人工全髋关节置换患者关节滑液中MCP-1和IL-8的表达水平及其与骨质溶解、关节磨损关系的探讨

The correlation of MCP-1 and IL-8 expression levels and osteolysis and wear particles in total hip arthroplasty

目的研究人工全髋关节置换患者关节滑液中白介素8(IL-8)和单核细胞趋化蛋白1(MCP-1)的表达水平,探讨其与人工关节周围骨质溶解及关节磨损之间的相关性。方法酶联免疫吸附法(ELISA)检测15例陶瓷-陶瓷、16例金属-金属材质人工关节置换组和10例对照组中MCP-1和IL-8的表达水平,扫描电子显微镜和x-射线分析人工关节周围骨质溶解及磨损微粒的水平。结果与对照组相比,陶瓷-陶瓷及金属-金属人工关节置换患者关节滑液中大量表达MCP-1及IL-8,且金属-金属人工关节置换组关节滑液中MCP-1的水平明显高于陶瓷-陶瓷组;金属-金属组中有8例患者发生了骨质溶解,陶瓷-陶瓷组中未检测到骨质溶解;MCP-1与骨质溶解及关节磨损微粒之间相关性较差,而IL-8与骨质溶解及关节磨损微粒的产生存在一定的相关性。结论人工关节存在促使大量MCP-1及IL-8表达,且IL-8大量产生能引起金属-金属人工关节周围发生骨质溶解及产生磨损微粒,表明有可能通过触发炎症反应引起骨质溶解诱导的人工关节松动,提示具有作为人工关节松动标记物的潜力,同时为人工关节无菌性松动防治提供新的思路。

Objective To explore the expression levels of interleukin 8 （IL-8） and monocyte chemoattractant protein 1 （MCP-1） in the synovial fluid. In addition, the relationship between these two chemokines and osteolysis and wear particles resulted from repeated abrasion was studied after total hip arthroplasty. Methods The expression levels of MCP-1 and IL-8 in fifteen ceramic-on-ceramic （cer-cer）, sixteen metal-on-metal （met-met） and ten control patients were detected by enzyme-linked immunosorbent assay （ELISA）. The presence of wear particles in the synovial fluid and osteolysis were analyzed by scanning electron microscopy and energy dispersive X-ray spectroscopy. Results The MCP 1 and IL-8 levels in the synovial fluid of patients with cer-cer and met-met couplings were significantly higher than con- trols,and the expression levels of MCP-1 in met-met coupling was notably higher than cer-cer coupling. Only eight pa- tients with osteolysis were detected in met-met coupling,and＇no osteolysis was found in patients with cer-cer coupling. Furthermore,a significant correlation was found between synovial fluid IL-8 levels and the area of osteolysis and the presence of wear particles in patients undergoing total hip arthroplasty. However,no obvious correlation was found be- tween MCP-1 levels and the area of osteolysis and the presence of wear particles. Conclusion The presence of the pros- thesis was responsible for an increase in the expression levels of MCP-1 and IL-8, and notably higher levels of IL-8 in met-met coupling resulted in area of osteolysis and the presence of wear particles. All of these results indicate that the chemokine can be related to osteolysis resulted from inflammatory reaction, and may be a useful aseptic loosening of hip prosthesis marker. What we did will open new opportunity in prevention of aseptic loosening of hip prosthesis.