Objective: To explore the relationship between the alterations of platelet-derived microparticles (PMPs) and endothelial cell-derived microparticles (EMPs) and steroid-induced osteonecrosis of the femoral head.
Methods: Forty-four adult Japanese white rabbits were randomly divided into 2 groups: experimental group (n = 44), injected intramuscularly once with 20 mg/kg of methylprednisolone acetate, and control group (n = 28) injected with normal saline of the same dose. Blood samples were collected from the auricular vein while the animals were in a fasting state in early morning prior to experiment (week 0), and 2, 4, and 8 weeks after the injection. The levels of prothrombin time (PT), activated partial prothrombin time (APTT), and anti-thrombokinase-III (AT-III) were examined. Plasma was ultra-centrifuged and the circulating platelet and EMPs were isolated to undergo flow cytometry to detect the amounts of CD31, CD42a, CD54, and CD62E. 1, 2, 4, and 8 week after the injection 6 rabbits from the experimental group and 4 rabbits from the control group were sacrificed respectively and their femoral heads were taken out to undergo histopathologic examination with HE staining and microthrombus and elastic fiber staining.
Results: The PT, APTT, and AT-III levels increased significantly 1 to 8 weeks after the injection. The numbers of EMPs and PMPs were also increased markedly after steroid administration. Histopathologic examination demonstrated an accumulation of bone marrow cell debris, presence bone empty lacunae in the trabeculae 1 week after the steroid injection. 2, 4, and 8 weeks after the steroid injection the bone necrosis was remarkable, fatty degeneration of bone marrow cells occurred, the diameter of fat cells increased, and the area ratio of fatty cells became higher. MSB staining was positive.
Conclusion: High dose glucocorticosteroid increases the levels of PMPs and EMPs that may be related to hypercoagulability and thrombosis in microcirculation and play an important role in steroid-induced osteonecrosis. MP can be considered a true target in the pharmacological control of steroid-induced osteonecrosis.