{
  "abstract": "Delayed union and pseudarthrosis remain complications of lumbar interbody fusion. We investigated Fuyuan Huoxue decoction (FY) in a rat extreme lateral interbody fusion model. FY improved bone mineral density and trabecular architecture. Reduced inflammatory macrophage infiltration and nuclear factor kappa B (NF-κB) activation at 4 weeks were accompanied by improved bony bridging at 8 weeks. Transcriptomic and network analyses nominated Toll-like receptor 9 (TLR9)/NF-κB signaling for functional investigation. FY-medicated serum reduced macrophage inflammatory markers and extracellular double-stranded DNA (dsDNA), promoted bone marrow mesenchymal stem cell (BMSC) osteogenesis, and attenuated impairment induced by inflammatory macrophage-conditioned medium. DNase treatment reduced this medium's inhibitory effects, whereas a separate exogenous dsDNA challenge impaired osteogenesis and was attenuated by a TLR9 antagonist. TLR9 agonist and antagonist experiments in BMSCs and a 2-week in vivo agonist intervention supported pathway involvement. Human nonunion single-cell data showed increased phospholipid scramblase 1 and interleukin-6 expression in myeloid cells. These findings support complementary pro-osteogenic and anti-inflammatory actions of FY and identify TLR9/NF-κB as a candidate pathway contributing to fusion repair.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.",
    "Laboratory of Sensory Neurobiology, School of Basic Medical Sciences, Hebei University, Baoding, People's Republic of China.",
    "School of Basic Medicine, Hebei Medical University, Shijiazhuang, People's Republic of China.",
    "Department of Spinal Surgery, Affiliated Hospital of Hebei University, Baoding, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hongwei Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Han Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Shaorong Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Weijian Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yijian Guo"
    },
    {
      "affs": [
        1
      ],
      "name": "Shuai Cheng"
    },
    {
      "affs": [
        2
      ],
      "name": "Jiayi Sun"
    },
    {
      "affs": [
        3
      ],
      "name": "Jilong An"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei Zhang",
      "orcid": "0009-0005-4238-1280"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5kr06fp79p2jg.bib",
  "cited_by": 0,
  "doi": "10.1002/advs.78444",
  "fulltext_url": "https://europepmc.org/articles/PMC13720390",
  "id": "5kr06fp79p2jg",
  "issns": [
    "2198-3844"
  ],
  "landing_url": "https://europepmc.org/article/MED/42958760",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2734|Spine and Intervertebral Disc Pathology"
    ]
  ],
  "openalex": "W7224829770",
  "pdf_url": "https://europepmc.org/articles/PMC13720390?pdf=render",
  "pmcid": "PMC13720390",
  "pmid": "42958760",
  "published": "2026-10-29",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/5kr06fp79p2jg.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:36Z",
      "native_id": "MED:42958760",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42958760"
    },
    {
      "first_seen": "2026-11-03T12:21:16Z",
      "native_id": "PMC13720390",
      "source": "pmc",
      "url": "https://doi.org/10.1002/advs.78444"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2734|Spine and Intervertebral Disc Pathology",
      "subfield": "general"
    }
  ],
  "title": "Fuyuan Huoxue Decoction Promotes Lumbar Interbody Fusion in Rats: Role of Macrophage-Driven Inflammation and the TLR9/NF-κB Pathway.",
  "title_text": "Fuyuan Huoxue Decoction Promotes Lumbar Interbody Fusion in Rats: Role of Macrophage-Driven Inflammation and the TLR9/NF-κB Pathway.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:21:16Z",
  "url": "https://research.draconitic.com/paper/5kr06fp79p2jg",
  "venue": "Advanced science (Weinheim, Baden-Wurttemberg, Germany)",
  "versions": []
}