Bone-resorbing cytokines in serum of patients with aseptic loosening of hip prostheses
Bone-resorbing cytokines in serum of patients with aseptic loosening of hip prostheses
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DOI：
10.1302/0301-620x.80b5.8513
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发表时间：
1998-09-01
影响因子：
--
通讯作者：
Montanaro, L
中科院分区：
文献类型：
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作者：
Granchi, D;Verri, E;Montanaro, L
我们的目的是确定全髋关节假体无菌性松动患者的骨吸收细胞因子（IL-1 β、TNF-α、IL-6、GM-CSF）的血清水平是否改变，以及这些水平是否受到植入物类型的影响。我们测定了35例全髋关节置换术失败患者翻修前血清中的细胞因子水平，并与25例健康供体进行了比较。我们还评估了血清中可溶性白细胞介素-2受体（sIL-2 r）作为对植入物的特异性免疫反应的指标，我们的研究结果表明，sIL-2 r和TNF-α血清水平没有变化。IL-6水平没有显著改变，但TiAlV假体患者的IL-6水平高于CrCoMo假体患者和骨水泥假体患者。发现使用TiAlV骨水泥型假体的患者的IL-1 β水平高于对照组（p = 0.0001）和其他患者组（p = 0.003 v非骨水泥型TiAlV，p = 0.01 v骨水泥型CrCoMo，p = 0.001 v非骨水泥型CrCoMo）。与健康受试者相比，患者的GM-CSF水平显著升高（p = 0.008），骨水泥型种植体的GM-CSF水平高于非骨水泥型种植体（p = 0.01）。只有非骨水泥型CrCoMo假体患者的GM-CSF水平与对照组相似。在翻修前最后几个月接受非甾体抗炎药（NSAID）治疗的患者中观察到最高的GM-CSF浓度（p = 0.04）。此外，当观察到大量骨质溶解时，GM-CSF水平有下降至对照组水平的趋势。
Our aim was to determine if the serum levels of bone-resorbing cytokines (IL-1 beta, TNF-alpha, IL-6, GM-CSF) are altered in patients with aseptic loosening of a total hip prosthesis, and if such levels are influenced by the type of implant. We determined cytokine levels in sera from 35 patients before revision for failed total hip arthroplasty and compared them with those in 25 healthy donors. We also assessed the soluble receptor of interleukin-2 (sIL-2r) in serum as an indication of a specific immune reaction against the implant.Our findings showed that the sIL-2r and TNF-alpha serum level did not change. The IL-6 level was not significantly altered, but was higher in patients with TiAlV prostheses than in those with a CrCoMo implant and in patients with cemented prostheses. The IL-1 beta level was found to be higher in those with a TiAlV cemented prosthesis than in the control group (p = 0.0001) and other groups of patients (p = 0.003 v uncemented TiAlV, p = 0.01 v cemented CrCoMo, p = 0.001 v uncemented CrCoMo). The GM-CSF level significantly increased in patients compared with healthy subjects (p = 0.008), and it was higher in those with cemented than with uncemented implants (p = 0.01). Only patients with cementless CrCoMo prostheses had levels of GM-CSF similar to those of the control group. The highest GM-CSF concentrations were observed in patients treated with non-steroidal anti-inflammatory drugs (NSAIDs) in the last months before revision (p = 0.04). In addition, when massive osteolysis was observed, the level of GM-CSF tended to decrease to that of the control group.