Muscle inflammation susceptibility: a prognostic index of recovery potential after hip arthroplasty?
Muscle inflammation susceptibility: a prognostic index of recovery potential after hip arthroplasty?
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DOI：
10.1152/ajpendo.00576.2014
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发表时间：
2015-04-15
影响因子：
5.1
通讯作者：
Singh, Jasvinder A.
中科院分区：
文献类型：
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作者：
Bamman, Marcas M.;Ferrando, Arny A.;Singh, Jasvinder A.
虽然在大多数情况下，选择性全髋关节置换术（THA）可以改善终末期骨关节炎（OA）的疼痛、活动功能和生活质量，但很大一部分患者会出现持续的肌肉萎缩、疼痛和活动障碍。在这些外科手术中，广泛的骨骼肌损伤是不可避免的，因此，在一些THA术后患者中，恢复不良和长期活动障碍与手术后肌肉再生和再生失败有关，而局部肌肉炎症易感性（MuIS）是一个主要因素。在这里，我们介绍两项综合研究的结果。在研究1中，我们比较了选择性THA （n = 15）与髋部骨折/创伤（HFX; n = 11）和非手术对照组（CON; n = 19）的肌肉炎症和蛋白质代谢信号。在研究2中，我们比较了基于tnf样细胞凋亡弱诱导剂（TWEAK）受体（Fn14）的肌肉表达将THA患者分为MuIS((+)) （n = 7）或MuIS((-)) （n = 7）的两个亚组。正如预期的那样，HFX表现出明显的全身和局部肌肉炎症和高代谢。相比之下，选择性THA患者未发现全身性炎症；然而，与MuIS(（-）相比，MuIS(（+）组围手术期肢体局部肌肉炎症较严重，并伴有肌肉蛋白合成抑制。MuIS（+）对侧肢体的肌肉未受影响，提供了终末期OA患者髋关节周围肌肉真正的炎症易感性的证据。我们建议在手术时评估MuIS状态可能是一个有用的肌肉恢复潜力的预后指标，因此可以为个性化的术后康复方法提供基础。
While elective total hip arthroplasty (THA) for end-stage osteoarthritis (OA) improves pain, mobility function, and quality of life in most cases, a large proportion of patients suffer persistent muscle atrophy, pain, and mobility impairment. Extensive skeletal muscle damage is unavoidable in these surgical procedures, and it stands to reason that poor recovery and long-term mobility impairment among some individuals after THA is linked to failed muscle regeneration and regrowth following surgery and that local muscle inflammation susceptibility (MuIS) is a major contributing factor. Here we present results of two integrated studies. In study 1, we compared muscle inflammation and protein metabolism signaling in elective THA (n = 15) vs. hip fracture/trauma (HFX; n = 11) vs. nonsurgical controls (CON; n = 19). In study 2, we compared two subgroups of THA patients dichotomized into MuIS((+)) (n = 7) or MuIS((-)) (n = 7) based on muscle expression of TNF-like weak inducer of apoptosis (TWEAK) receptor (Fn14). As expected, HFX demonstrated overt systemic and local muscle inflammation and hypermetabolism. By contrast, no systemic inflammation was detected in elective THA patients; however, local muscle inflammation in the perioperative limb was profound in MuIS((+)) and was accompanied by suppressed muscle protein synthesis compared with MuIS((-)). Muscle from the contralateral limb of MuIS((+)) was unaffected, providing evidence of a true inflammation susceptibility localized to the muscle surrounding the hip with end-stage OA. We suggest MuIS status assessed at the time of surgery may be a useful prognostic index for muscle recovery potential and could therefore provide the basis for a personalized approach to postsurgery rehabilitation.