Corticosteroid-induced Osteonecrosis of the Femoral Head: Detection, Diagnosis, and Treatment in Earlier Stages

Liu, Li-Hua; Zhang, Qing-Yu; Sun, Wei; Li, Zi-Rong; Gao, Fu-Qiang

Research studies on particular types of gene variants more focused on single nucleotide polymorphism variant correlated with the pathogenic hypotheses, including abnormal coagulation and fibrinolysis system, lipid metabolism, angiogenesis, hypoxia, and cytokine stimulation. The inherited hypofibrinolysis proved to be a risk factor of idiopathic ONFH. [34] Sun et al. [35] investigated the etiology of post-SARS osteonecrosis and indicated that PAI-1 was a sensitive blood symbol for screening high-risk susceptible populations. Clinical and basic research studies showed that a low hepatic CYP3A activity may significantly contribute to the risk of steroid-induced ONFH. [36] A genome-wide association study including 2285 children with ALL demonstrated that osteonecrosis was associated with inherited variations near glutamate receptor genes. [37] The characteristics of gene variants are related to the evolution and have wide geographical and demographic distributions. There may be a genetic basis associated with the risk factor, which would determine the development of ONFH in a particular individual. The establishment of this association requires not only further research studies for verification but also a novel alternative to gene therapy.