Erythropoietin suppresses osteoblast apoptosis and ameliorates steroid-induced necrosis of the femoral head in rats by inhibition of STAT1-caspase 3 signaling pathway

BMC Musculoskelet Disord. 2023 Nov 17;24(1):894. doi: 10.1186/s12891-023-07028-y.

Abstract

Background: Steroid-induced avascular necrosis of the femoral head (SANFH) is characterized by osteoblast apoptosis, leading to a loss of bone structure and impaired hip joint function. It has been demonstrated that erythropoietin (EPO) performs a number of biological roles.

Objective: We examined the effects of EPO on SANFH and its regulation of the STAT1-caspase 3 signaling pathway.

Method: In vitro, osteoblasts were treated with dexamethasone (Dex) or EPO. We identified the cytotoxicity of EPO by CCK-8, the protein expression of P-STAT1, cleaved-caspase9, cleaved-caspase3, Bcl-2, BAX, and cytochrome c by Western blotting, and evaluated the apoptosis of osteoblasts by flow cytometry. In vivo, we analyzed the protective effect of EPO against SANFH by hematoxylin and eosin (H&E), Immunohistochemical staining, and Micro-computed tomography (CT).

Results: In vitro, EPO had no apparent toxic effect on osteoblasts. In Dex-stimulated cells, EPO therapy lowered the protein expression of BAX, cytochrome c, p-STAT1, cleaved-caspase9, and cleaved-caspase3 while increasing the expression of Bcl-2. EPO can alleviate the apoptosis induced by Dex. In vivo, EPO can lower the percentage of empty bone lacunae in SANFH rats.

Conclusion: The present study shows that EPO conferred beneficial effects in rats with SANFH by inhibiting STAT1-caspase 3 signaling, suggesting that EPO may be developed as a treatment for SANFH.

Keywords: Apoptosis; Erythropoietin; Necrosis of the femoral head; STAT1-caspase 3.

MeSH terms

  • Animals
  • Apoptosis
  • Caspase 3 / metabolism
  • Cytochromes c / metabolism
  • Cytochromes c / pharmacology
  • Erythropoietin* / pharmacology
  • Femur Head Necrosis* / chemically induced
  • Femur Head Necrosis* / drug therapy
  • Femur Head Necrosis* / metabolism
  • Osteoblasts / metabolism
  • Proto-Oncogene Proteins c-bcl-2 / metabolism
  • Rats
  • Signal Transduction
  • Steroids / adverse effects
  • X-Ray Microtomography
  • bcl-2-Associated X Protein / metabolism

Substances

  • Caspase 3
  • bcl-2-Associated X Protein
  • Cytochromes c
  • Proto-Oncogene Proteins c-bcl-2
  • Erythropoietin
  • Steroids