Sypniewska Grazyna, Lis Kinga, Bilinski Piotr J
Department of Laboratory Medicine, The L. Rydygier Medical University, Bydgoszcz, Poland.
Acta Orthop Scand. 2002 Oct;73(5):518-22. doi: 10.1080/000164702321022785.
We analyzed bone turnover markers (osteocalcin, bone ALP, beta-crosslaps-CTX) and cytokines (IL-1, IL-8 and IL-10) in hip joint fluid in 10 patients before revision surgery and in 39 with idiopathic coxarthrosis. Patients with loose implants had lower concentrations of resorption marker than those with arthrosis (0.8 vs 1.3 ng/mL), but bone formation marker osteocalcin was reduced (4.2 vs 22.6 ng/mL). IL-8 and IL-10 levels were elevated in patients with implant failure (870 vs 340 pg/mL; 14.3 vs 4.0 pg/mL). We found a negative correlation between the bone resorption marker (CTX) and IL-10 in cases with prosthesis loosening and a positive correlation between IL-10 and time-to-revision. We conclude that enhanced local production of inflammatory cytokines leading to suppressed bone formation is a part of the loosening process. The expression of anti-inflammatory mediators is not sufficient to counteract the imbalance in bone turnover.
我们分析了10例翻修手术前患者及39例特发性髋关节病患者髋关节液中的骨转换标志物（骨钙素、骨碱性磷酸酶、β-交联C端肽-CTX）和细胞因子（白细胞介素-1、白细胞介素-8和白细胞介素-10）。植入物松动的患者其吸收标志物浓度低于患有关节病的患者（0.8对1.3 ng/mL），但骨形成标志物骨钙素降低（4.2对22.6 ng/mL）。植入物失败患者的白细胞介素-8和白细胞介素-10水平升高（870对340 pg/mL；14.3对4.0 pg/mL）。我们发现，在假体松动的病例中，骨吸收标志物（CTX）与白细胞介素-10之间呈负相关，白细胞介素-10与翻修时间呈正相关。我们得出结论，导致骨形成受抑制的炎性细胞因子局部产生增加是松动过程的一部分。抗炎介质的表达不足以抵消骨转换的失衡。
