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Hameister R, Lohmann CH, Dheen ST, Singh G, Kaur C. The effect of TNF-α on osteoblasts in metal wear-induced periprosthetic bone loss. Bone Joint Res 2020; 9:827-839. [PMID: 33179535 PMCID: PMC7672328 DOI: 10.1302/2046-3758.911.bjr-2020-0001.r2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Aims This study aimed to examine the effects of tumour necrosis factor-alpha (TNF-α) on osteoblasts in metal wear-induced bone loss. Methods TNF-α immunoexpression was examined in periprosthetic tissues of patients with failed metal-on-metal hip arthroplasties and also in myeloid MM6 cells after treatment with cobalt ions. Viability and function of human osteoblast-like SaOs-2 cells treated with recombinant TNF-α were studied by immunofluorescence, terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) assay, western blotting, and enzyme-linked immunosorbent assay (ELISA). Results Macrophages, lymphocytes, and endothelial cells displayed strong TNF-α immunoexpression in periprosthetic tissues containing metal wear debris. Colocalization of TNF-α with the macrophage marker CD68 and the pan-T cell marker CD3 confirmed TNF-α expression in these cells. Cobalt-treated MM6 cells secreted more TNF-α than control cells, reflecting the role of metal wear products in activating the TNF-α pathway in the myeloid cells. While TNF-α did not alter the immunoexpression of the TNF-receptor 1 (TNF-R1) in SaOs-2 cells, it increased the release of the soluble TNF-receptor 1 (sTNF-R1). There was also evidence for TNF-α-induced apoptosis. TNF-α further elicited the expression of the endoplasmic reticulum stress markers inositol-requiring enzyme (IRE)-1α, binding-immunoglobulin protein (BiP), and endoplasmic oxidoreductin1 (Ero1)-Lα. In addition, TNF-α decreased pro-collagen I α 1 secretion without diminishing its synthesis. TNF-α also induced an inflammatory response in SaOs-2 cells, as evidenced by the release of reactive oxygen and nitrogen species and the proinflammatory cytokine vascular endothelial growth factor. Conclusion The results suggest a novel osteoblastic mechanism, which could be mediated by TNF-α and may be involved in metal wear debris-induced periprosthetic bone loss. Cite this article: Bone Joint Res 2020;9(11):827–839.
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Affiliation(s)
- Rita Hameister
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - S Thameem Dheen
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Charanjit Kaur
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Zhang HY, Blunt L, Jiang XQ, Brown L, Barrans S, Zhao Y. Femoral stem wear in cemented total hip replacement. Proc Inst Mech Eng H 2008; 222:583-92. [DOI: 10.1243/09544119jeim346] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The great success of cemented total hip replacement to treat patients with end-stage osteoarthritis and osteonecrosis has been well documented. However, its long-term survivorship has been compromised by progressive development of aseptic loosening, and few hip prostheses could survive beyond 25 years. Aseptic loosening is mainly attributed to bone resorption which is activated by an in-vivo macrophage response to particulate debris generated by wear of the hip prosthesis. Theoretically, wear can occur not only at the articulating head—cup interface but also at other load-bearing surfaces, such as the stem—cement interface. Recently, great progress has been made in reducing wear at the head—cup interface through the introduction of new materials and improved manufacture; consequently femoral stem wear is considered to be playing an increasingly significant role in the overall wear of cemented total hip replacement. In this review article, the clinical incidences of femoral stem wear are comprehensively introduced, and its significance is highlighted as a source of generation of wear debris and corrosion products. Additionally, the relationship between femoral stem surface finish and femoral stem wear is discussed and the primary attempts to reproduce femoral stem wear through in-vitro wear testing are summarized. Furthermore, the initiation and propagation processes of femoral stem wear are also proposed and a better understanding of the issue is considered to be essential to reduce femoral stem wear and to improve the functionality of cemented total hip replacement.
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Affiliation(s)
- H-Y Zhang
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - L Blunt
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - X-Q Jiang
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - L Brown
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - S Barrans
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - Y Zhao
- School of Management, Tianjin University, Tianjin, People's Republic of China
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Koulouvaris P, Ly K, Ivashkiv LB, Bostrom MP, Nestor BJ, Sculco TP, Purdue PE. Expression profiling reveals alternative macrophage activation and impaired osteogenesis in periprosthetic osteolysis. J Orthop Res 2008; 26:106-16. [PMID: 17729302 DOI: 10.1002/jor.20486] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Interactions between periprosthetic cells and prosthetic wear debris have been recognized as an important event in the development of osteolysis and aseptic loosening. Although the ability of wear debris to activate pro-inflammatory macrophage signaling has been documented, the full repertoire of macrophage responses to wear particles has not been established. Here, we examined the involvement of alternative macrophage activation and defective osteogenic signaling in osteolysis. Using real-time RT-PCR analysis of periprosthetic soft tissue from osteolysis patients, we detected elevated levels of expression of alternative macrophage activation markers (CHIT1, CCL18), chemokines (IL8, MIP1 alpha) and markers of osteoclast precursor cell differentiation and multinucleation (Cathepsin K, TRAP, DC-STAMP) relative to osteoarthritis controls. The presence of cathepsin K positive multinuclear cells was confirmed by immunohistochemistry. Reduced expression levels of the osteogenic signaling components BMP4 and FGF18 were detected. Expression levels of TNF-alpha, IL-6, and RANKL were unchanged, while the anti-osteoclastogenic cytokine OPG was reduced in osteolysis patients, resulting in elevated RANKL:OPG ratios. In vitro studies confirmed the role of particulate debris in alternative macrophage activation and inhibition of osteogenic signaling. Taken together, these results suggest involvement in osteolysis of alternative macrophage activation, accompanied by elevated levels of various chemokines. Increased recruitment and maturation of osteoclast precursors is also observed, as is reduced osteogenesis. These findings provide new insights into the molecular pathogenesis of osteolysis, and identify new potential candidate markers for disease progression and therapeutic targeting.
