Factors regulating bone remodeling processes in aseptic implant loosening
Factors regulating bone remodeling processes in aseptic implant loosening
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DOI：
10.1002/jor.23274
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发表时间：
2017-02-01
影响因子：
2.8
通讯作者：
Mayer-Wagner, Susanne
中科院分区：
文献类型：
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作者：
Hartmann, Eliza S.;Koehler, Miriam I.;Mayer-Wagner, Susanne
本研究旨在筛选特定条件下假体周围组织中的一系列分子成分，并描述它们在无菌性松动的骨重建过程中的作用。PPT样本来自24例人工关节翻修术患者(n=24)和18例骨关节炎患者(n=18)的滑膜组织，排除了任何形式的炎性关节炎。组织标本通过微生物学、组织学(H&E，TRAP)、免疫组织化学(CD68/anti-S100a4)、实时定量聚合酶链式反应(ALP、COL1A1、组织蛋白酶K、M-CSF、MMP13、OPG、RANK、RANKL、TNF-和TRAP)和内毒素检测。PPT标本含有多种细胞成分，TRAP(56%)、CD68(100%)和S100a4(100%)染色阳性。CD68和S100a4染色阳性的细胞内可见磨屑。在PPTs中，ALP、COL1A1、MMP13、RANK、RANKL和TRAP的表达显著升高，RANKL/OPG比值显著升高，而OPG的表达显著降低。两组间M-CSF、肿瘤坏死因子-α、组织蛋白酶K和内毒素水平无显著差异。总之，我们发现与对照组相比，PPT中成骨蛋白(ALP，COL1A1)、蛋白水解酶(MMP-13)、破骨细胞分化标志物(RANK，RANKL)和破骨细胞活性(TRAP)显著增加，而OPG表达显著降低。我们提供了关于PPT中一大系列分子成分的数据，并描述了关于它们在无菌植入物松动方面的表达水平的新的和关键的发现。(C)2016年骨科研究会。由Wiley期刊公司出版，J Orthop Res 35：248-257,2017。
This study was undertaken to screen periprosthetic tissues (PPTs) under specified conditions for a series of molecular components and describe them in bone remodeling processes within aseptic loosening. PPT samples were obtained from patients undergoing revision surgery of endoprostheses (n=24) and synovial tissues from patients with OA (control) (n=18), patients with any form of inflammatory arthritides were excluded. Tissue samples were examined via microbiology, histology (H&E, TRAP), immunohistochemistry (CD68/anti-S100a4), quantitative real-time PCR (ALP, COL1A1, cathepsin K, M-CSF, MMP13, OPG, RANK, RANKL, TNF-, and TRAP) and an endotoxin-assay. PPT samples contained a variety of cellular components and stained positive for TRAP (56%), CD68 (100%), and S100a4 (100%). Wear debris were found in cells staining positive for CD68 and S100a4. In PPTs significantly higher ALP, COL1A1, MMP-13, RANK, RANKL, and TRAP expression were found along with a significantly higher RANKL/OPG ratio and a significantly lower OPG expression. No significant difference was observed for M-CSF, TNF-, cathepsin K, and endotoxin levels. In conclusion we found osteogenic proteins (ALP, COL1A1), a proteolytic enzyme (MMP-13), markers for osteoclast differentiation (RANK, RANKL), and osteoclast activity (TRAP) to be increased in PPT, whereas OPG expression decreased significantly in comparison to control. We present data about a large series of molecular components in PPT and describe novel and key findings about their expression levels in regards to aseptic implant loosening. (c) 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:248-257, 2017.