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We hypothesized that P\u2010gp overexpression can prevent<jats:styled-content style=\"fixed-case\">ONFH<\/jats:styled-content>by regulating bone marrow\u2013derived multipotent stromal cell (<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>) adipogenesis and osteogenesis.<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s from Sprague\u2013Dawley rats were transfected with green fluorescent protein (<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>) or the multidrug resistance gene 1 (<jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content>1) encoding<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>and P\u2010gp. Dexamethasone was used to induce<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>differentiation. Adipogenesis was determined by measuring peroxisome proliferator\u2010activated receptor (<jats:styled-content style=\"fixed-case\">PPAR<\/jats:styled-content>\u2010\u03b3) expression and the triglyceride level. Osteogenesis was determined by measuring runt\u2010related transcription factor 2 (Runx2) expression and alkaline phosphatase activity. For<jats:italic>in vivo<\/jats:italic>experiments, rats were injected with saline,<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s expressing<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>(<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s) or<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s expressing<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>\u2010P\u2010gp (<jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content>1\u2010<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s). After dexamethasone induction, adipogenesis was determined by measuring<jats:styled-content style=\"fixed-case\">PPAR<\/jats:styled-content>\u2010\u03b3 expression and fatty marrow, whereas osteogenesis was detected by measuring Runx2 expression, trabecular parameters and the mineral apposition rate, followed by evaluation of the incidence of<jats:styled-content style=\"fixed-case\">ONFH<\/jats:styled-content>. Overexpression of P\u2010gp in<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s resulted in markedly decreased expression of adipogenic markers and increased expression of osteogenic markers. Compared with rats injected with saline, rats injected with<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s showed reduced<jats:styled-content style=\"fixed-case\">ONFH<\/jats:styled-content>, and the injected<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>\u2010positive<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s attached to trabecular surfaces and exhibited an osteoblast\u2010like morphology. Compared with the rats injected with<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s expressing<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>alone, rats injected with<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>s overexpressing<jats:styled-content style=\"fixed-case\">GFP<\/jats:styled-content>and P\u2010gp showed lower adipocytic variables, higher osteogenic variables and lower incidence of<jats:styled-content style=\"fixed-case\">ONFH<\/jats:styled-content>. Overexpression of P\u2010gp inhibited<jats:styled-content style=\"fixed-case\">BMSC<\/jats:styled-content>adipogenesis and promoted osteogenesis, which reduced the incidence of steroid\u2010induced<jats:styled-content style=\"fixed-case\">ONFH<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/jcmm.12917","type":"journal-article","created":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T11:36:36Z","timestamp":1468236996000},"page":"2173-2182","source":"Crossref","is-referenced-by-count":24,"title":["P\u2010glycoprotein overexpression in bone marrow\u2013derived multipotent stromal cells decreases the risk of steroid\u2010induced osteonecrosis in the femoral head"],"prefix":"10.1111","volume":"20","author":[{"given":"Ning","family":"Han","sequence":"first","affiliation":[{"name":"Shanghai East Hospital of Tongji University Shanghai China"},{"name":"Shanghai Tenth People's Hospital of Tongji University Shanghai 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