Platelet-rich plasma promotes bone formation, restrains adipogenesis and accelerates vascularization to relieve steroids-induced osteonecrosis of the femoral head

Abstract

Steroid-associated necrosis of the femoral head (SANFH) is one of the most common and refractory chronic diseases with increasing incidence. The typical pathological changes of SANFH include decreased osteogenic differentiation, enhanced intramedullary adipocytes deposition and impaired osseous circulation. In this study, we investigated the effects and potential mechanisms of Platelet-rich plasma (PRP) on SANFH. Sixty Sprague-Dawley rats were randomly divided into the control, PRP donor, model, and PRP groups. Compared to the model group, PRP treatment significantly increased the hemorheological indexes and serum levels of bone gla-protein (BGP) and vascular endothelial growth factor (VEGF), while decreased the levels of triglyceride (TG) and total cholesterol (TC). Meanwhile, Micro-CT and histopathological stain (Hematoxylin-eosin and Alcian blue-hematoxylin/orange G staining) were performed on the femoral head for morphological and histopathological evaluation, indicating that bone trabecular microstructure and bone mineral density (BMD) were significantly improved after PRP treatment. Immunohistochemical analysis revealed that PRP remarkably up-regulated the expression of osteogenic markers including β-catenin and alkaline phosphatase (ALP), angiogenic markers containing VEGF and platelet endothelial cell adhesion molecule-1 (CD31), while down-regulated adipogenic markers involving fatty acid-binding protein (FABP-4), and peroxisome proliferator-activated receptor gamma (PPAR-γ) in SANFH rat models. In summary, for the first time, PRP was demonstrated to prevent the development of SANFH through stimulating bone formation and vascularization as well as retarding adipogenesis.

Keywords:

• Platelet-rich plasma
• steroid-associated necrosis of the femoral head
• osteogenesis
• lipogenesis
• angiogenesis

Author Contributions

H.X and S.L. conceived and designed the study, performed the acquisition and interpretation of data, and were involved in drafting the manuscript. L.F, C.X, P.Z, R.X, Z.S, Z.Z, Q.G and P.W. were involved in the acquisition and interpretation of data. P.T. and H.J. were involved in the interpretation of data, and critical revision of the manuscript for important intellectual content. All authors read and approved of the final manuscript

Conflict of Interest

The authors declare that they have no conflict of interest

Ethical approval

All applicable institutional and/or national guidelines for the care and use of animals were followed

Additional information

Funding

This research has been partially supported by Natural Science Foundation of China [Grant no. 81973869, 81904221, 81904223, 81904219, and 81873325]; the State Administration of Traditional Chinese Medicine of Zhejiang Province [Grant no. 2018ZA034, 2018ZZ011, 2019ZQ018 and 2020ZA035]; Health Commission of Zhejiang Province [Grant no. 2019RC225]; Opening Project of Zhejiang Provincial Preponderant and Characteristic Subject of Key University (Chinese Traditional Medicine), Zhejiang Chinese Medical University [Grant no. ZYX2018001 and ZYX2018004]; Youth Foundation of Zhejiang Chinese Medical University [Grant no. KC201932 and Q2019Y01]; and China Association for Science and Technology [Grant no. CACM-2018-QNRC2-C03].