Differences between infected and noninfected synovial fluid.
Differences between infected and noninfected synovial fluid.
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DOI：
10.1302/2046-3758.101.bjr-2020-0285.r1
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发表时间：
2021-01
影响因子：
4.6
通讯作者：
Gupte CM
中科院分区：
文献类型：
--
作者：
Akhbari P;Jaggard MK;Boulangé CL;Vaghela U;Graça G;Bhattacharya R;Lindon JC;Williams HRT;Gupte CM
关节感染的诊断是一门不精确的科学，需要结合血液炎症标志物、显微镜、培养和滑膜液（SF）的敏感性。感染SF的小分子代谢物有可能作为感染标记物，可以提高检测的准确性和速度。本研究的目的是利用核磁共振（NMR）光谱鉴定感染和未感染的人SF之间的小分子差异。总共从患者中收集了16个SF样本（8个感染的天然关节和假体关节加上8个未感染的终末期骨关节炎需要关节置换术的关节）。核磁共振波谱法用于分析每个样品中的代谢物。采用主成分分析和单变量统计分析研究两组间代谢差异。共发现16种代谢物在组间浓度有显著差异。感染组中有3种相对浓度较高（脂质、胆固醇和n -乙酰化分子），13种相对浓度较低（柠檬酸盐、甘氨酸、糖胺聚糖、肌酐、组氨酸、赖氨酸、甲酸盐、葡萄糖、脯氨酸、缬氨酸、二甲基砜、甘露糖和谷氨酰胺）。在感染队列中发现的代谢物浓度明显较高，是炎症和感染的标志。它们在脂质代谢和炎症反应中发挥作用。这些浓度显著降低的细胞参与碳水化合物代谢、核苷代谢、谷氨酸代谢途径、患病状态下氧化应激增加、关节软骨破裂减少。这是首次使用非感染配对队列来证明感染和未感染的人类SF代谢谱差异的研究，并可能代表推定的生物标志物，形成新的感染SF诊断测试的基础。本文引用本文：骨关节杂志，2021;10(1):85-95。
The diagnosis of joint infections is an inexact science using combinations of blood inflammatory markers and microscopy, culture, and sensitivity of synovial fluid (SF). There is potential for small molecule metabolites in infected SF to act as infection markers that could improve accuracy and speed of detection. The objective of this study was to use nuclear magnetic resonance (NMR) spectroscopy to identify small molecule differences between infected and noninfected human SF. In all, 16 SF samples (eight infected native and prosthetic joints plus eight noninfected joints requiring arthroplasty for end-stage osteoarthritis) were collected from patients. NMR spectroscopy was used to analyze the metabolites present in each sample. Principal component analysis and univariate statistical analysis were undertaken to investigate metabolic differences between the two groups. A total of 16 metabolites were found in significantly different concentrations between the groups. Three were in higher relative concentrations (lipids, cholesterol, and N-acetylated molecules) and 13 in lower relative concentrations in the infected group (citrate, glycine, glycosaminoglycans, creatinine, histidine, lysine, formate, glucose, proline, valine, dimethylsulfone, mannose, and glutamine). Metabolites found in significantly greater concentrations in the infected cohort are markers of inflammation and infection. They play a role in lipid metabolism and the inflammatory response. Those found in significantly reduced concentrations were involved in carbohydrate metabolism, nucleoside metabolism, the glutamate metabolic pathway, increased oxidative stress in the diseased state, and reduced articular cartilage breakdown. This is the first study to demonstrate differences in the metabolic profile of infected and noninfected human SF, using a noninfected matched cohort, and may represent putative biomarkers that form the basis of new diagnostic tests for infected SF. Cite this article: Bone Joint Res 2021;10(1):85–95.