Different differentiation of stroma cells from patients with osteonecrosis: a pilot study.

Osteonecrosis (ON) is commonly caused by high doses of glucocorticoids or ethanol intake. We previously reported suppression of BMP-2 by dexamethasone was more pronounced and enhancement by lovastatin was less pronounced in bone marrow stromal cells (BMSCs) from patients with ON than from patients without ON. We therefore presumed the BMSCs might be dysfunctional in patients with ON and performed this pilot study. We obtained BMSCs from 10 patients with ethanol-induced ON, 10 patients with glucocorticoid-induced ON, and 12 patients without ON as control subjects, checking third passage cells for osteogenic and adipogenic gene expression and differentiation ability. BMSCs from patients with glucocorticoid-induced ON possessed less osteogenic gene expression and less osteogenic differentiation, whereas BMSCs from patients with ethanol-induced ON possessed more adipogenic gene expression and more adipogenic differentiation. Dysfunction of BMSCs may be one of the causes of ON, with differing dysfunction in ethanol-induced ON and glucocorticoid-induced ON. Glucocorticoids may possess more of a suppressive effect on osteogenesis than ethanol, whereas ethanol may possess a more potent adipogenic effect than glucocorticoids on BMSCs.