- Demonstration of pathophysiological mechanisms involvement in osteonecrosis of the femoral head in sickle cell disease.
| Author | Year | Study design | Study Population | Age | Method used | Mechanisms associated with ON pathophysiology | P-value |
|---|---|---|---|---|---|---|---|
| Daltro et al23 | 2020 | Case–control | 9 SCD patients, 15 SCD-ON patients, 19 control | 10-55 year | flow cytometry | CD4+T lymphocytes raised circulatory levels of simultaneously produced pro-inflammatory cytokines IL-17+-IL4+ and IFN-γ+-IL4+ contributing to ON inflammation at target organ site. The polyclonal stimulation with phorbol myristate acetate/ inomycin in vitro in SCD, SCD-ON showed significantly raised IL4+TCD4+ cells. | p=0.0016, p=0.0017 |
| Al-Ghaithi et al24 | 2021 | Experimental | 7 SCD patients | 22–32 years | Raman Spectroscopy | Decline in bone quality and drop in mineral volume due to decrease in bone phosphate to amide ratio, carbonate to amide ratio carbonate-to-phosphate | p=0.01 p=0.02 p=0.008 |
| Adesina and Neumayr25 | 2019 | Case study | 1 SCD patient | 19 year | - | Progression of R-ONFH with decreased joint space, cysts (Steinberg stage V) and sclerosis; and minimal flattening (Steinberg stage II) at the left femoral head | p<0.05 |
| Chaouch et al8 | 2015 | Case–control | 100 SCD patients | 30±5 year | PCR/sequencing | BMP6 polymorphisms in articular cartilage destruction during pathogenesis of ON in SCA patients showed significant association between osteonecrosis and alleles G of rs267201 and A of 267196 | p=0.04 p=0.0023 |
SCD: sickle cell disease, SCD-ON: sickle cell disease with osteonecrosis, IL: interleukin, IFN-γ: Interferon gamma, ONFH: osteonecrosis of the femoral head, PCR: polymerase chain reaction, ON: osteonecrosis, BMP: bone morphogenetic protein