[Role and mechanism of macrophage-mediated osteoimmune in osteonecrosis of the femoral head]

Abstract

Objective: To summarize the research progress on the role of macrophage-mediated osteoimmune in osteonecrosis of the femoral head (ONFH) and its mechanisms.

Methods: Recent studies on the role and mechanism of macrophage-mediated osteoimmune in ONFH at home and abroad were extensively reviewed. The classification and function of macrophages were summarized, the osteoimmune regulation of macrophages on chronic inflammation in ONFH was summarized, and the pathophysiological mechanism of osteonecrosis was expounded from the perspective of osteoimmune, which provided new ideas for the treatment of ONFH.

Results: Macrophages are important immune cells involved in inflammatory response, which can differentiate into classically activated type (M1) and alternatively activated type (M2), and play specific functions to participate in and regulate the physiological and pathological processes of the body. Studies have shown that bone immune imbalance mediated by macrophages can cause local chronic inflammation and lead to the occurrence and development of ONFH. Therefore, regulating macrophage polarization is a potential ONFH treatment strategy. In chronic inflammatory microenvironment, inhibiting macrophage polarization to M1 can promote local inflammatory dissipation and effectively delay the progression of ONFH; regulating macrophage polarization to M2 can build a local osteoimmune microenvironment conducive to bone repair, which is helpful to necrotic tissue regeneration and repair to a certain extent.

Conclusion: At present, it has been confirmed that macrophage-mediated chronic inflammatory immune microenvironment is an important mechanism for the occurrence and development of ONFH. It is necessary to study the subtypes of immune cells in ONFH, the interaction between immune cells and macrophages, and the interaction between various immune cells and macrophages, which is beneficial to the development of potential therapeutic methods for ONFH.

Keywords: Osteonecrosis of the femoral head; chronic inflammation; macrophage; osteoimmunology.

图 1

Schematic diagram of M1 macrophages mediating the chronic inflammatory microenvironment to inhibit the process of osteonecrosis repair and promote the development of ONFH M1型巨噬细胞介导慢性炎症免疫微环境抑制骨坏死修复过程，进而促使ONFH发生、发展示意图

图 2

Schematic diagram of inhibiting the polarization of macrophages to M1 or (and) regulating the polarization of macrophages to M2 in the chronic inflammatory microenvironment to delay the progress of ONFH 在慢性炎症微环境中抑制巨噬细胞M1型极化或（和）调控巨噬细胞向M2型极化延缓ONFH进展示意图