Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Bone and Mineral Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Sci Rep. 2019 Jul 18;9(1):10429. doi: 10.1038/s41598-019-46934-x.
Chronic inflammatory insults compromise immune cell responses and ultimately contribute to pathologic outcomes. Clinically, it has been suggested that bone debris and implant particles, such as polymethylmethacrylate (PMMA), which are persistently released following implant surgery evoke heightened immune, inflammatory, and osteolytic responses that contribute to implant failure. However, the precise mechanism underlying this pathologic response remains vague. T, the chief immune-suppressive cells, express the transcription factor Foxp3 and are potent inhibitors of osteoclasts. Using an intra-tibial injection model, we show that PMMA particles abrogate the osteoclast suppressive function of T. Mechanistically, PMMA particles induce T instability evident by reduced expression of Foxp3. Importantly, intra-tibial injection of PMMA initiates an acute innate immune and inflammatory response, yet the negative impact on T by PMMA remains persistent. We further show that PMMA enhance T17 response at the expense of other T effector cells (T), particularly T1. At the molecular level, gene expression analysis showed that PMMA particles negatively regulate Nrp-1/Foxo3a axis to induce T instability, to dampen T activity and to promote phenotypic switch of T to T17 cells. Taken together, inflammatory cues and danger signals, such as bone and implant particles exacerbate inflammatory osteolysis in part through reprogramming T.
慢性炎症刺激会损害免疫细胞的反应,最终导致病理性后果。临床上,有人认为,骨碎片和植入物颗粒(如聚甲基丙烯酸甲酯[PMMA])在植入手术后持续释放,会引发强烈的免疫、炎症和溶骨性反应,从而导致植入物失败。然而,这种病理性反应的确切机制仍不清楚。T 细胞是主要的免疫抑制细胞,表达转录因子 Foxp3,是破骨细胞的有效抑制剂。我们通过胫骨内注射模型发现,PMMA 颗粒会破坏 T 细胞的破骨细胞抑制功能。从机制上讲,PMMA 颗粒诱导 T 细胞的不稳定性,表现为 Foxp3 表达减少。重要的是,胫骨内注射 PMMA 会引发急性先天免疫和炎症反应,但 PMMA 对 T 细胞的负面影响仍然持续存在。我们进一步发现,PMMA 以牺牲其他 T 效应细胞(如 T1)为代价,增强了 T17 反应。在分子水平上,基因表达分析表明,PMMA 颗粒通过负调控 Nrp-1/Foxo3a 轴来诱导 T 细胞不稳定,从而抑制 T 细胞的活性,并促进 T 细胞向 T17 细胞的表型转换。总之,炎症信号和危险信号(如骨和植入物颗粒)通过重编程 T 细胞,加剧了炎症性骨溶解。