Asymptomatic prospective and retrospective cohorts with metal-on-metal hip arthroplasty indicate acquired lymphocyte reactivity varies with metal ion levels on a group basis.
Asymptomatic prospective and retrospective cohorts with metal-on-metal hip arthroplasty indicate acquired lymphocyte reactivity varies with metal ion levels on a group basis.
复制标题
DOI：
10.1002/jor.22214
复制
发表时间：
2013-02
影响因子：
2.8
通讯作者：
Jacobs, Joshua J.
中科院分区：
文献类型：
--
作者：
Hallab, Nadim J.;Caicedo, Marco;McAllister, Kyron;Skipor, Anastasia;Amstutz, Harlan;Jacobs, Joshua J.
来自金属对金属（MoM）髋关节置换术翻修的一些组织已经显示出适应性免疫反应性的证据（即，过度的植入物周围淋巴细胞浸润/活化）。我们假设，在出现症状之前，一些MoM髋关节置换术患者会出现与外周金属离子水平相关的可量化的金属诱导淋巴细胞反应性反应。我们测试了3个队列（第1组：n=21例前瞻性纵向MoM髋关节置换术;第2组：n=17例回顾性MoM髋关节置换术;第3组：n=20例对照，无植入物）。我们比较了植入位置、金属离子释放和免疫反应性。早在术后3个月，MoM队列的血清Co和Cr含量就高于对照组（p<0.01）（第1组：1. 2 ppb-Co，1. 5 ppb-Cr;第2组：3.4ppb-Co，5.4ppb-Cr;第3组：0. 01 ppb-Co，0. 1 ppb-Cr）。然而，仅在术后1至4年后，第1组中56%的患者发生金属反应性（与术前5%的患者相比，金属-LTT，SI>2），而第2组中为76%，第3组对照组中为15%（斑贴试验是一种较差的诊断指标，只有1/21的第1组阳性）。组1中较高的杯外展角（50° vs. 40°）与较高的血清Cr相关（p<0.07）。然而，次优髋臼杯前倾角（9° vs. 20°）具有较高的血清Co（p<0.08）。反应性与非反应性组1参与者的血清Cr和Co显著升高（p<0.04）。与无反应的第1组受试者相比，金属反应性受试者的CD 4 + CD 69+辅助性T淋巴细胞（而非CD 8+）和IL-1β、IL-12和IL-6细胞因子均显著升高。我们的研究结果表明，淋巴细胞对金属的反应性可以在无症状患者的MoM关节成形术后的前1至4年内发展，并滞后于金属离子水平的增加。这种增加的金属反应性在具有极端杯角度和较高循环金属量的个体中更普遍。
Some tissues from metal-on-metal (MoM) hip arthroplasty revisions have shown evidence of adaptive-immune reactivity (i.e., excessive peri-implant lymphocyte infiltration/activation). We hypothesized that, prior to symptoms, some people with MoM hip arthroplasty will develop quantifiable metal-induced lymphocyte reactivity responses related to peripheral metal ion levels. We tested 3 cohorts (Group-1: n=21 prospective longitudinal MoM hip arthroplasty; Group-2: n=17 retrospective MoM hip arthroplasty; and Group-3: n=20 controls without implants). We compared implant position, metal-ion release, and immuno-reactivity. MoM cohorts had elevated (p<0.01) amounts of serum Co and Cr compared to controls as early as 3 mos post-op (Group-1:1.2ppb-Co, 1.5ppb-Cr; Group-2: 3.4ppb-Co,, 5.4ppb-Cr; Group-3: 0.01ppb-Co, 0.1ppb-Cr). However, only after 1 to 4 yrs post-op did 56% of Group-1 develop metal-reactivity (vs. 5%pre-op, metal-LTT, SI>2), compared with 76% of Group-2 and 15% of Group-3 controls (patch testing was a poor diagnostic indicator with only 1/21 Group-1 positive). Higher cup-abduction angles (50° vs. 40°) in Group-1 were associated with higher serum Cr (p<0.07). However, sub-optimal cup-anteversion angles (9° vs. 20°) had higher serum Co (p<0.08). Serum Cr and Co were significantly elevated in reactive vs. non-reactive Group-1 participants (p<0.04). CD4+CD69+ T-helper lymphocytes (but not CD8+) and IL-1β, IL-12 and IL-6 cytokines were all significantly elevated in metal-reactive vs. non-reactive Group-1 participants. Our results showed that lymphocyte reactivity to metals can develop within the first 1 to 4 years after MoM arthroplasty in asymptomatic patients and lags increases in metal ion levels. This increased metal reactivity was more prevalent in those individuals with extreme cup angles and higher amounts of circulating metal.
登录
查看更多内容
影响因子：
4.9
作者：
Arora, A;Song, Y;Goodman, S
通讯作者：
Goodman, S
影响因子：
4.2
作者：
Campbell, Pat;Ebramzadeh, Edward;Nelson, Scott;Takamura, Karren;De Smet, Koen;Amstutz, Harlan C.
通讯作者：
Amstutz, Harlan C.
影响因子：
4.9
作者：
Hallab, NJ;Anderson, S;Jacobs, JJ
通讯作者：
Jacobs, JJ
DOI：
10.2106/00004623-199810000-00006
发表时间：
1998-10-01
影响因子：
5.3
作者：
Jacobs, JJ;Skipor, AK;Galante, JO
通讯作者：
Galante, JO
DOI：
10.1302/0301-620x.92b1.22770
发表时间：
2010-01-01
影响因子：
--
作者：
Langton, D. J.;Jameson, S. S.;Nargol, A. V. F.
通讯作者：
Nargol, A. V. F.