趋化因子系统在组织对假体副产物的反应导致假体周围骨溶解和无菌性松动中的作用。

The Role of the Chemokine System in Tissue Response to Prosthetic By-products Leading to Periprosthetic Osteolysis and Aseptic Loosening.

作者信息

Dyskova Tereza, Gallo Jiri, Kriegova Eva

机构信息

Faculty of Medicine and Dentistry, Department of Immunology, Palacky University Olomouc, Olomouc, Czechia.

Faculty of Medicine and Dentistry, Department of Orthopaedics, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czechia.

出版信息

Front Immunol. 2017 Aug 24;8:1026. doi: 10.3389/fimmu.2017.01026. eCollection 2017.

Abstract

Millions of total joint replacements are performed annually worldwide, and the number is increasing every year. The overall proportion of patients achieving a successful outcome is about 80-90% in a 10-20-years time horizon postoperatively, periprosthetic osteolysis (PPOL) and aseptic loosening (AL) being the most frequent reasons for knee and hip implant failure and reoperations. The chemokine system (chemokine receptors and chemokines) is crucially involved in the inflammatory and osteolytic processes leading to PPOL/AL. Thus, the modulation of the interactions within the chemokine system may influence the extent of PPOL. Indeed, recent studies in murine models reported that (i) blocking the CCR2-CCL2 or CXCR2-CXCL2 axis or (ii) activation of the CXCR4-CXCL12 axis attenuate the osteolysis of artificial joints. Importantly, chemokines, inhibitory mutant chemokines, antagonists of chemokine receptors, or neutralizing antibodies to the chemokine system attached to or incorporated into the implant surface may influence the tissue responses and mitigate PPOL, thus increasing prosthesis longevity. This review summarizes the current state of the art of the knowledge of the chemokine system in human PPOL/AL. Furthermore, the potential for attenuating cell trafficking to the bone-implant interface and influencing tissue responses through modulation of the chemokine system is delineated. Additionally, the prospects of using immunoregenerative biomaterials (including chemokines) for the prevention of failed implants are discussed. Finally, this review highlights the need for a more sophisticated understanding of implant debris-induced changes in the chemokine system to mitigate this response effectively.

摘要

全球每年进行数百万例全关节置换手术,且数量逐年增加。术后10至20年,总体成功的患者比例约为80%至90%,假体周围骨溶解(PPOL)和无菌性松动(AL)是膝关节和髋关节植入物失败及再次手术最常见的原因。趋化因子系统(趋化因子受体和趋化因子)在导致PPOL/AL的炎症和骨溶解过程中起关键作用。因此,调节趋化因子系统内的相互作用可能会影响PPOL的程度。事实上,最近在小鼠模型中的研究报告称:(i)阻断CCR2-CCL2或CXCR2-CXCL2轴;或(ii)激活CXCR4-CXCL12轴可减轻人工关节的骨溶解。重要的是,趋化因子、抑制性突变趋化因子、趋化因子受体拮抗剂或附着于或掺入植入物表面的趋化因子系统的中和抗体可能会影响组织反应并减轻PPOL,从而延长假体使用寿命。本综述总结了人类PPOL/AL中趋化因子系统的当前知识水平。此外,还描述了通过调节趋化因子系统减弱细胞向骨-植入物界面迁移并影响组织反应的可能性。此外,还讨论了使用免疫再生生物材料(包括趋化因子)预防植入物失败的前景。最后,本综述强调需要更深入地了解植入物碎片引起的趋化因子系统变化,以有效减轻这种反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c0c/5573717/04477392f889/fimmu-08-01026-g001.jpg

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