Shih Lauren, Guler Nil, Syed Daneyal, Hopkinson William, McComas Kyra N, Walborn Amanda, Hoppensteadt Debra, Fareed Jawed, Rondina Matthew T
1 Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.
2 Department of Internal Medicine, University of Washington, Seattle, WA, USA.
Clin Appl Thromb Hemost. 2018 May;24(4):583-588. doi: 10.1177/1076029617747412. Epub 2017 Dec 19.
Dysregulated inflammation is a central component of wound healing following surgery. We prospectively enrolled older patients (n = 25, age 65 ± 7 years) undergoing elective total knee arthroplasty or total hip arthroplasty secondary to advanced osteoarthritis (OA) and healthy controls (n = 48). Inflammatory, proangiogenic (vascular endothelial growth factor [VEGF], monocyte chemoattractant protein-1 [MCP-1], and interleukin-8 [IL-8]), and antiangiogenic (interferon γ [IFN-γ] and IL-4) factors were measured using a high-sensitivity biochip. Patients with OA had significantly higher baseline VEGF (10.5 ± 1.2 pg/mL vs 4.8 ± 0.2 pg/mL, P < .001), MCP-1 (130.6 ± 7.7 pg/mL vs 88.6 ± 3.9 pg/mL, P < .0001), and IL-8 (4.0 ± 0.5 pg/mL vs 2.6 ± 0.1 pg/mL, P < .05). Postoperatively, the levels of VEGF (10.5 ± 1.2 pg/mL vs 18.8 ± 1.5 pg/mL, P < .001) and MCP-1 (130.6 ± 7.7 pg/mL vs 153.1 ± 11.5 pg/mL, P < .05) increased significantly. Baseline and postoperative MCP-1 levels correlated positively and significantly with age. The levels of IFN-γ and IL-4 (which has anti-inflammatory properties) did not significantly differ at baseline in patients with OA compared to controls and did not significantly rise postoperatively. We conclude that systemic levels of pro-inflammatory and angiogenic proteins are increased in patients with OA and rise further postoperatively, while proteins that restrain inflammation and angiogenesis do not coordinately rise. These findings implicate imbalance in inflammatory pathways in OA that may contribute to its pathobiology.
炎症调节异常是手术后伤口愈合的核心组成部分。我们前瞻性纳入了因晚期骨关节炎（OA）接受择期全膝关节置换术或全髋关节置换术的老年患者（n = 25，年龄65±7岁）以及健康对照者（n = 48）。使用高灵敏度生物芯片检测炎症、促血管生成（血管内皮生长因子[VEGF]、单核细胞趋化蛋白-1[MCP-1]和白细胞介素-8[IL-8]）和抗血管生成（干扰素γ[IFN-γ]和IL-4）因子。OA患者的基线VEGF（10.5±1.2 pg/mL对4.8±0.2 pg/mL，P <.001）、MCP-1（130.6±7.7 pg/mL对88.6±3.9 pg/mL，P <.0001）和IL-8（4.0±0.5 pg/mL对2.6±0.1 pg/mL，P <.05）显著更高。术后，VEGF（10.5±1.2 pg/mL对18.8±1.5 pg/mL，P <.001）和MCP-1（130.6±7.7 pg/mL对153.1±11.5 pg/mL，P <.05）水平显著升高。基线和术后MCP-1水平与年龄呈显著正相关。与对照组相比，OA患者基线时IFN-γ和具有抗炎特性的IL-4水平无显著差异，术后也未显著升高。我们得出结论，OA患者促炎和促血管生成蛋白的全身水平升高，术后进一步升高，而抑制炎症和血管生成的蛋白并未协同升高。这些发现提示OA炎症途径失衡，这可能有助于其病理生物学过程。
