1721-1732

[265]

Xiang S, Li Z, Weng X. The role of lncRNA RP11-154D6 in steroid-induced osteonecrosis of the femoral head through BMSC regulation. J. Cell. Biochem., 2019, 120: 18435-18445

[266]

Xiang S, Li Z, Weng X. Changed cellular functions and aberrantly expressed miRNAs and circRNAs in bone marrow stem cells in osteonecrosis of the femoral head. Int. J. Mol. Med., 2020, 45: 805-815

[267]

Chen Get al.. Circular RNA CDR1as promotes adipogenic and suppresses osteogenic differentiation of BMSCs in steroid-induced osteonecrosis of the femoral head. Bone, 2020, 133: 115258

[268]

Mao Z, Liu G, Xiao G-Y, Zhao C, Zou Y-C. CircCDR1as suppresses bone microvascular endothelial cell activity and angiogenesis through targeting miR-135b/ FIH-1 axis. Orthop. Surg., 2021, 13: 573-582

[269]

Feng, X. et al. CircHGF suppressed cell proliferation and osteogenic differentiation of BMSCs in ONFH via inhibiting miR-25-3p binding to SMAD7. Mol. Ther. Nucleic Acids28, 99–113 (2022)

[270]

Han N, Qian F, Niu X, Chen G. Circ_0058792 regulates osteogenic differentiation through miR-181a-5p/Smad7 axis in steroid-induced osteonecrosis of the femoral head. Bioengineered, 2022, 13: 12807-12822

[271]

Jiao Met al.. Circular RNA and messenger RNA expression profile and competing endogenous RNA network in subchondral bone in osteonecrosis of the femoral head. DNA Cell Biol., 2021, 40: 61-69

[272]

Powell C, Chang C, Naguwa SM, Cheema G, Gershwin ME. Steroid induced osteonecrosis: an analysis of steroid dosing risk. Autoimmun. Rev., 2010, 9: 721-743

[273]

Henneicke H, Gasparini SJ, Brennan-Speranza TC, Zhou H, Seibel MJ. Glucocorticoids and bone: local effects and systemic implications. Trends Endocrinol. Metab., 2014, 25: 197-211

[274]

Ding Set al.. Combined application of mesenchymal stem cells and different glucocorticoid dosing alleviates osteoporosis in SLE murine models. Immun. Inflamm. Dis., 2024, 12: e1319

[275]

Hirayama T, Sabokbar A, Athanasou NA. Effect of corticosteroids on human osteoclast formation and activity. J. Endocrinol., 2002, 175: 155-163

[276]

Kim H-Jet al.. Glucocorticoids and the osteoclast. Ann. N. Y. Acad. Sci., 2007, 1116: 335-339

[277]

Peng Yet al.. Glucocorticoids disrupt skeletal angiogenesis through transrepression of NF-κB-mediated preosteoclast Pdgfb transcription in young mice. J. Bone Min. Res., 2020, 35: 1188-1202

[278]

Zhao, D. W. & Hu, Y. C. Chinese guideline for the diagnosis and treatment of osteonecrosis of the femoral head in adults. Orthop. Surg.9, 3–12 (2017).

[279]

Ma H, Zhang W, Shi J. Differentially expressed genes reveal the biomarkers and molecular mechanism of osteonecrosis. J. Health Eng., 2022, 2022: 8684137

[280]

Zhang Y-Yet al.. Insights and implications of sexual dimorphism in osteoporosis. Bone Res., 2024, 12: 8

[281]

Li Zet al.. Advances in experimental models of osteonecrosis of the femoral head. J. Orthop. Transl., 2023, 39: 88-99

[282]

Xu J, Gong H, Lu S, Deasey MJ, Cui Q. Animal models of steroid-induced osteonecrosis of the femoral head-a comprehensive research review up to 2018. Int. Orthop., 2018, 42: 1729-1737

[283]

Ma Jet al.. Animal models of femur head necrosis for tissue engineering and biomaterials research. Tissue Eng. Part C Methods, 2022, 28: 214-227

[284]

Casey KMet al.. Management of morbidity and mortality in a New Zealand white rabbit model of steroidinduced osteonecrosis of the femoral head. Comp. Med., 2021, 71: 86-98

[285]

Xie XH, Wang XL, Yang HL, Zhao DW, Qin L. Steroid-associated osteonecrosis: Epidemiology, pathophysiology, animal model, prevention, and potential treatments (an overview). J. Orthop. Transl., 2015, 3: 58-70

[286]

Duan Xet al.. Bioinformatic analysis of related immune cell infiltration and key genes in the progression of osteonecrosis of the femoral head. Front. Immunol., 2023, 14: 1340446

[287]

Wang Yet al.. Multi-sequence MRI-based radiomics: an objective method to diagnose early-stage osteonecrosis of the femoral head. Eur. J. Radio., 2024, 177: 111563

[288]

Xu W, Wang L, Shi P, Liu L, Zhang W. Risk factors and prediction model for osteonecrosis of the femoral head in female systemic lupus erythematosus. Front. Immunol., 2024, 15: 1381035

[289]

Yan, Y., Wang, J., Wang, Y., Wu, W. & Chen, W. Research on lipidomic profiling and biomarker identification for osteonecrosis of the femoral head. Biomedicines12, 2827 (2024).

