Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo 060-8638, Japan; Global Institution for Collaborative Research and Education (GI-CoRE), Frontier Research Center for Advanced Material and Life Science, Bldg No 2, Hokkaido University, Japan.
Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo 060-8638, Japan.
Acta Biomater. 2018 Jan;65:417-425. doi: 10.1016/j.actbio.2017.11.001. Epub 2017 Nov 3.
UNLABELLED: Osteolysis is a serious postoperative complication of total joint arthroplasty that leads to aseptic loosening and surgical revision. Osteolysis is a chronic destructive process that occurs when host macrophages recognize implant particles and release inflammatory mediators that increase bone-resorbing osteoclastic activity and attenuate bone-formation osteoblastic activity. Although much progress has been made in understanding the molecular responses of macrophages to implant particles, the pathways/signals that initiate osteolysis remain poorly characterized. Transcriptomics and gene-expression profiling of these macrophages may unravel key mechanisms in the pathogenesis of osteolysis and aid the identification of molecular candidates for therapeutic intervention. To this end, we analyzed the transcriptional profiling of macrophages exposed to ultra-high molecular weight polyethylene (UHMWPE) particles, the most common components used in bearing materials of orthopedic implants. Regulated genes in stimulated macrophages were involved in cytokine, chemokine, growth factor and receptor activities. Gene enrichment analysis suggested that stimulated macrophages elicited common gene expression signatures for inflammation and rheumatoid arthritis. Among the regulated genes, tumor necrosis factor superfamily member 15 (TNFSF15) and chemokine ligand 20 (CCL20) were further characterized as molecular targets involved in the pathogenesis of osteolysis. Treatment of monocyte cultures with TNFSF15 and CCL20 resulted in an increase in osteoclastogenesis and bone-resorbing osteoclastic activity, suggesting their potential contribution to loosening between implants and bone tissues. STATEMENT OF SIGNIFICANCE: Implant loosening due to osteolysis is the most common mode of arthroplasty failure and represents a great challenge to orthopedic surgeons and a significant economic burden for patients and healthcare services worldwide. Bone loss secondary to a local inflammatory response initiated by particulate debris from implants is considered the principal feature of the pathogenesis of osteolysis. In the present study, we analyzed the transcriptional profiling of human macrophages exposed to UHMWPE particles and identified a large number of inflammatory genes that were not identified previously in macrophage responses to wear particles. Our data provide a new insight into the molecular pathogenesis of osteolysis and highlights a number of molecular targets with prognostic and therapeutic implications.
未加标签:骨溶解是全关节置换术后的一种严重并发症,可导致无菌性松动和手术翻修。骨溶解是一种慢性破坏过程,当宿主巨噬细胞识别出植入物颗粒并释放炎症介质时,就会发生这种破坏过程,这些炎症介质会增加破骨细胞的活性,从而减弱成骨细胞的活性。尽管人们在理解巨噬细胞对植入物颗粒的分子反应方面取得了很大进展,但引发骨溶解的途径/信号仍知之甚少。对这些巨噬细胞进行转录组学和基因表达谱分析,可能会揭示骨溶解发病机制中的关键机制,并有助于确定治疗干预的分子候选物。为此,我们分析了暴露于超高分子量聚乙烯(UHMWPE)颗粒的巨噬细胞的转录组谱,UHMWPE 颗粒是骨科植入物中最常用的轴承材料。受刺激的巨噬细胞中的调节基因参与细胞因子、趋化因子、生长因子和受体活性。基因富集分析表明,受刺激的巨噬细胞引发了炎症和类风湿关节炎的常见基因表达特征。在受调节的基因中,肿瘤坏死因子超家族成员 15(TNFSF15)和趋化因子配体 20(CCL20)进一步被表征为参与骨溶解发病机制的分子靶标。用 TNFSF15 和 CCL20 处理单核细胞培养物会导致破骨细胞生成和骨吸收破骨细胞活性增加,表明它们可能有助于植入物与骨组织之间的松动。 意义声明:由于骨溶解导致的植入物松动是最常见的关节置换失败模式,这对骨科医生来说是一个巨大的挑战,对全球患者和医疗保健服务来说也是一个巨大的经济负担。由植入物磨损颗粒引发的局部炎症反应引起的骨丢失被认为是骨溶解发病机制的主要特征。在本研究中,我们分析了暴露于 UHMWPE 颗粒的人巨噬细胞的转录组谱,并鉴定出大量以前在巨噬细胞对磨损颗粒的反应中未鉴定出的炎症基因。我们的数据为骨溶解的分子发病机制提供了新的见解,并强调了一些具有预后和治疗意义的分子靶标。
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