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Affiliation(s)
- Panagiotis Koulouvaris
- Osteolysis Research Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, USA
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Hundrić-Haspl Z, Pecina M, Haspl M, Tomicic M, Jukic I. Plasma cytokines as markers of aseptic prosthesis loosening. Clin Orthop Relat Res 2006; 453:299-304. [PMID: 16906105 DOI: 10.1097/01.blo.0000229365.57985.96] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The proinflammatory cytokines IL-1beta, IL-8, and TNF-alpha play a major role in the process of bone resorption during aseptic loosening of large joint prostheses. These cytokines secreted locally during bone resorption in aseptic loosening may enter peripheral circulation. Increased concentration of IL-1gamma, IL-8, and TNF-alpha in peripheral circulation may indicate aseptic loosening. We determined whether bone resorption could be verified by cytokine presence in plasma. We recruited 50 patients with aseptic prosthesis loosening, 50 with stable prostheses, 50 with osteoarthritis, and 50 healthy individuals. Cytokine levels were determined in plasma by ELISA tests. Patients with prosthesis loosening had higher plasma levels (IL-10, 3.7 +/- 5.5 pg/mL; IL-8, 14.7 +/- 9 pg/mL; TNF-alpha, 32.7 +/-+/- 32.4 pg/mL) than patients with stable prostheses (IL-1beta, 1.5 +/- 2 pg/mL; IL-8, 8.1 +/- 4.7 pg/mL; TNF-alpha, 22.9 +/- 18.7 pg/mL), patients with osteoarthritis (IL-1beta, 0.7 +/- 1.1 pg/mL; IL-8, 5.8 +/- 3.8 pg/mL; TNF-alpha, 9.8 +/- 7.7 pg/mL) and healthy individuals (IL-1beta, 0.7 +/- 1.1 pg/mL; IL-8, 4.2 +/- 1.3 pg/mL; TNF-alpha, 3.9 +/- 3.9 pg/mL). Our data suggest elevated plasma levels of proinflammatory cytokines may be useful as markers of bone resorption in the laboratory diagnosis of prosthesis loosening.
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Oum'hamed Z, Garnotel R, Josset Y, Trenteseaux C, Laurent-Maquin D. Matrix metalloproteinases MMP-2, -9 and tissue inhibitors TIMP-1, -2 expression and secretion by primary human osteoblast cells in response to titanium, zirconia, and alumina ceramics. J Biomed Mater Res A 2004; 68:114-22. [PMID: 14661256 DOI: 10.1002/jbm.a.20001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Osteogenic properties of bone cells are a key parameter governing osseointegration of implant devices. In this context, osteoblasts have a central role via extracellular matrix synthesis and remodeling that they regulate through different protease activity. In this study, we have analyzed the expression of two matrix metalloproteinases (MMPs): MMP-2 (72 kDa) and MMP-9 (92 kDa) and their specific tissue inhibitors TIMP-1 and TIMP-2 in primary human osteoblastic cells. The effect of titanium, zirconia, and alumina ceramics on the synthesis of these proteases was assessed using reverse transcriptase-polymerase chain reaction, enzyme-linked immunosorbent assay, and zymographic analysis. Our results showed that osteoblasts express MMP-2 and -9 mRNA. Furthermore, MMP-2 mRNA expression was decreased by titanium and increased by alumina whereas zirconia did not have any significant effect. Conversely, MMP-9 mRNA expression was stimulated by titanium but decreased with zirconia, whereas alumina induced no significant changes. Zymographic analysis has evidenced pro-MMP-2 gelatinolytic activity in all cell populations with time-dependent increase profile; pro-MMP-9, however, was not detected. Enzyme-linked immunosorbent assay data confirmed the production of MMP-2 and very low levels of MMP-9. In addition, TIMP-1 was secreted in 24-h-cultured cells and increased to maximal level at 48-72 h whereas TIMP-2 levels were very low. The interactions between human osteoblasts and the studied biomaterials altered both MMP-2, -9 and TIMP-1expression indicating that biomaterials may influence osseointegration and bone remodeling.
