Department of Pathology and Laboratory Medicine, 25815Loyola University Medical Center, Maywood, IL, USA.
Medical Clinic Division of Vascular Medicine, University Medical Centre Ljubljana, Slovenia.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:1076029621995569. doi: 10.1177/1076029621995569.
Osteoarthritis (OA) is a chronic condition marked by joint pain, inflammation and loss of articular cartilage, that can be treated with total joint arthroplasty (TJA) at end stages. TJA is marked by post-operative inflammation, which directly effects levels of cartilage degradation biomarkers, proteoglycan-4 (PRG4) and matrix metalloproteinase-9 (MMP-9). PRG4 is a protective glycoprotein that is decreased in individuals with OA. MMP-9 is a matrix metalloproteinase that contributes to articular cartilage loss and is elevated in OA patients. It is upregulated by pro-inflammatory markers, such as IL-1, IL-6 and CRP. This study aims to elucidate the immediate post-operative changes in levels of PRG4, MMP-9, IL-6, CRP, and WBC in patients undergoing TJA to clarify the role of inflammation in recovery after surgery and in the overall pathogenesis of OA. Blood was collected at 3 time points (day 0, day 1 post-operatively, and days 5-7 post-operatively), from 63 patients undergoing TJA due to OA, and levels of these biomarkers were quantified. IL-6, CRP, WBC and MMP-9 were lowest at day 0, highest at day 1, and stabilized at an intermediate level at days 5-7. Meanwhile, PRG4 followed the opposite trend. These studies suggest that IL-6, CRP and WBC showed predictable fluctuations, with pro-inflammatory biomarkers upregulating MMP-9 and downregulating PRG4. Measuring these biomarkers may help expose the role of inflammation in the post-surgical recovery of TJA patients and in long-term pathogenesis of OA. These levels may help risk stratify patients pre-operatively and help develop individualized post-surgical plans.
骨关节炎（OA）是一种慢性疾病，其特征为关节疼痛、炎症和关节软骨丧失，在晚期可以通过全关节置换术（TJA）进行治疗。TJA 术后伴有炎症，这直接影响软骨降解生物标志物，蛋白聚糖 4（PRG4）和基质金属蛋白酶 9（MMP-9）的水平。PRG4 是一种保护性糖蛋白，在 OA 患者中减少。MMP-9 是一种参与关节软骨丧失的基质金属蛋白酶，在 OA 患者中升高。它被促炎标志物（如 IL-1、IL-6 和 CRP）上调。本研究旨在阐明接受 TJA 的患者术后即刻 PRG4、MMP-9、IL-6、CRP 和 WBC 水平的变化，以阐明炎症在手术后恢复和 OA 整体发病机制中的作用。从 63 名因 OA 接受 TJA 的患者中采集 3 个时间点（手术前 0 天、术后 1 天和术后 5-7 天）的血液，并定量这些生物标志物的水平。IL-6、CRP、WBC 和 MMP-9 在第 0 天最低，在第 1 天最高，在第 5-7 天稳定在中间水平。同时，PRG4 则呈现相反的趋势。这些研究表明，IL-6、CRP 和 WBC 表现出可预测的波动，促炎生物标志物上调 MMP-9 并下调 PRG4。测量这些生物标志物可能有助于揭示炎症在 TJA 患者术后恢复和 OA 长期发病机制中的作用。这些水平可能有助于术前对患者进行风险分层，并帮助制定个体化的术后计划。
