Baxter-Parker Gregory, Roffe Lloyd, Cross Sean, Frampton Chris, Hooper Gary J, Gieseg Steven P
School of Biological Sciences, University of Canterbury, Christchurch 8140, New Zealand.
Department of Orthopaedic Surgery & Musculoskeletal Medicine, University of Otago Christchurch, PO Box 4345, Christchurch, New Zealand.
Clin Biochem. 2019 Jan;63:39-45. doi: 10.1016/j.clinbiochem.2018.11.002. Epub 2018 Nov 3.
Knee arthroplasty surgery is significant trauma, leading to an activated immune system causing inflammation and oxidative stress. Many current biomarkers are invasive, costly, and often slow to analyse, limiting their use for rapid inflammatory measurements.
We have examined the use of urinary neopterin and total neopterin in knee arthroplasty patients to non-invasively measure oxidative stress and inflammation from immune system activation. We aim to validate the use of these biomarkers for quick, cost effective and predictive measurements of post-surgical inflammation assessment.
19 Knee arthroplasty patients were analysed pre-operatively and for a defined post-operative period to determine the urinary levels of neopterin and total neopterin (neopterin +7,8-dihydroneopterin) using high performance liquid chromatography with fluorescence detection. These results were then compared to a control group of 20 participants with normal knee function.
7,8-Dihydroneopterin was stable in urine over 12 h when refrigerated. Knee arthritis was associated with an increase in pre-operative neopterin (oxidative stress) and total neopterin (inflammation). The subsequent arthroplasty surgery generated a significant increase neopterin and total neopterin. Both biomarkers were reduced immediately post-operatively, before becoming elevated on the following days. There was no clear evidence of an association between initial neopterin and total neopterin levels and a patient's level of inflammation during in-hospital recovery.
The stability of 7,8-dihydroneopterin in urine allows for its use as an inflammatory marker. Urinary neopterin and total neopterin provided a fast, non-invasive, and simple measure of oxidative stress and inflammation after knee arthroplasty.
膝关节置换手术是重大创伤，会导致免疫系统激活，引发炎症和氧化应激。当前许多生物标志物具有侵入性、成本高且分析过程往往较慢，限制了它们在快速炎症测量中的应用。
我们研究了膝关节置换患者尿液中新蝶呤和总蝶呤的用途，以非侵入性方式测量免疫系统激活引起的氧化应激和炎症。我们旨在验证这些生物标志物在快速、经济高效且可预测的术后炎症评估测量中的应用。
对19名膝关节置换患者进行术前及术后特定时间段的分析，采用高效液相色谱荧光检测法测定尿液中新蝶呤和总蝶呤（新蝶呤+7,8-二氢新蝶呤）的水平。然后将这些结果与20名膝关节功能正常的参与者组成的对照组进行比较。
7,8-二氢新蝶呤在冷藏条件下于尿液中12小时内保持稳定。膝关节关节炎与术前新蝶呤（氧化应激）和总蝶呤（炎症）升高有关。随后的关节置换手术使新蝶呤和总蝶呤显著增加。两种生物标志物在术后立即降低，随后几天又升高。没有明确证据表明初始新蝶呤和总蝶呤水平与患者住院恢复期间的炎症水平之间存在关联。
7,8-二氢新蝶呤在尿液中的稳定性使其可作为炎症标志物。尿液中的新蝶呤和总蝶呤为膝关节置换术后的氧化应激和炎症提供了一种快速、非侵入性且简单的测量方法。
