Гений oртопедии (Jun 2024)
The effect of the IL-6 monoclonal blocker on the course of aseptic femoral head necrosis in the experiment (pilot study)
Abstract
Background There is currently no pathogenetically based treatment for aseptic necrosis of the femoral head. One of the most promising areas of possible targeted therapy is the use of genetically engineered drugs, including monoclonal blockers of proinflammatory cytokines, aimed at inhibiting inflammation and indirectly reducing the activity of osteodestruction. The aim of the work is to evaluate the effectiveness of the use of the IL-6 monoclonal blocker in the course of aseptic necrosis of the femoral head in an experiment. Purpose Evaluate the preliminary results of the use of the IL-6 monoclonal blocker in the course of aseptic necrosis of the femoral head in an experiment. Materials and methods Surgical induction of aseptic necrosis of the femoral head was performed in 18 male Wistar rats. The animals were divided into two groups of 9 individuals each. The first group did not receive any treatment, the second received therapy with a monoclonal IL-6 receptor blocker, starting from the second week of the experiment, one injection once every two weeks. All animals were removed from the experiment at 4, 6 and 8 weeks after the induction of aseptic necrosis, 3 rats from each group at a time. Total RNA was isolated from the femoral head on the aseptic necrosis side and the conditionally healthy side as a control. The expression of genes of regulatory proteins of osteogenesis was studied by PCR. To study the features of osteodestructive processes, histological examination of femoral head preparations in all animals was conducted. Results Histological preparations of femoral heads of the second group animals were characterized by less pronounced osteodestructive, chondrodestructive processes compared to the animals that did not receive therapy. The mRNA profile of the rats of the second group displayed an increase in the expression of genes encoding proteins involved in osteoreparation at all stages of the experiment. At the same time, the activity of genes encoding proteins of proinflammatory cytokines, regulatory molecules of osteoclastogenesis was reduced relative to the first group. Discussion The data obtained indicate an important role of inflammation in the regulation of osteodestruction. Inhibition of the biological action of IL-6 contributed to inhibition of the expression of osteoclastogenesis genes, increased activity of bone metabolism genes, and caused a decrease in the intensity of osteodestruction and activation of osteoreparation. Conclusion Preliminary results of the use of a monoclonal blocker of the proinflammatory cytokine IL-6 indicate the inhibition of osteodestructive and strengthening of osteoreparative processes due to the correction of the expression of bone metabolism genes during the progression of aseptic necrosis of the femoral head in rats in an experimental model.
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