Liu C, Li W, Zhang C, Pang F, Wang DW. Previously unexplored etiology for femoral head necrosis: Metagenomics detects no pathogens in necrotic femoral head tissue. World J Clin Cases 2022; 10(7): 2138-2146 [PMID: 35321171 DOI: 10.12998/wjcc.v10.i7.2138]
Corresponding Author of This Article
Da-Wei Wang, MD, PhD, Director, Professor, Department of Orthopedics, Liaocheng People's Hospital, No. 67 Dongchang West Road, Liaocheng 252000, Shandong Province, China. wangdaweisci@126.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 6, 2022; 10(7): 2138-2146 Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2138
Previously unexplored etiology for femoral head necrosis: Metagenomics detects no pathogens in necrotic femoral head tissue
Chao Liu, Wei Li, Chao Zhang, Feng Pang, Da-Wei Wang
Chao Liu, Wei Li, Da-Wei Wang, Department of Orthopedics, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
Chao Liu, Chao Zhang, Department of Orthopedics, Shandong The First Medical University, Taian 271016, Shandong Province, China
Feng Pang, Department of Clinical Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
Author contributions: Wang DW and Pang F study concept and design; Wang DW study supervision; Pang F administrative, technical, and material support; Liu C and Li W analysis and interpretation of data; Zhang C acquisition of data; Liu C drafting of the manuscript; Zhang C, Pang F, and Liu C critical revision of the manuscript for important intellectual content; Zhang C statistical analysis; Wang DW and Pang F contributed equally to this study; all authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Liaocheng People's Hospital (Approval No.2018010).
Clinical trial registration statement: This study was conducted as part study registered with the Chinese Clinical Trial Registry (ChiCTR-RRC-16010123).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Wei Wang, MD, PhD, Director, Professor, Department of Orthopedics, Liaocheng People's Hospital, No. 67 Dongchang West Road, Liaocheng 252000, Shandong Province, China. wangdaweisci@126.com
Received: September 30, 2021 Peer-review started: September 30, 2021 First decision: December 4, 2021 Revised: December 17, 2021 Accepted: January 20, 2022 Article in press: January 20, 2022 Published online: March 6, 2022 Processing time: 152 Days and 19.5 Hours
Abstract
BACKGROUND
Osteonecrosis of the femoral head (ONFH) is a frequent and refractory disease whose pathogenesis has not yet been elucidated. Infection and other factors that reduce the local blood supply can lead to bone necrosis.
AIM
To aim of this study was to assess the relationship of ONFH with bone infection by use of metagenomic sequencing.
METHODS
Twelve patients with idiopathic ONFH and 12 comparable controls who were undergoing hip arthroplasty were followed up in parallel. Necrotic femoral head specimens were collected for bacterial and fungal cultures using standard methods. Bone specimens were subjected to preliminary processing, and metagenomics sequencing of microorganisms was performed. A one-way analysis of variance was used to compare bacterial species in the two groups.
RESULTS
Bacterial and fungal cultures exhibited no evidence of microbial growth in all isolated necrotic femoral head tissues. We thus performed metagenomic sequencing and classified the species as suspected pathogens or suspected background microorganisms based on known bacterial pathogenicity. There was no evidence of viruses, fungi, parasites, M. tuberculosis complex, or mycoplasma/chlamydia. There were also no significant differences in suspected pathogens or suspected background microorganisms (P > 0.05).
CONCLUSION
Although we found no pathogens specific for ONFH in necrotic femoral head tissue, our research provides a foundation for future research on the metagenomics of bone pathogens.
Core Tip: Osteonecrosis of the femoral head (ONFH) is a frequent and refractory disease whose pathogenesis has not been elucidated. Infection and other factors that reduce the local blood supply can lead to osteonecrosis. We performed culture and metagenomic sequencing to examine the presence of pathogens in necrotic femoral head tissue. The results confirmed the absence of viruses, fungi, parasites, or mycoplasma/chlamydia in the specimens, and no significant differences in bacterial distribution and suspected background microorganisms. Although we did not identify an ONFH-specific pathogen, our study lays the groundwork for future research on metagenomics of bone pathogens.
