{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:37:13Z","timestamp":1788878233404,"version":"build-2803163510"},"reference-count":68,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, Science and Technological Development, Republic of Serbia","award":["III41004"],"award-info":[{"award-number":["III41004"]}]},{"name":"Ministry of Education, Science and Technological Development, Republic of Serbia","award":["451-03-68\/2022-14\/200042"],"award-info":[{"award-number":["451-03-68\/2022-14\/200042"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Perthes disease is a juvenile form of osteonecrosis of the femoral head that affects children under the age of 15. One hundred years after its discovery, some light has been shed on its etiology and the biological factors relevant to its etiology and disease severity. Methods: The aim of this study was to summarize the literature findings on the biological factors relevant to the pathogenesis of Perthes disease, their diagnostic and clinical significance, and their therapeutic potential. A special focus on candidate genes as susceptibility factors and factors relevant to clinical severity was made, where studies reporting clinical or preclinical results were considered as the inclusion criteria. PubMed databases were searched by two independent researchers. Sixty-eight articles were included in this review. Results on the factors relevant to vascular involvement and inflammatory molecules indicated as factors that contribute to impaired bone remodeling have been summarized. Moreover, several candidate genes relevant to an active phase of the disease have been suggested as possible biological therapeutic targets. Conclusions: Delineation of molecular biomarkers that underlie the pathophysiological process of Perthes disease can allow for the provision of earlier and more accurate diagnoses of the disease and more precise follow-ups and treatment in the early phases of the disease.<\/jats:p>","DOI":"10.3390\/diagnostics13030471","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T08:28:23Z","timestamp":1675067303000},"page":"471","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Molecular Biomarkers in Perthes Disease: A Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Vesna","family":"Spasovski","sequence":"first","affiliation":[{"name":"Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11010 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3419-9869","authenticated-orcid":false,"given":"Sanja","family":"Srzenti\u0107 Dra\u017eilov","sequence":"additional","affiliation":[{"name":"Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11010 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordana","family":"Nik\u010devi\u0107","sequence":"additional","affiliation":[{"name":"Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11010 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran","family":"Ba\u0161\u010darevi\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia"},{"name":"Institute of Orthopedics \u201cBanjica\u201d, Mihajla Avramovi\u0107a 28, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Stojiljkovi\u0107","sequence":"additional","affiliation":[{"name":"Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11010 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Pavlovi\u0107","sequence":"additional","affiliation":[{"name":"Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11010 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5419-5737","authenticated-orcid":false,"given":"Du\u0161ko","family":"Spasovski","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia"},{"name":"Institute of Orthopedics \u201cBanjica\u201d, Mihajla Avramovi\u0107a 28, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1080\/17453674.2016.1227055","article-title":"Incidence of Perthes\u2019 disease in children born between 1973 and 1993","volume":"88","author":"Johansson","year":"2016","journal-title":"Acta Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/aje\/kwr293","article-title":"Racial and Geographic Factors in the Incidence of Legg-Calv\u00e9-Perthes\u2019 Disease: A Systematic Review","volume":"175","author":"Perry","year":"2012","journal-title":"Am. 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