[290]

Yang S, Zhao Y, Tan Y, Zheng C. Identification of microtubule-associated biomarker using machine learning methods in osteonecrosis of the femoral head and osteosarcoma. Heliyon, 2024, 10: e31853

[291]

Abu-Shakra Met al.. Effect of tocilizumab on fatigue and bone mineral density in patients with rheumatoid arthritis. Isr. Med. Assoc. J., 2018, 20: 239-244

[292]

Cosman Fet al.. Romosozumab treatment in postmenopausal women with osteoporosis. N. Engl. J. Med., 2016, 375: 1532-1543

[293]

Kobayakawa Tet al.. Denosumab versus romosozumab for postmenopausal osteoporosis treatment. Sci. Rep., 2021, 11 11801

[294]

Li L, Li A, Zhu L, Gan L, Zuo L. Roxadustat promotes osteoblast differentiation and prevents estrogen deficiency-induced bone loss by stabilizing HIF-1α and activating the Wnt/β-catenin signaling pathway. J. Orthop. Surg. Res., 2022, 17: 286

[295]

Zhang Pet al.. Yougui pills exert osteoprotective effects on rabbit steroid-related osteonecrosis of the femoral head by activating β-catenin. Biomed. Pharmacother., 2019, 120: 109520

[296]

Kong Xet al.. Aqueous fraction of Huogu formula promotes osteogenic differentiation of bone marrow stromal cells through the BMP and Wnt signaling pathways. Rejuvenation Res., 2016, 19: 509-520

[297]

Guo Yet al.. Analysis of the potential biological mechanisms of Danyu Gukang Pill against osteonecrosis of the femoral head based on network pharmacology. BMC Complement Med. Ther., 2023, 23: 28

[298]

Han Jet al.. Gujiansan ameliorates avascular necrosis of the femoral head by regulating autophagy via the HIF-1α/BNIP3 pathway. Evid. Based Complement Altern. Med., 2021, 2021: 6683007

[299]

Jiang Yet al.. Achyranthes bidentata extract exerts osteoprotective effects on steroid-induced osteonecrosis of the femoral head in rats by regulating RANKL/RANK/OPG signaling. J. Transl. Med., 2014, 12 334

[300]

Du X, Zhao L, Qiao Y, Liu Y, Guo D. The system research of the molecular mechanism of Quyushengxin capsule in the treatment of osteonecrosis of the femoral head. Evid. Based Complement Altern. Med., 2022, 2022: 2968075

[301]

Fang Bet al.. Huo Xue Tong Luo capsule ameliorates osteonecrosis of femoral head through inhibiting lncRNA-Miat. J. Ethnopharmacol., 2019, 238: 111862

[302]

Li J-Cet al.. Study on the molecular mechanism of BuShenHuoXue capsule in treatment of steroid-induced osteonecrosis of the femoral head. Ann. Transl. Med, 2020, 8: 1680

[303]

Li H, Meng D, Zhang X, Yuan D. Effect of psoralen on the expression of PPARγ, osteocalcin, and trabecular bone area in rabbits with steroid-induced avascular necrosis of the femoral head. J. Orthop. Surg. Res., 2019, 14: 11

[304]

Yang Cet al.. Tongluo Shenggu capsule promotes angiogenesis to ameliorate glucocorticoid-induced femoral head necrosis via upregulating VEGF signaling pathway. Phytomedicine, 2023, 110: 154629

[305]

Zeng Jet al.. Increased serum protein levels by Yuanshi Shengmai Chenggu Tablet in treatment of avascular osteonecrosis of the femoral head. Mol. Med. Rep., 2018, 17: 2121-2126

[306]

Zuo Ret al.. Exosomes derived from human CD34+ stem cells transfected with miR-26a prevent glucocorticoid-induced osteonecrosis of the femoral head by promoting angiogenesis and osteogenesis. Stem Cell Res. Ther., 2019, 10: 321

[307]

Kuang M-Jet al.. Exosomes derived from Wharton’s jelly of human umbilical cord mesenchymal stem cells reduce osteocyte apoptosis in glucocorticoid-induced osteonecrosis of the femoral head in rats via the miR-21-PTEN-AKT signalling pathway. Int. J. Biol. Sci., 2019, 15: 1861-1871

[308]

