Serum biomarkers discovery of steroid-induced femoral head osteonecrosis in Chinese female by comparative proteome

Abstract Background: Steroid-induced osteonecrosis of femoral head (SONFH) is a disabling, aseptic and ischemic disease due to excessive glucocorticoids (GCs) usage. SONFH patients are commonly asymptomatic, which makes its early diagnosis a challenge, the pathological mechanisms of SONFH are not well-known, the purpose of the present study was to screen diagnostic biomarkers for SONFH. Methods: The differential expression of serum proteins from SONFH, traumatic osteonecrosis of the femoral head (TONFH) patients and healthy volunteers (CK) in Chinese females was compared using Tandem Mass Tag (TMT) quantitative proteomics, and potential diagnostic biomarkers were verified by western blotting. Results: Bioinformatics analyses revealed key proteins, pathways, and domains differentially regulated among SONFH, TONFH and healthy volunteers in Chinese females, the results showed that peptidase S1, fibrinogen, transferrin, lipid transport domains, hematopoietic cell lineage, fat digestion, absorption, and peroxisome proliferator-activated receptor (PPAR) pathways were associated with the development of SONFH. C-reactive protein (CRP), serum amyloid A protein (SAA1), alpha-1-acid glycoprotein 1 (ORM1), and dopamine beta-hydroxylase were selected for verification of differential expression using western blotting. Conclusions: Our data suggest that dysfunction of hematopoietic cell lineage, adhesion, fat digestion and absorption, PPAR pathways may be involved in the pathogenesis of SONFH, serum proteins SAA1, ORM1 could be used as new potential diagnostic biomarkers for SONFH.