REVIEW article
Front. Immunol.
Sec. Inflammation
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1626617
This article is part of the Research TopicInnovations in Immunometabolic Treatment and Controlled Release Systems for Bone and Joint DisordersView all 12 articles
Immunological Mechanisms in Steroid-Induced Osteonecrosis of the Femoral Head
Provisionally accepted
- Lanzhou University, Lanzhou, China
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Steroid-induced osteonecrosis of the femoral head (SONFH) represents a prevalent and complex orthopedic condition, intricately linked to multifaceted dysregulation of the immune system. Prolonged administration of high doses of GCs (GCs) represents a major cause of non-traumatic osteonecrosis of the femoral head (ONFH), with its pathogenesis rooted in the interaction between immune cell dysfunction and imbalances in bone metabolism. This review systematically explores the molecular mechanisms through which GCs induce osteonecrosis via immunological pathways, with emphasis on the impact of macrophage polarization imbalance on the disruption of the bone immune microenvironment. This encompasses the metabolic reprogramming of macrophages and the involvement of critical signaling pathways. This study sought to establish a comprehensive theoretical framework for the immunological regulatory mechanisms underlying SONFH, to provide a detailed understanding of the mechanisms by which GCs induce bone immune disorders, and to offer a robust theoretical foundation for the formulation of early intervention strategies.
Keywords: glucocorticoid, immune cells, osteoimmunity, Macrophage polarization, SONFH
Received: 11 May 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Yin, Wu, Huang and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haiyan Zhao, Lanzhou University, Lanzhou, China
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