Jiranek W A, Machado M, Jasty M, Jevsevar D, Wolfe H J, Goldring S R, Goldberg M J, Harris W H
Orthopaedic Biomechanics Laboratory, Massachusetts General Hospital, Boston 02114.
J Bone Joint Surg Am. 1993 Jun;75(6):863-79. doi: 10.2106/00004623-199306000-00007.
The chronic inflammatory response to wear particles from orthopaedic joint implants is believed to cause osteolysis and to contribute to prosthetic loosening. Previous in vitro experiments have demonstrated that particulate debris from joint implants causes cells in culture to release products that have been implicated in this pathological bone resorption. The purpose of the current study was to investigate the in vivo features of this complex process in patients who had had a total hip replacement. Membraneous tissue was obtained from the cement-bone interface of ten polyethylene acetabular components that had been revised for aseptic loosening in ten patients. The immunoperoxidase technique, which involves the use of specific antibodies for each cell type, showed that macrophages were the predominant cellular constituents but also that fibroblasts, many of which were not identified on plain histological study, were present and were actively producing collagen. T lymphocytes were present variably, but they generally composed less than 10 percent of the cells. Particulate debris (polyethylene, methylmethacrylate, and metal) was present in all membrane specimens but was intracellular only in macrophages and multinucleated giant cells. 35S-labeled nucleic-acid probes, complementary to human interleukin-1-beta and to platelet-derived growth-factor-2 messenger RNA (mRNA), were hybridized with serial tissue sections. Hybridization demonstrated interleukin-1-beta mRNA predominantly in macrophages, and not in fibroblasts or in T lymphocytes to any major extent. In contrast, immunolocalization demonstrated interleukin-1-beta protein on both macrophages and fibroblasts, suggesting that macrophages release interleukin-1-beta, which then binds to both fibroblasts and macrophages. Platelet-derived growth-factor transcripts were found in both macrophages and fibroblasts.
对骨科关节植入物磨损颗粒的慢性炎症反应被认为会导致骨溶解并促使假体松动。以往的体外实验表明，关节植入物的颗粒碎片会使培养中的细胞释放出与这种病理性骨吸收有关的产物。本研究的目的是调查全髋关节置换患者体内这一复杂过程的特征。从10例因无菌性松动而进行翻修的患者的10个聚乙烯髋臼部件的骨水泥 - 骨界面获取膜性组织。免疫过氧化物酶技术，即针对每种细胞类型使用特异性抗体，结果显示巨噬细胞是主要的细胞成分，但也存在成纤维细胞，其中许多在普通组织学研究中未被识别，并且它们正在活跃地产生胶原蛋白。T淋巴细胞数量不一，但通常占细胞总数的比例不到10%。所有膜标本中均存在颗粒碎片（聚乙烯、甲基丙烯酸甲酯和金属），但仅在巨噬细胞和多核巨细胞内发现。与人类白细胞介素 - 1 - β和血小板衍生生长因子 - 2信使核糖核酸（mRNA）互补的35S标记核酸探针与连续组织切片杂交。杂交结果显示白细胞介素 - 1 - β mRNA主要存在于巨噬细胞中，在成纤维细胞或T淋巴细胞中则没有明显表达。相比之下，免疫定位显示巨噬细胞和成纤维细胞上均有白细胞介素 - 1 - β蛋白，这表明巨噬细胞释放白细胞介素 - 1 - β，然后它会与成纤维细胞和巨噬细胞结合。在巨噬细胞和成纤维细胞中均发现了血小板衍生生长因子转录本。
