@article { author = {Naderi Ghale-Noie, Zari and Hassani, Mohammad and Kachooei, Amir R. and Kerachian, Mohammad A.}, title = {High Serum Alpha-2-Macroglobulin Level in Patients with Osteonecrosis of the Femoral Head}, journal = {The Archives of Bone and Joint Surgery}, volume = {6}, number = {3}, pages = {219-224}, year = {2018}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2017.25310.1668}, abstract = {  Background: Diagnosis of osteonecrosis of the femoral head (ONFH) is complicated due to the lack of reliable serum biomarkers. Up-regulation of alpha-2-macroglobulin (A2M) gene has been reported in glucocorticoid-induced ANFH rat model. This study aimed to investigate whether the serum level of alpha-2-macroglobulin (A2M) can be used for ONFH diagnosis. Methods: Serum protein capillary electrophoresis was performed on the sera of 36 ONFH patients. Also, human enzyme-linked immunosorbent assay was performed to evaluate the serum levels of A2M. Results: Alpha-2 subunit level, composed of alpha-2-macroglobulin, ceruloplasmin and 2-2 haptoglobin phenotype, was increased significantly as compared to healthy subjects (P=0.0001). Moreover, ELISA assay confirmed significant elevation in the A2M (P=0.037). Conclusion: Our findings suggest that avascular necrotic femur head presumably directly or indirectly elevates A2M in the bloodstream. Thus, serum level of A2M might be used as a reliable diagnostic tool in clinical practice. Level of evidence: II }, keywords = {Alpha-2-macroglobulin,Avascular necrosis of femoral head,Femur,Osteonecrosis}, url = {https://abjs.mums.ac.ir/article_10280.html}, eprint = {https://abjs.mums.ac.ir/article_10280_14372147a556ba2581f034a97c923ff3.pdf} }