Differential expression of transforming growth factor-α and macrophage colony-stimulating factor/colony-stimulating factor-1R (c-fms) by multinucleated giant cells involved in pathological bone resorption at the site of orthopaedic implants
Differential expression of transforming growth factor-α and macrophage colony-stimulating factor/colony-stimulating factor-1R (c-fms) by multinucleated giant cells involved in pathological bone resorption at the site of orthopaedic implants
复制标题
DOI：
10.1002/jor.1100180518
复制
发表时间：
2000-09-01
影响因子：
2.8
通讯作者：
Revell, PA
中科院分区：
文献类型：
--
作者：
Al-Saffar, N;Revell, PA
对人工生物材料颗粒的免疫反应的特点是富含巨噬细胞的炎性浸润，形成多核巨细胞，以及关节置换部位的无菌性松动。我们研究了临床失败的骨科种植体患者(n=30)骨侵蚀部位转化生长因子α、巨噬细胞集落刺激因子和集落刺激因子-1受体的体内表达和组织分布。进一步与类风湿性关节炎或骨关节炎患者(n=15)和1例破骨细胞瘤(骨巨细胞瘤)患者炎症滑膜中检测到的表达进行比较。免疫组织化学染色显示，炎性巨噬细胞内的转化生长因子α阳性，病变滑膜和骨-种植体界面的多核巨细胞浸润。滑膜和回收界面膜(假滑膜)的对比分析显示，在所有假性滑膜置换失败的患者中，转化生长因子α都有高水平的表达，并在多核巨细胞上有强烈的膜染色。此外，界面多核巨细胞表达转化生长因子α的频率、抗原表型和模式与破骨细胞瘤中观察到的多核巨细胞明显相似。界面内的多核巨细胞缺乏巨噬细胞集落刺激因子和集落刺激因子-1受体的表达，而位于骨表面的多核巨细胞表现出较强的免疫反应。骨-种植体界面多核巨细胞主要表达转化生长因子-α，其与破骨细胞瘤的相似性突出了评估转化生长因子-α作为骨科种植失败部位骨吸收巨细胞发展的可能因素的重要性。
The immunologic response to prosthetic biomaterial particles is characterized by macrophage-rich inflammatory infiltrate, formation of multinucleated giant cells, and aseptic loosening at the site of arthroplasty. We investigated the in vivo expression and tissue distribution of transforming growth factor alpha, macrophage colony-stimulating factor, and the receptor for colony-stimulating factor-1 at the site of bone erosion in patients with clinically failed orthopaedic implants (n = 30). The: expression was further compared with that detected in the inflamed synovial membranes from patients with rheumatoid arthritis or osteoarthritis (n = 15) and one patient with osteoclastoma (giant cell tumour of bone). Immunostaining of the tissue demonstrated positivity for transforming growth factor alpha within the inflammatory macrophage and multinucleated giant cell infiltrate in the diseased synovial membrane and the bone-implant interface. A comparative analysis between the synovium and retrieval interface membranes (pseudosynovium) revealed a high level of expression of transforming growth factor alpha, with intense membrane staining on multinucleated giant cells in all failed arthroplasties with pseudosynovium. In addition, the frequency, antigenic phenotype, and pattern of transforming growth factor alpha expression on multinucleated giant cells in the interface were markedly similar to those observed for multinucleated giant cells in osteoclastoma. Multinucleated giant cells within the interface lacked the expression of macrophage colony-stimulating factor and colony-stimulating factor-1 receptor, whereas those at the bone surfaces exhibited strong immunoreactivity. The predominant expression of transforming growth factor alpha by multinucleated giant cells in the bone-implant interface and its similarity to osteoclastoma highlight the importance of assessing transforming growth factor alpha as a possible contributor to the development of bone-resorbing giant cells at the site of failed orthopaedic implants.