The Study Of TGF-β1 And CTGF In Avascular Necrosis Of The Adult Femoral Head

objectiveWe discuss the relationship between TGF-β1 and CTGF and the pathology of ANFH through observation of the histopathologic ANFH and investigation the expression of TGF-β1 and CTGF in ANFH by immunohistochemical analysis,thereby, try to elucidate the pathogenesis of ANFH at the level of molecular pathology.MethodsThe specimens were 30 femoral heads from patients undergoing total hip replacement including 15 cases of ANFH(pathology group)and 15 cases of the femoral head fracture under the capsule(control group).We collect the specimens from the sites of bone necrosis and neighborhood in the femoral heads,and the specimens for control group correspondent to athology group.(1) observe the basic pathologicchanges of ANFH under light microscope stained by HE.(2) search the characteristics of the expression of TGF-1 and CTGF by immunohistochemical analysis.(3) statistics analysis(Npar Tests)using software SPSS.Results(1)histopathologic observation:①we found bone cells manifested necrosis collapse and karyopyknosis in pathological group.The bone lacunas were hollow,the circumferential lamella turned turbulent and a part of them dissolved.A few new bone can be seen around dead bone in the femoral heads.congestion of the tissue around the necrotic bone and infiltration of lymphatic cells and plasma cells also are observed,and there are proliferation of fibrous tissue and granulomatous tissue in the gross hap.②In control group,circumferential lamella were excessive and parallell in the order.Bone lacunas locate in the bone lamella or among them,single and separately,stained by blue-purple.Bone cell lies in lacuna.No necrosis and granulation tissues or fibrous tissues can be found in control.(2) Immunohistochemical analysis:The expressions of TGF-β1,CTGF protein are both positive in the part of necrotic femoral head and the circumferential of necrotic bone.But the later is higher,furthmore,the positive immunostaining were more ofen seen in granulomatous tissue and fibrous tissue.The immunostaining was located in the cell plasma or in the nuclear occasionally.①The expressions of TGF-β1,CTGF are both lower in the part of necrotic femoral head than that in the control withstatistical significance at 0.05 level(P＜0.05).②The expressions of TGF-β1,CTGF are both higher in the circumferential part of necrotic bone than that in the control with statistical significance at 0.05 level(P＜0.05).③The expressions of TGF-β1,CTGF are both higher in the circumferential part of necrotic bone than that in the part of necrotic femoral head with statistical significance at 0.05 level(P＜0.05).Conclusion1.The proliferation of granulomatous tissue and fibrous tissues is significant pathologic changes in the necrotic femoral head and plays an important role in the development of the necrosis of femoral head.2.The expressions of TGF-β1,CTGF in the circumferential part of necrotic bone is higher,suggestd that the good reparative ability occur in it.Their expressions are related to the formation of new bone and hyperplasia of granulomatous tissue and fibrous tissue.They play important roles in the formation necrotic histopathology of femoral head.3.The expressions of TGF-β1,CTGF in the part of necrotic bone is lower, demonstrating that its'reparative abilityis poor.The failure in the revival of necrotic bone may contribute to the lower expressions of TGF-β1,CTGF.4.Data suggest that the overexpressions of TGF-β1,CTGF are close to hyperplasia and fibrosis of granulomatous and fibrous tissue,and may play a role in the development of the necrosis of femoral head.