C. Eugene Bennett Department of Chemistry, West Virginia University, Morgantown, West Virginia, USA.
Department of Orthopedics, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
J Orthop Res. 2021 Oct;39(10):2159-2168. doi: 10.1002/jor.24940. Epub 2020 Dec 15.
Systemic cytokine concentrations have been extensively studied in implant-associated infections, providing sensitive diagnostic markers. However, less is known about the relationships of tissue-level cytokines surrounding the joint. The aim of this study was to define the cytokine profiles of tissues to investigate the use of these cytokines as markers of debridement in chronic joint infection. Using a rodent model, muscle samples were obtained from rats following Kirschner wire implantation and infection with Staphylococcus aureus to determine if: (1) differences exist in cytokine concentrations with proximity to infection, and (2) localized infection-specific markers can be identified on a tissue level to potentially serve as debridement markers in the future. Samples were collected from 4 distinct locations, and the concentrations of interleukin(IL)-1α, IL-1β, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, granulocyte-macrophage colony-stimulating factor, interferon-γ, and tumor necrosis factor-α were quantified in each sample, relative to the amount of tissue. Cytokine concentrations differed with proximity to the joint when implant or infection was present, and tissues at the operative knee joint showed the highest levels of most cytokines. Additionally, IL-1β, IL-4, and IL-6 showed promise, beyond diagnostics, as tissue-level indicators of infection response. Ultimately, this study illustrated that tissue-level evaluation provided insight into infection-specific response, and these markers may be useful for guiding the debridement of implant-associated infections.
系统细胞因子浓度已在植入物相关感染中进行了广泛研究，提供了敏感的诊断标志物。然而，关于关节周围组织水平细胞因子的关系知之甚少。本研究旨在确定组织中的细胞因子谱，以研究这些细胞因子作为慢性关节感染清创术的标志物的用途。使用啮齿动物模型，在金黄色葡萄球菌植入和感染后从大鼠获得肌肉样本，以确定：(1) 感染附近细胞因子浓度是否存在差异，以及 (2) 是否可以在组织水平上确定特定于局部感染的标记物，以便将来可能作为清创术的标记物。从 4 个不同的位置采集样本，并定量分析每个样本中白细胞介素(IL)-1α、IL-1β、IL-4、IL-5、IL-6、IL-10、IL-12p70、IL-13、粒细胞-巨噬细胞集落刺激因子、干扰素-γ 和肿瘤坏死因子-α 的浓度，相对于组织量。当存在植入物或感染时，细胞因子浓度与关节的接近程度不同，手术膝关节处的组织表现出大多数细胞因子的最高水平。此外，IL-1β、IL-4 和 IL-6 除了诊断之外，还显示出作为感染反应的组织水平指标的潜力。最终，本研究表明，组织水平评估提供了对感染特异性反应的深入了解，这些标志物可能有助于指导植入物相关感染的清创术。
