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
ARTICLE HIGHLIGHTS
Research background
The immediate cause of femoral head necrosis is localized damage to the blood flow to the femoral head and disruption of the intraosseous circulation. Inflammatory as well as infectious factors are thought to lead to microangiopathy and depletion of the intraosseous circulation, which in turn leads to femoral head necrosis.
Research motivation
The motivation for this study was to assess the relationship between infection and osteonecrosis of the femoral head (ONFH) using metagenomic next-generation sequencing (mNGS) sequencing.
Research objectives
Our objectives were to identify the pathogens associated with ONFH in necrotic femoral heads and to investigate the relationship between ONFH and infection.
Research methods
Two groups of subjects, the ONFH group and the control group, were recruited and femoral head specimens were collected using standard methods. Differences in the microbial distribution of the femoral head specimens between the two groups were assessed by culture and mNGS sequencing methods.
Research results
No evidence of microbial growth could be detected by bacterial or fungal culture methods in any of the femoral head specimens isolated from the subjects. Metagenomic sequencing results also did not support the presence of viruses, fungi, parasites, Mycobacterium tuberculosis complex or mycoplasma/chlamydia. There were no significant differences in the suspected background microorganisms between the two subject groups (P > 0.05).
Research conclusions
No specific pathogens associated with the pathogenesis of ONFH were identified, this study lays the foundation for mNGS studies of ONFH disease.
Research perspectives
So far as we are aware, this is the first study to examine whether pathogenic microbial infections are the cause of idiopathic ONFH in patients with no apparent risk factors.
