Corticosteroid-Induced Osteoporosis and Osteonecrosis: The Role of Oxidative Stress

Document Type : Original Article

Authors

1 Zagazig University student's Hospital, Zagazig University, Egypt

2 Pharmacology Department, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt, 44511

Abstract

Glucocorticoids (GCs) are mainly used in different chemotherapeutic protocols and play a major  role in the normal tuning of bone remodeling. But, the use of GCs for long time associated oxidative injury have a crucial role in the development of osteoporosis (OP), osteonecrosis (ON) and apoptosis. This study intended to investigate the effects of ginseng as a natural, novel free radical scavenger that may help in alleviating the osteoporetic changes. Forty mature male New Zealand white rabbits were divided equally into control (C), steroid-administered (S) and ginseng-administered (G) and group of steroid with ginseng (S+ G). Two separate experiments were conducted, one for acute model receiving 20 mg/kg.BW injected in upper gluteal muscle once for one week and ginseng orally daily by dose 14 mg/kg.BW. The second (chronic model) where animals received 4 mg/kg.BW injection in upper gluteal muscle once weekly for six weeks and ginseng orally daily by dose 14 mg/kg.bw for six weeks. Oxidant (MDA)/antioxidant (GSH) status was determined in steroid-induced OP & ON in an acute and chronic model. The presence or absence of ON, OP and intravascular thrombi were examined histopathologically and immunohistochemically using calcitonin, caspase 3 and nuclear factor kappa–B cells (NF- κB) markers.. The biochemical study revealed a significant increase in the plasma GSH level and significant decrease in the MDA with the use of ginseng compared with steroid groups in acute and chronic experiment. The (G+S) treated group maintained their morphology compared to corticosteroid treated group, which showed marked osteoporotic changes. In conclusion, ginseng, as a natural, free radical scavenger could significantly suppress the development of osteoporetic changes.  

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