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Updated: Apr 2, 2026

Author Spotlight: Developing a Rat Model for Weight-Bearing Intervention to Investigate Osteonecrosis of the Femoral Head
Published on: September 27, 2024
ANK1 and EPB41 Variants and The Risk of Glucocorticoid-Induced Osteonecrosis
Shengbao Chen1, Xianmin Zhu2, Zhongzhong Chen3
1Department of Orthopaedic Surgery and Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedics, Shanghai, China.
Rare variants in ANK1 and EPB41 genes are linked to steroid-induced osteonecrosis of the femoral head (SONFH). These genetic factors compromise red blood cell integrity, increasing SONFH risk when combined with steroid use.
Area of Science:
- Genetics
- Hematology
- Orthopedics
Background:
- Steroid-induced osteonecrosis of the femoral head (SONFH) is a debilitating condition with unclear genetic causes.
- Identifying rare genetic variants is crucial for understanding SONFH pathogenesis.
Purpose of the Study:
- To identify rare damaging variants associated with SONFH.
- To investigate the role of these variants in disease development.
Main Methods:
- Whole-exome sequencing (WES) was performed on SONFH patients and controls.
- Genetic burden analysis identified rare variants in ANK1 and EPB41.
- Functional assessments of erythrocyte membrane integrity were conducted.
Main Results:
- Rare heterozygous variants in ANK1 and EPB41 were found in SONFH patients but not controls.
- These variants significantly increased SONFH risk.
- Variants caused erythrocyte membrane dysfunction, including reduced ANK1 expression and increased hemolysis.
Conclusions:
- Rare ANK1 and EPB41 variants are novel risk factors for SONFH.
- These variants impair erythrocyte membrane integrity, contributing to microcirculatory damage.
- Glucocorticoid use acts as a second hit, exacerbating SONFH in individuals with these variants.
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