Kuang M-Jet al.. Exosomal miR-365a-5p derived from HUC-MSCs regulates osteogenesis in GIONFH through the Hippo signaling pathway. Mol. Ther. Nucleic Acids, 2021, 23: 565-576

[309]

Guo S-Cet al.. Exosomes from Human synovial-derived mesenchymal stem cells prevent glucocorticoid-induced osteonecrosis of the femoral head in the rat. Int. J. Biol. Sci., 2016, 12: 1262-1272

[310]

Chen C-Yet al.. Extracellular vesicles from human urine-derived stem cells inhibit glucocorticoid-induced osteonecrosis of the femoral head by transporting and releasing pro-angiogenic DMBT1 and anti-apoptotic TIMP1. Acta Biomater., 2020, 111: 208-220

[311]

Li H, Bai X, Pan S. Repetitive 1.6 ATA hyperbaric oxygen therapy for bilateral ARCO Stage II steroid-associated osteonecrosis of the femoral head. Undersea Hyperb. Med., 2020, 47: 625-633

[312]

Ma, J. et al. Extracellular vesicles from BMSCs prevent Glucocorticoid-induced BMECs injury by regulating autophagy via the PI3K/Akt/mTOR pathway. Cells11, 2104 (2022).

[313]

Liu Xet al.. Exosomes secreted from human-induced pluripotent stem cell-derived mesenchymal stem cells prevent osteonecrosis of the femoral head by promoting angiogenesis. Int. J. Biol. Sci., 2017, 13: 232-244

[314]

Nan Ket al.. Exosomes from miRNA-378-modified adipose-derived stem cells prevent glucocorticoid-induced osteonecrosis of the femoral head by enhancing angiogenesis and osteogenesis via targeting miR-378 negatively regulated suppressor of fused (Sufu). Stem Cell Res. Ther., 2021, 12: 331

[315]

Wu Het al.. Mechanism of vascular endothelial cell-derived exosomes modified with vascular endothelial growth factor in steroid-induced femoral head necrosis. Biomed. Mater., 2023, 18: 025017

[316]

Zhai Let al.. Effects of focused extracorporeal shock waves on bone marrow mesenchymal stem cells in patients with avascular necrosis of the femoral head. Ultrasound Med. Biol., 2016, 42: 753-762

[317]

Cheng J-H, Jhan S-W, Hsu C-C, Chiu H-W, Hsu S-L. Extracorporeal shockwave therapy modulates the expressions of proinflammatory cytokines IL33 and IL17A, and their receptors ST2 and IL17RA, within the articular cartilage in early avascular necrosis of the femoral head in a rat model. Mediators Inflamm., 2021, 2021: 9915877

[318]

Li J-P, Chen S, Peng H, Zhou J-L, Fang H-S. Pulsed electromagnetic fields protect the balance between adipogenesis and osteogenesis on steroid-induced osteonecrosis of femoral head at the pre-collapse stage in rats. Bioelectromagnetics, 2014, 35: 170-180

[319]

Kim HKW, Stephenson N, Garces A, Aya-ay J, Bian H. Effects of disruption of epiphyseal vasculature on the proximal femoral growth plate. J. Bone Jt. Surg. Am., 2009, 91: 1149-1158

[320]

Morgan MJ, Liu Z-g. Crosstalk of reactive oxygen species and NF-κB signaling. Cell Res., 2011, 21: 103-115

[321]

Huang Pet al.. Glucocorticoid activates STAT3 and NF-κB synergistically with inflammatory cytokines to enhance the anti-inflammatory factor TSG6 expression in mesenchymal stem/stromal cells. Cell Death Dis., 2024, 15 70

[322]

Hudson WHet al.. Cryptic glucocorticoid receptor-binding sites pervade genomic NF-κB response elements. Nat. Commun., 2018, 9 1337

[323]

Bradbury Det al.. Vascular endothelial growth factor induction by prostaglandin E2 in human airway smooth muscle cells is mediated by E prostanoid EP2/EP4 receptors and SP-1 transcription factor binding sites. J. Biol. Chem., 2005, 280: 29993-30000

[324]

Wang X, Klein RD. Prostaglandin E2 induces vascular endothelial growth factor secretion in prostate cancer cells through EP2 receptor-mediated cAMP pathway. Mol. Carcinog., 2007, 46: 912-923

[325]

Sun Yet al.. Mechanical stimulation on mesenchymal stem cells and surrounding microenvironments in bone regeneration: regulations and applications. Front. Cell Dev. Biol., 2022, 10: 2022

[326]

Yousefi Fet al.. TGF-β and WNT signaling pathways in cardiac fibrosis: non-coding RNAs come into focus. Cell Commun. Signal, 2020, 18 87

[327]

Luo, K. Signaling cross talk between TGF-β/Smad and other signaling pathways. Cold Spring Harb. Perspect. Biol.9, a022137 (2017).

