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Human Umbilical Cord Mesenchymal Stem Cells Improve the Necrosis and Osteocyte Apoptosis in Glucocorticoid-Induced Osteonecrosis of the Femoral Head Model through Reducing the Macrophage Polarization
International Journal of Stem Cells
Published online December 31, 2021;  
© 2021 Korean Society for Stem Cell Research.

Gang Tian1,*, Chuanjie Liu2,3,*, Qi Gong3, Zhiping Yu4, Haitao Wang5, Daoqiang Zhang3, Haibo Cong6

1Department of Orthopedics, Weihai Central Hospital Affiliated to Qingdao University & Qingdao University, Weihai, China
2Xinxiang Medical University, Xinxiang, China
3Weihai Key Laboratory of Autoimmunity & Central Laboratory of Weihai Central Hospital, Weihai, China
4Department of Sports Medicine, Weihai Central Hospital Affiliated to Qingdao University, Weihai, China
5Department of Trauma Surgery, Weihai Central Hospital Affiliated to Qingdao University, Weihai, China
6Department of Orthopedics, Weihai Central Hospital Affiliated to Qingdao University & Weihai Key Laboratory of Autoimmunity, Weihai, China
Correspondence to: Daoqiang Zhang
Weihai Key Laboratory of Autoimmunity & Central Laboratory of Weihai Central Hospital, 3 Midong Road West, Wendeng District, Weihai 264400, China
Tel: +86-18306305073, Fax: +86-0631-3806831, E-mail: zhdqwd@163.com
Haibo Cong
Department of Orthopedics, Weihai Central Hospital Affiliated to Qingdao University & Weihai Key Laboratory of Autoimmunity, 3 Midong Road West, Wendeng District, Weihai 264400, China
Tel: +86-13906318868, Fax: +86-0631-3806830, E-mail: haibocong@163.com
*These authors contributed equally to this work.
Received June 28, 2021; Revised October 1, 2021; Accepted October 25, 2021.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background and Objectives: Apoptosis is an outstanding determinant of glucocorticoid (GC)-induced osteonecrosis of the femoral head (ONFH). Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been demonstrated to be associated with apoptosis in diseases models. However, the role of hUC-MSCs in GC-induced ONFH via regulating apoptosis still needs further study.
Methods and Results: In the present study, a GC-induced ONFH model was built in vivo through a consecutive injection with lipopolysaccharide (LPS) and methylprednisolone. The necrosis and apoptosis of the femoral head was evaluated by histological and Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) assay. The level of collagen and TRAP positive cells were determined by Masson and TRAP staining, respectively. M1 macrophage polarization was assessed using immunofluorescence assay. The level of proinflammatory cytokines including tumor necrosis factor (TNF)‐α, Interleukin (IL)‐1β and IL-6 of femoral head was determined by enzyme-linked immunosorbent assay (ELISA) kits. The protein expression of AKT, mTOR, p-AKT and p-mTOR was detected using western blot assay. The results showed that hUC-MSCs treatment prominently promoted the GC-induced the decrease of the collagen level and the increase of TRAP positive cells. Besides, hUC-MSCs treatment decreased necrosis and apoptosis, macrophage polarization, the level of TNF‐α, IL‐1β and IL-6, the protein expression of p-AKT and p-mTOR, and the radio of p-AKT to AKT and p-mTOR to mTOR of femoral head in vivo.
Conclusions: Therefore, the present study revealed that hUC-MSCs improved the necrosis and osteocyte apoptosis in GC-induced ONFH model through reducing the macrophage polarization, which was associated with the inhibition of AKT/mTOR signaling pathway.
Keywords : Osteonecrosis of the femoral head (ONFH), Glucocorticoid, Human umbilical cord mesenchymal stem cells, apoptosis, macrophage polarization