Volume 23 Issue 5
May  2025
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Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(5): 750-755
XU Xilin, WANG Gang, KANG Boyuan, LIU Bo, ZHANG Zheng, JIANG Yichang. Prediction of collapse in non-traumatic osteonecrosis of the femoral head based on serum exosome proteomics[J]. Chinese Journal of General Practice, 2025, 23(5): 750-755. doi: 10.16766/j.cnki.issn.1674-4152.003993
Citation: XU Xilin, WANG Gang, KANG Boyuan, LIU Bo, ZHANG Zheng, JIANG Yichang. Prediction of collapse in non-traumatic osteonecrosis of the femoral head based on serum exosome proteomics[J]. Chinese Journal of General Practice, 2025, 23(5): 750-755. doi: 10.16766/j.cnki.issn.1674-4152.003993
shu

Prediction of collapse in non-traumatic osteonecrosis of the femoral head based on serum exosome proteomics

doi: 10.16766/j.cnki.issn.1674-4152.003993
  • 1.

    Department of Orthopaedics, the Third Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150030, China

Funds:

 8237153419

 GZ20210136

 GA21C006

 国中医药人教发〔2020〕7号

 ZHY2023-099

  • Received Date: 2024-11-22
    Available Online: 2025-08-14
    Abstract
  •   Objective  This study aimed to elucidate the molecular mechanisms underlying the progression of non-traumatic osteonecrosis of the femoral head (NONFH) and to identify potential biomarkers associated with femoral head collapse using bioinformatics and machine learning approaches.  Methods  Peripheral blood samples were collected from early-stage (n=11, ARCO Ⅰ stage) and collapsed-stage (n=9, ARCO Ⅲc-Ⅳ stage) NONFH patients treated at the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine between March 2022 and May 2023. Exosomes were isolated and purified from serum and characterized using transmission electron microscopy, nanoparticle tracking analysis, and Western blotting. Serum exosomal proteins were identified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Biomarkers associated with NONFH collapse were screened using bioinformatics, support vector machine-recursive feature elimination (SVM-RFE) algorithm, and least absolute shrinkage and selection operator (LASSO) regression model. Correlation analysis was performed between collapse-associated proteins and immune cells.  Results  (1) The cholesterol level in the collapsed-stage group [(1.52±0.36) mmol/L] was significantly higher than that in the early-stage group [(1.13±0.31) mmol/L, t=2.587, P=0.019]. However, no significant differences were observed in age, total cholesterol, low-density lipoprotein cholesterol, alkaline phosphatase, or triglyceride levels (P>0.05). (2) The area under the curve (AUC) values for the candidate biomarkers SAA1, C4A, and RPS8 were 0.66, 0.89, and 0.84, respectively, demonstrating good predictive potential. (3) Correlation analysis indicated that C4A, SAA1, and RPS8 might be involved in NONFH pathogenesis by regulating various immune cells.  Conclusion  C4A, SAA1, and RPS8 can serve as predictive biomarkers for predicting femoral head collapse in NONFH and may contribute to disease progression through immune cell modulation. These findings provide new insights into early intervention and clinical treatment strategies for NONFH.

     

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