Ghrelin attenuates avascular necrosis of the femoral head induced by steroids in rabbits

Purpose: Ghrelin is an endogenous ligand for growth hormone secretagogue receptor. The current study was aimed at examining the effect of ghrelin on avascular necrosis of the femoral head (ANFH) induced by steroids in a rabbit model and also exploring the underlying mechanism. Methods: Experimental rabbits were separated into three groups: Control, Vehicle and Ghrelin. We established a steroid-induced ANFH model in rabbits. Then, MRI scanning and hematoxylin-eosin staining (HE) were conducted to see ANFH. The mRNA levels of Vascular Endothelial Growth Factor (VEGF) and Bone Morphogenetic Protein 2 (BMP-2) were evaluated using real-time qRT-PCR. Results: Rabbits in the Vehicle group showed increased empty bone lacunae, reduced bone trabecula in femoral head; the number of hematopoietic cells in the bone marrow was reduced, whereas number of adipocytes increased with evident fusion phenomenon in comparison with the Control group. All of the changes induced in Vehicle group were attenuated in Ghrelin group. MRI scanning showed obvious necrosis of femoral head in the Vehicle group and less in the Ghrelin group. The mRNA levels of VEGF and BMP-2 were raised in Vehicle group and further enhanced in Ghrelin group. Conclusion: Ghrelin attenuates steroid-induced avascular necrosis in femoral head in rabbit model. A possible mechanism may be through VEGF/BMP-2 axis.