PRODUCTION OF CYTOKINES AROUND LOOSENED CEMENTED ACETABULAR COMPONENTS - ANALYSIS WITH IMMUNOHISTOCHEMICAL TECHNIQUES AND IN-SITU HYBRIDIZATION
PRODUCTION OF CYTOKINES AROUND LOOSENED CEMENTED ACETABULAR COMPONENTS - ANALYSIS WITH IMMUNOHISTOCHEMICAL TECHNIQUES AND IN-SITU HYBRIDIZATION
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DOI：
10.2106/00004623-199306000-00007
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发表时间：
1993-06-01
影响因子：
5.3
通讯作者：
HARRIS, WH
中科院分区：
文献类型：
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作者：
JIRANEK, WA;MACHADO, M;HARRIS, WH
对骨科关节植入物磨损颗粒的慢性炎症反应被认为是导致骨溶解并导致假体松动的原因。以前的体外实验已经证明，关节植入物的颗粒碎片会导致培养细胞释放与这种病理性骨吸收有关的产物。本研究的目的是研究全髋关节置换术患者体内这一复杂过程的特点。从10名患者的10个聚乙烯髋臼假体的骨水泥-骨界面上获取膜组织，这些假体经过无菌松动后进行了修订。免疫过氧化物酶技术涉及到每种细胞类型的特定抗体的使用，表明巨噬细胞是主要的细胞成分，但也存在成纤维细胞，其中许多在普通组织学研究中没有被识别出来，并活跃地产生胶原。T淋巴细胞的存在多种多样，但它们通常不到细胞的10%。颗粒碎片(聚乙烯、甲基丙烯酸甲酯和金属)存在于所有膜标本中，但仅存在于巨噬细胞和多核巨细胞中。S-35标记的核酸探针，补充人白细胞介素1-β和血小板衍生生长因子-2信使RNA(MRNA)，与连续组织切片杂交。杂交显示IL-1-βmRNA主要在巨噬细胞中表达，而在成纤维细胞或T淋巴细胞中几乎不表达。相反，免疫定位显示巨噬细胞和成纤维细胞上都有IL-1-β蛋白，这表明巨噬细胞释放IL-1-β，然后IL-1-β与成纤维细胞和巨噬细胞结合。在巨噬细胞和成纤维细胞中都发现了血小板衍生生长因子转录本。临床相关性：这些数据表明，白介素1-β和血小板衍生生长因子这两种与许多疾病状态有关的强大细胞因子是在失败的关节假体的骨水泥界面产生的。这些细胞因子可能参与骨吸收、纤维增殖，最终导致假体松动。即使有技术进步，完全关节置换产生的颗粒磨损碎片也不太可能被消除。然而，了解哪些细胞因子导致骨吸收，哪些细胞产生细胞因子将增强阻止颗粒磨损碎屑的有害影响的能力，并将导致重建关节的寿命延长。
The chronic inflammatory response to wear particles from orthopaedic joint implants is believed to cause osteolysis and to contribute to prosthetic loosening. Previous in vitro experiments have demonstrated that particulate debris from joint implants causes cells in culture to release products that have been implicated in this pathological bone resorption. The purpose of the current study was to investigate the in vivo features of this complex process in patients who had had a total hip replacement.Membranous tissue was obtained from the cement-bone interface of ten polyethylene acetabular components that had been revised for aseptic loosening in ten patients. The immunoperoxidase technique, which involves the use of specific antibodies for each cell type, showed that macrophages were the predominant cellular constituents but also that fibroblasts, many of which were not identified on plain histological study, were present and were actively producing collagen. T lymphocytes were present variably, but they generally composed less than 10 per cent of the cells.Particulate debris (polyethylene, methylmethacrylate, and metal) was present in all membrane specimens but was intracellular only in macrophages and multi-nucleated giant cells.S-35-labeled nucleic-acid probes, complementary to human interleukin-1-beta and to platelet-derived growth-factor-2 messenger RNA (mRNA), were hybridized with serial tissue sections. Hybridization demonstrated interleukin-1-beta mRNA predominantly in macrophages, and not in fibroblasts or in T lymphocytes to any major extent. In contrast, immunolocalization demonstrated interleukin-1-beta protein on both macrophages and fibroblasts, suggesting that macrophages release interleukin-1-beta, which then binds to both fibroblasts and macrophages. Platelet-derived growth-factor transcripts were found in both macrophages and fibroblasts.CLINICAL RELEVANCE: These data demonstrate that interleukin-1-beta and platelet-derived growth factor, two potent cytokines that have been implicated in many disease states, are produced at the cement-bone interface of failed joint prostheses. These cytokines are probably involved in bone resorption, fibrous proliferation, and, ultimately, loosening of prostheses.Even with technological advances, it is unlikely that particulate wear debris from total joint replacements will be eliminated. However, an understanding of which cytokines cause bone resorption and which cells produce the cytokines will enhance the ability to block the deleterious effects of particulate wear debris and will lead to an increase in the longevity of reconstructed joints.