膝关节假体无菌性松动时滑膜中白细胞介素-17及肿瘤坏死因子-α的表达

The expression of interleukin-1 and tumor necrosis factor-α in synovial membrane with aseptic prosthesis loosening after total knee arthroplasty

目的 观察膝关节假体无菌性松动时关节滑膜中白细胞介素-17（IL-17）及肿瘤坏死因子-α（TNF-α）的表达.方法 实验组选择40例膝关节置换术后翻修的患者,对照组为20例初次行膝关节置换的患者.观察滑膜的镜下病理性改变;应用免疫组织化学及实时定量逆转录酶聚合酶链反应（RT-PCR）分别在蛋白质及mRNA水平上检测标本中IL-17及TNF-α的表达.结果 翻修组较初次置换组,滑膜出现以巨噬细胞为主的炎性细胞浸润,实验组中IL-17在蛋白水平的表达（0.10 ±0.01）较对照组中（0.03±0.01）明显增加,两组比较差异有统计学意义（P＜0.05）.实验组中TNF-α在蛋白水平的表达（0.13±0.03）较对照组中明显增加（0.05±0.01）,两组比较差异有统计学意义（P＜0.05）.在mRNA水平,IL-17在实验组中的表达较对照组中的表达增加1.62倍（P＜0.05）,TNF-α在实验组中的表达较对照组中的表达增加1.98倍（P＜0.05）.IL-17及TNF-α蛋白及mRNA的表达呈正相关（r=0.81、0.63,P＜0.05）.结论 IL-17及TNF-α可能参与了膝关节假体的无菌性松动.

Objective To observe the expression of interleukin-1 （IL-17） and tumor necrosis factor-α （TNF-α） in synovial membrane with aseptic prosthesis loosening after total knee arthroplasty.Methods Forty patients treated with revison arthroplasty were selected as the experimental group,and 20 patients treated with primary arthroplasty served as the control group.The pathological changes of the synovial membrane were observed by light microscopy.Immunohistochemistry and real-time polymerase chains reaction （RT-PCR） were used to detect the expression of IL-1 and TNF-α in synovial membrane.Results Compared to the control group,macrophages infiltration in synovial tissue was significantly increased in experiment group.The expression of IL-17 protein in experimental group （0.10 ±0.01） was higher than in control group （0.03 ±0.01）.The expression of TNF-α protein in experimental group （0.13 ±0.03） was higher than in control group （0.05 ±0.01）.The expression of IL-17 mRNA in experimental group was increased by 1.62 times higher than in control group,and that of TNF-α mRNA in experimental group by 1.98 times than in control group.There was a positive correlation between TNF-α and IL-17.Conclusion IL-17 and TNF-α in the cells of synovial membrane may be involved in the progress of aseptic prosthesis loosening after total knee arthroplasty.