Perivascular lymphocytic aggregates in hip prosthesis-associated adverse local tissue reactions demonstrate Th1 and Th2 activity and exhausted CD8
| Autor: | Nelson V. Greidanus, Rizhi Wang, Felipe Eltit, Michael E. Cox, Indira Medina, Clive P. Duncan, Anne Haegert, Nissreen Mohammad, Bassam A. Masri, Donald S. Garbuz, Tony Ng |
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| Rok vydání: | 2021 |
| Předmět: |
Reoperation
Chemokine medicine.medical_treatment Lymphocyte Arthroplasty Replacement Hip 0206 medical engineering 02 engineering and technology CD8-Positive T-Lymphocytes Prosthesis Design Lymphocytic Infiltrate 03 medical and health sciences 0302 clinical medicine medicine Synovial fluid Humans Orthopedics and Sports Medicine Lymphocytes Macrophage inflammatory protein B cell Chemokine CCL3 030203 arthritis & rheumatology biology business.industry Interleukin-6 Interleukin-8 020601 biomedical engineering Prosthesis Failure Chemokine CXCL10 Cytokine medicine.anatomical_structure Delayed hypersensitivity Metals Polyethylene Immunology biology.protein Metal-on-Metal Joint Prostheses Hip Prosthesis business |
| Zdroj: | Journal of orthopaedic research : official publication of the Orthopaedic Research SocietyREFERENCES. 39(12) |
| ISSN: | 1554-527X |
| Popis: | Hip implants are a successful solution for osteoarthritis; however, some individuals with metal-on-metal (MoM) and metal-on-polyethylene (MoP) prosthetics develop adverse local tissue reactions (ALTRs). While MoM and MoP ALTRs are presumed to be delayed hypersensitivity reactions to corrosion products, MoM- and MoP-associated ALTRs present with different histological characteristics. We compared MoM- and MoP-associated ALTRs histopathology with cobalt and chromium levels in serum and synovial fluid. We analyzed the gene expression levels of leukocyte aggregates and synovial fluid chemokines/cytokines to resolve potential pathophysiologic differences. In addition, we classified ALTRs from 79 patients according to their leukocyte infiltrates as macrophage-dominant, mixed, and lymphocyte-dominant. Immune-related transcript profiles from lymphocyte-dominant MoM- and MoP-associated ALTR patients with perivascular lymphocytic aggregates were similar. Cell signatures indicated predominantly macrophage, Th1 and Th2 lymphocytic infiltrate, with strong exhausted CD8+ signature, and low Th17 and B cell, relative to healthy lymph nodes. Lymphocyte-dominant ALTR-associated synovial fluid contained higher levels of induced protein 10 (IP-10), interleukin-1 receptor antagonist (IL-1RN), IL-8, IL-6, IL-16, macrophage inflammatory protein 1 (MIP-1α), IL-18, MCP-2, and lower cell-attracting chemokine levels, when compared with prosthetic revisions lacking ALTRs. In addition, the higher levels of IP-10, IL-8, IL-6, MIP-1α, and MCP-2 were observed within the synovial fluid of the lymphocyte-dominant ALTRs relative to the macrophage-dominant ALTRs. Not all cytokines/chemokines were detected in the perivascular aggregate transcripts, suggesting the existence of other sources in the affected synovia. Our results support the hypothesis of common hypersensitivity pathogenesis in lymphocyte-dominant MoM and MoP ALTRs. The exhausted lymphocyte signature indicates chronic processes and an impaired immune response, although the cause of the persistent T-cell activation remains unclear. The cytokine/chemokine signature of lymphocyte-dominant-associated ATLRs may be of utility for diagnosing this more aggressive pathogenesis. |
| Databáze: | OpenAIRE |
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