Bone necrosis after injecting of polymethylmethacrylate (PMMA) bone cement will lead to re-fracture of bone tissue. As a new type of necrosis, there is little research related to the necroptosis of surrounding bone tissue near the bone cement. The purpose of our study was to (i) investigate the presence of necroptosis in vivo and, (ii) established as a new type of bone cement containing PMMA, calcium phosphate cement (CPC) and Necrostatin-1 (Nec-1) to inhibit necroptosis of bone tissue. A total of 12 Japanese rabbits were used to establish the animal model and randomly divided into 4 groups signed as a control group, PMMA group, PMMA-CPC group and PMMA-CPC-Nec-1 group, respectively. We used scanning electron microscope to observe the structure of the samples, used HE staining to detect the necrosis, and used western blotting as well as ELISA test to examine the iconic molecule receptor interacting protein kinase-3 (RIP 3) protein and tumor necrosis factor α (TNF-α). After analyzing the results of our study, we found that the structure in both PMMA bone cement group and composite bone cement group was damaged and there was an evidence of necrosis, but it was absent in control group. Through molecule detection, the RIP 3 protein expression was decreased in PMMA-CPC-Nec-1 (P < 0.05). TNF-α expression was increased in bone cement groups with and without CPC (P < 0.05), but was inhibited in PMMA-CPC-Nec-1 group. We have concluded that the necroptosis could be confirmed in bone tissue necrosis induced by TNF-α after bone cement injection and also could be inhibited by composite bone cement with Nec-1.

中文翻译：

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负载necrostatin-1复合骨水泥抑制兔骨组织坏死性凋亡。

注射聚甲基丙烯酸甲酯（PMMA）骨水泥后骨坏死会导致骨组织再次骨折。作为一种新型坏死，关于骨水泥附近周围骨组织坏死性凋亡的研究较少。我们研究的目的是 (i) 研究体内坏死性凋亡的存在，以及 (ii) 建立一种新型骨水泥，含有 PMMA、磷酸钙水泥 (CPC) 和 Necrostatin-1 (Nec-1) 以抑制骨组织坏死性凋亡。采用12只日本兔建立动物模型，随机分为4组，分别为对照组、PMMA组、PMMA-CPC组和PMMA-CPC-Nec-1组。采用扫描电镜观察样品结构，采用HE染色检测坏死情况，采用Western blotting和ELISA检测检测标志性分子受体相互作用蛋白激酶3（RIP 3）蛋白和肿瘤坏死因子α (TNF-α)。通过分析我们的研究结果，我们发现PMMA骨水泥组和复合骨水泥组的结构均受到破坏，并有坏死的迹象，而对照组则没有。通过分子检测，PMMA-CPC-Nec-1中RIP 3蛋白表达量降低（P < 0.05）。骨水泥组和无CPC组TNF-α表达均升高（P < 0.05），但PMMA-CPC-Nec-1组TNF-α表达受到抑制。我们的结论是，骨水泥注射后TNF-α诱导的骨组织坏死可以证实坏死性凋亡，并且Nec-1复合骨水泥也可以抑制坏死性凋亡。