[328]

Wu M, Wu S, Chen W, Li Y-P. The roles and regulatory mechanisms of TGF-β and BMP signaling in bone and cartilage development, homeostasis and disease. Cell., 2024, 34: 101-123

[329]

Wu Zet al.. Regulation of bone homeostasis: signaling pathways and therapeutic targets. MedComm, 2024, 5: e657

[330]

Li C, Zhao B, Lin C, Gong Z, An X. TREM2 inhibits inflammatory responses in mouse microglia by suppressing the PI3K/NF-κB signaling. Cell Biol. Int., 2019, 43: 360-372

[331]

Li Tet al.. Pomegranate flower extract bidirectionally regulates the proliferation, differentiation and apoptosis of 3T3-L1 cells through regulation of PPARγ expression mediated by PI3K-AKT signaling pathway. Biomed. Pharmacother., 2020, 131: 110769

[332]

Delerive Pet al.. Peroxisome proliferator-activated receptor alpha negatively regulates the vascular inflammatory gene response by negative cross-talk with transcription factors NF-kappaB and AP-1. J. Biol. Chem., 1999, 274: 32048-32054

[333]

Gélinas DS, Bernatchez PN, Rollin S, Bazan NG, Sirois MG. Immediate and delayed VEGF-mediated NO synthesis in endothelial cells: role of PI3K, PKC and PLC pathways. Br. J. Pharmacol., 2002, 137: 1021-1030

[334]

Zhang Ret al.. Nitric oxide enhances angiogenesis via the synthesis of vascular endothelial growth factor and cGMP after stroke in the rat. Circ. Res., 2003, 92: 308-313

[335]

Kang, H. et al. Somatic SMAD3-activating mutations cause melorheostosis by up-regulating the TGF-β/SMAD pathway. J. Exp. Med.217, e20191499 (2020).

[336]

Velchev, J. D., Verstraeten, A. & Loeys, B. Hide and seek: somatic SMAD3 mutations in melorheostosis. J. Exp. Med. 217, e20200185 (2020).

[337]

Hjelmeland AB, Schilling SH, Guo X, Quarles D, Wang X-F. Loss of Smad3-mediated negative regulation of Runx2 activity leads to an alteration in cell fate determination. Mol. Cell. Biol., 2005, 25: 9460-9468

[338]

Li Jet al.. Smad2 overexpression enhances Smad4 gene expression and suppresses CBFA1 gene expression in osteoblastic osteosarcoma ROS17/2.8 cells and primary rat calvaria cells. J. Biol. Chem., 1998, 273: 31009-31015

[339]

Lian Net al.. Transforming growth factor β suppresses osteoblast differentiation via the vimentin activating transcription factor 4 (ATF4) axis. J. Biol. Chem., 2012, 287: 35975-35984

[340]

Luo, X., Wu, J. & Wu, G. PPARγ activation suppresses the expression of MMP9 by downregulating NF-κB post intracerebral hemorrhage. Neurosci. Lett.752, 135770 (2021).

[341]

Lee EJet al.. Anti-inflammatory and anti-oxidant mechanisms of an MMP-8 inhibitor in lipoteichoic acid-stimulated rat primary astrocytes: involvement of NF-κB, Nrf2, and PPAR-γ signaling pathways. J. Neuroinflamm., 2018, 15 326

[342]

van Geffen EWet al.. IL-37 diminishes proteoglycan loss in human OA cartilage: donor-specific link between IL-37 and MMP-3. Osteoarthr. Cartil., 2019, 27: 148-157

[343]

Larsson BAMet al.. Association between cortical bone microstructure and statin use in older women. J. Clin. Endocrinol. Metab., 2019, 104: 250-257

[344]

Abbasloo Set al.. The associations of statin intake and the trabecular bone score and bone mineral density status in elderly Iranian individuals: a cross-sectional analysis of the Bushehr Elderly Health (BEH) program. Arch. Osteoporos., 2021, 16 144

[345]

Chao AM, Tronieri JS, Amaro A, Wadden TA. Semaglutide for the treatment of obesity. Trends Cardiovasc. Med., 2023, 33: 159-166

[346]

Lv Y-Jet al.. Resveratrol counteracts bone loss via mitofilin-mediated osteogenic improvement of mesenchymal stem cells in senescence-accelerated mice. Theranostics, 2018, 8: 2387-2406

[347]

Huang Zet al.. Icariin protects against Glucocorticoid-induced osteonecrosis of the femoral head in rats. Cell Physiol. Biochem., 2018, 47: 694-706

[348]

Yue JAet al.. Preliminary study of icariin indicating prevention of steroid-induced osteonecrosis of femoral head by regulating abnormal expression of miRNA-335 and protecting the functions of bone microvascular endothelial cells in rats. Gene, 2021, 766: 145128

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