The gut microbiota may be a novel pathogenic mechanism in loosening of orthopedic implants in rats.
The gut microbiota may be a novel pathogenic mechanism in loosening of orthopedic implants in rats.
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DOI：
10.1096/fj.202001364r
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Sumner DR
中科院分区：
文献类型：
--
作者：
Moran MM;Wilson BM;Li J;Engen PA;Naqib A;Green SJ;Virdi AS;Plaas A;Forsyth CB;Keshavarzian A;Sumner DR
从植入物释放的颗粒导致炎性骨丢失，这是无菌性松动的关键因素，是关节置换失败的最常见原因。随着未来十年全关节置换术发生率的预期增加，植入物失效将继续给患者带来负担。肠道微生物组越来越被认为是骨生理学的重要因素，然而，其在植入物松动中的作用目前尚不清楚。我们在临床前模型中检验了植入物松动与肠道微生物群变化相关的假设。当颗粒挑战引起局部关节炎症、种植体周围骨体积减少和种植体固定减少时，肠道微生物群受到影响。当颗粒挑战没有引起这种局部效应时，肠道微生物群不受影响。我们的研究结果表明，这些间室之间的串扰是一个以前未被认识到的机制失败后，全关节置换术。关节置换手术后，骨科植入物会脱落小颗粒，这些颗粒会刺激关节。这种关节刺激引起植入物周围的骨丢失，导致植入物松动。该过程被称为颗粒诱导的植入物松动，是关节置换术失败的最常见原因。修复失效松动植入物的唯一疗法是翻修手术，包括手术取出原来松动的植入物，并更换新植入物。肠道微生物组部分是肠道内发现的细菌。这种细菌现在被认为是骨骼健康的重要因素，但其在种植体松动中的作用目前尚不清楚。在这项研究中，我们希望使用模拟颗粒诱导植入物松动的人类状况的大鼠模型来确定植入物松动是否与肠道微生物组的变化相关。我们发现，当颗粒引起关节炎症、植入物周围骨质流失和植入物固定丧失（植入物松动的一种衡量标准）时，肠道细菌发生了改变。当颗粒没有在膝关节中引起这三种效应时，肠道细菌没有改变。我们的研究结果表明，在植入物和肠道之间存在一种以前未被认识到的沟通，这种沟通可能与全关节置换术后的植入物失败有关。这是非常重要的，因为我们的研究可能提供一种新的方法来预防或治疗植入物松动，并最终减少翻修手术的需要。
Particles released from implants cause inflammatory bone loss, which is a key factor in aseptic loosening, the most common reason for joint replacement failure. With the anticipated increased incidence of total joint replacement in the next decade, implant failure will continue to burden patients. The gut microbiome is increasingly recognized as an important factor in bone physiology, however, its role in implant loosening is currently unknown. We tested the hypothesis that implant loosening is associated with changes in the gut microbiota in a preclinical model. When the particle challenge caused local joint inflammation, decreased peri-implant bone volume and decreased implant fixation, the gut microbiota was affected. When the particle challenge did not cause this triad of local effects, the gut microbiota was not affected. Our results suggests that cross-talk between these compartments is a previously unrecognized mechanism of failure following total joint replacement. After joint replacement surgery, orthopedic implants shed small particles and these particles irritate the joint. This joint irritation induces bone loss around the implant and results in a loosened implant. This process is known as particle-induced implant loosening and it is the most common reason for joint replacement failure. The only therapy to fix a failed, loosened implant is revision surgery, which includes the surgical removal of the original, loosened implant and the replacement with a new implant. The gut microbiome is, in part, the bacteria found inside the intestine. This bacteria is now recognized as an important factor in bone health, but its role in implant loosening is currently unknown. In this study, we wanted to determine if implant loosening was associated with changes in the gut microbiome using a rat model that mimics the human condition of particle-induced implant loosening. We found that when the particles caused joint inflammation, loss of bone around the implant and loss of implant fixation (a measure of implant loosening), the gut bacteria was altered. When the particles did not cause this triad of effects in the knee joint, the gut bacteria was not altered. Our results suggest that there is a previously unrecognized communication between the implant and the gut that is likely involved in implant failure following total joint replacement. This is significant because our research may provide a new method for preventing or treating implant loosening and eventually reducing the need for revision surgery.
DOI：
10.2174/1874325001307010605
发表时间：
2013
期刊：
The open orthopaedics journal
影响因子：
--
作者：
Yadav J;Samelko L;Gilvar P;McAllister K;Hallab NJ
通讯作者：
Hallab NJ