1. Academic Validation
  2. Pentraxin 3 ameliorates glucocorticoid-induced osteonecrosis of the femoral head via TLR4/NF-κB/FGF21 signaling axis

Pentraxin 3 ameliorates glucocorticoid-induced osteonecrosis of the femoral head via TLR4/NF-κB/FGF21 signaling axis

  • Commun Biol. 2025 Dec 2;9(1):27. doi: 10.1038/s42003-025-09282-3.
Jinxu Li # 1 2 Zhonghua Zhou # 1 2 Yan Kong 3 Yang Li 1 Zhe Wang 1 Yongkang Yang 2 4 Jingyi Wang 2 4 Tianyi Liu 5 Xinyu Wang 6 Dan Luo 7 8 Fan Zhang 2 4 Cheng Qiu 9 10 Jingwei Liu # 11 12 13
Affiliations

Affiliations

  • 1 Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China.
  • 2 Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
  • 3 Department of General Surgery, Muping District Traditional Chinese Medicine Hospital of Yantai City, Yantai, Shandong, PR China.
  • 4 Department of Burn and Plastic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China.
  • 5 Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
  • 6 Department of Anaesthesia, National Center for Orthopaedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, PR China.
  • 7 Department of Oral Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China.
  • 8 School of Stomatology of Qingdao University, Qingdao, Shandong, PR China.
  • 9 Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China. [email protected].
  • 10 Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China. [email protected].
  • 11 Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China. [email protected].
  • 12 Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China. [email protected].
  • 13 Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China. [email protected].
  • # Contributed equally.
Abstract

Glucocorticoid-induced osteonecrosis of the femoral head (ONFH) is a debilitating bone disorder characterized by impaired osteogenesis and apoptosis-driven bone collapse. This study identifies significantly reduced pentraxin 3 (PTX3) levels in patient samples and models. Recombinant PTX3 (rPTX3) alleviated dexamethasone-induced osteogenic suppression and Apoptosis in vitro by activating TLR4/NF-κB pathway to downregulate Fibroblast Growth Factor 21 (FGF21). In Ptx3-knockout mice, glucocorticoid-induced bone deterioration was exacerbated, while PTX3 administration preserved bone architecture. Pharmacological blockade of TLR4/NF-κB signaling abolished PTX3's protective effects. Notably, FGF21 suppression by activating transcription factor 3 (ATF3) retained bone-protective effects even in PTX3-deficient models, underscoring its role as a downstream effector. These findings establish the PTX3-TLR4/NF-κB-FGF21 axis as a key mechanism and suggest PTX3 supplementation as a potential therapeutic strategy against glucocorticoid-induced ONFH.

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