Resveratrol prevents steroid‐induced osteonecrosis of the femoral head via miR‐146a modulation

Abstract The purpose of this study was to investigate the possible use of resveratrol (Res) to reverse abnormal osteogenesis/osteoclastogenesis activity that occurs during femoral head osteonecrosis and to explore the detailed mechanisms. Application of Res to bone marrow–derived mesenchymal stem cells in vitro promoted survival, inhibited apoptosis, and downregulated expression of reactive oxygen species expression. Moreover, Res application was associated with elevated microRNA‐146a (miR‐146a) expression, osteogenic differentiation, and suppressed osteoclastic differentiation, which were markedly reversed by miR‐146a inhibitor. Histopathological observations and micro‐computed tomography scanning results indicated that the Res‐treated group had lower incidence of osteonecrosis and better bone microstructure than the untreated group. Res inhibited osteoclastogenesis through altering the levels of sirtuin1 (Sirt1), nuclear transcription factor‐κB (NF‐κB), and receptor activator of NF‐κB ligand (RANKL). Simultaneously, Res treatment improved bone formation and increased β‐catenin and runt‐related transcription factor 2 (Runt2) expression levels, while reducing forkhead box class O (FOXO) family protein levels. The results of our study suggest that Res prevents steroid‐induced osteonecrosis by upregulating miR‐146a, and thereby stabilizes osteogenesis/osteoclastogenesis homeostasis via Wnt/FOXO and Sirt1/NF‐κB pathways.