Cross-sectional association between systemic metal concentrations and immune markers in patients with total joint arthroplasty.
Cross-sectional association between systemic metal concentrations and immune markers in patients with total joint arthroplasty.
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DOI：
10.3389/fimmu.2023.1130209
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发表时间：
2023
影响因子：
7.3
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中科院分区：
文献类型：
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全关节置换术（TJA）假体由金属部件组成。虽然它们被认为是安全的，但长期暴露于特定植入材料的长期免疫效应尚不清楚。我们招募了115名髋关节和/或膝关节TJA患者（平均年龄68岁），他们提供了测量铬、钴、钛浓度、炎症标志物和全身免疫细胞分布的抽血。我们检查了免疫标记物和全身铬、钴和钛浓度之间的差异。铬和钴浓度高于中位数的患者中，CD66-b中性粒细胞、早期自然杀伤细胞（NK）和嗜酸性粒细胞的比例较高。在钛中观察到相反的模式，在未检测到钛的患者中，CD66-b中性粒细胞、早期NK细胞和嗜酸性粒细胞的百分比更高。钴浓度与较高的γ δ T细胞百分比呈正相关。铬和钴浓度均与较高的等离子母细胞百分比呈正相关。钛浓度与CD4效应记忆T细胞、调节性T细胞计数和Th1 CD4辅助细胞升高呈正相关。在这项探索性研究中，我们观察到全身金属浓度升高的TJA患者免疫细胞分布的改变。虽然这些相关性不强，但这些探索性发现值得进一步研究血液中金属循环增加的作用及其在免疫调节中的作用。
Total joint arthroplasty (TJA) implants are composed of metal components. Although they are regarded safe, the long-term immunological effects of chronic exposure to the specific implant materials are unknown. We recruited 115 hip and/or knee TJA patients (mean age 68 years) who provided a blood draw for measurement of chromium, cobalt, titanium concentrations, inflammatory markers and systemic distribution of immune cells. We examined differences between the immune markers and the systemic concentrations of chromium, cobalt and titanium. CD66-b neutrophils, early natural killer cells (NK), and eosinophils were present in higher percentages in patients with chromium and cobalt concentrations greater than the median. The opposite pattern was observed with titanium where the percentages of CD66-b neutrophils, early NK, and eosinophils were higher in patients with undetectable titanium. Cobalt concentrations were positively correlated with a higher percentage of gamma delta T cells. Both chromium and cobalt concentrations were positively correlated with higher percentages of plasmablasts. Titanium concentrations were positively correlated with higher CD4 effector memory T cells, regulatory T cell count and Th1 CD4 helper cells. In this exploratory study, we observed altered distribution of immune cells in TJA patients with elevated systemic metal concentrations. Although these correlations were not strong, these exploratory findings warrant further investigation into the role of increased metals circulating in blood and its role in immune modulation.