Integrative Analysis Of Cellular Autophagy–Related Genes In The Steroid-Induced Osteonecrosis Of The Femoral Head

Objective: This study aimed to identify and evaluate genes associated with cellular autophagy in hormonal femoral head necrosis.Methods: Autophagy-related differentially expressed genes(ARDEGs)in steroid-induced osteonecrosis of the femoral head(SONFH)were identified by obtaining the intersection of differentially expressed genes(DEGs)and autophagy-related genes in a SONFH Gene Expression Omnibus dataset.The ARDEGs were screened,and correlations between gene expression and immune cell infiltration were evaluated.Finally,the validation of hub genes was undertaken through Quantitative real-time-PCR.Results: A comparison of peripheral blood samples from patients with and without SONFH revealed 189 DEGs.Gene Ontology,Kyoto Encyclopedia of Genes and Genomes,and gene set enrichment analyses showed that the DEGs were related to various biological processes(e.g.,neutrophil activation)and pathways(e.g.,hematopoietic cell lineage).The expression levels of these genes were correlated with the infiltration of multiple immune cell types.Among the 189 putative autophagy-related genes associated with SONFH,three genes,RPL6,RPL9,and RPL23,were identified as candidate biomarkers or therapeutic targets based on network analysis and their correlations with immune cell subtypes.Finally,the q RT-PCR results showed that the m RNA expression of RPL9 and RPS6 was consistent with our prediction.Conclusions: In this study,we identified 189 putative autophagy-related genes associated with SONFH,including three genes(RPL6,RPL9,and RPL23)with potential as candidate biomarkers or therapeutic targets,thereby expanding our understanding of the contribution of autophagy to SONFH.