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Affiliation(s)
- Z Oum'hamed
- Unité INSERM ERM 0203, IFR 53, UFR Odontologie-1, Faculté de Pharmacie/Médecine 1, Ave du Maréchal Juin, 51095 Reims Cedex, France.
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Mulhall KJ, Curtin WA, Given HF. Comparison of different anti-inflammatory agents in suppressing the monocyte response to orthopedic particles. Orthopedics 2003; 26:1219-23. [PMID: 14690293 DOI: 10.3928/0147-7447-20031201-12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Three different anti-inflammatory agents--diclofenac, dexamethasone, and N-acetylcysteine--were compared to evaluate their effectiveness in suppressing monocyte-macrophage cell culture activation and mediator release (tumor necrosis factor-alpha [TNF-alpha] and interleukin-1beta [IL-1beta]) in response to polymethylmethacrylate particulate debris. N-acetylcysteine and diclofenac were most effective in suppressing TNF-alpha and IL-1beta expression by the monocyte-macrophages. Dexamethasone reduced TNF-alpha expression but was not as effective suppressing IL-1beta expression. N-acetylcysteine and dexamethasone had no effect on cell viability whereas diclofenac at the highest concentrations decreased cell viabilities. N-acetylcysteine and diclofenac, but less so dexamethasone, are effective in suppressing wear debris-related cell activation and mediator release and thus potentially represent therapeutic or preventive modalities for periprosthetic osteolysis.
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Affiliation(s)
- Kevin J Mulhall
- Department of Orthopedics, Merlin Park Hospital, Galway, Ireland
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Kim KJ, Kotake S, Udagawa N, Ida H, Ishii M, Takei I, Kubo T, Takagi M. Osteoprotegerin inhibits in vitro mouse osteoclast formation induced by joint fluid from failed total hip arthroplasty. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2002; 58:393-400. [PMID: 11410897 DOI: 10.1002/jbm.1033] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Osteoprotegerin (OPG) is a key regulator of osteoclastogenesis. We investigated the presence of OPG and bone-resorbing cytokines, the potential of osteoclastic differentiation in joint fluid from failed total hip arthroplasty (THA), and the inhibitory effect of OPG on osteoclast formation in vitro induced by the joint fluid. The study was aimed to clarify one important step in the cascade of periprosthetic osteolysis in the process of implant loosening. OPG levels in failed THA joint fluid of 20 cases were significantly lower than osteoarthritis (OA) joint fluid of 15 cases (p < 0.001). The levels of bone-resorbing cytokines, interleukin (IL)-1beta, and IL-6 were significantly higher in failed THA joint fluid than OA fluid (p < 0.001 and p = 0.001, respectively). Marked osteoclast formation was observed in the presence of failed THA joint fluid in the mouse coculture system, when compared to OA fluid (p < 0.001). The addition of 100 ng/mL OPG to the mouse coculture system completely inhibited osteoclast formation in the presence of failed THA joint fluid (p < 0.001). The data suggest that low levels of OPG combined with higher IL-1beta and IL-6 levels represent the potential of osteoclast differentiation and its activation in failed THA joint fluid. Inhibition of osteoclastogenesis in vitro by OPG suggests that a low level of OPG with elevated bone resorbing cytokines contributes to periprosthetic osteolysis via osteolytic joint fluid, thus leading to THA prosthesis loosening.
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Affiliation(s)
- K J Kim
- Department of Orthopaedic Surgery, Tokyo Woman's Medical University, Tokyo 162-8666, Japan
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McEvoy A, Jeyam M, Ferrier G, Evans CE, Andrew JG. Synergistic effect of particles and cyclic pressure on cytokine production in human monocyte/macrophages: proposed role in periprosthetic osteolysis. Bone 2002; 30:171-7. [PMID: 11792581 DOI: 10.1016/s8756-3282(01)00658-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Macrophages, activated by particulate wear debris, are important in the process of osteolysis, which occurs during joint implant loosening. We previously found increased levels of interleukin-1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha in cultured macrophages subjected to cyclical pressure of 0.138 MPa, suggesting that cyclic pressure may be another relevant cause of macrophage activation. The current study first investigated the effects of a range of cyclic pressures on cultured macrophages, including an investigation of the time course of cytokine expression. At 0.138 MPa, supernatant levels of TNF-alpha were maximal at 12 h, whereas IL-6 and IL-1beta were maximal at 24 h. All four cyclic pressure levels tested (without particles) resulted in increased production of all three cytokines relative to control. These increases were most marked at 0.069 and 0.035 MPa, and the increase in cytokine production at 0.017 MPa was not statistically significant. Further studies demonstrated that conditioned media from cyclically pressurized macrophages stimulated bone resorption in a neonatal mouse calvarial assay system. There were increased levels of calcium released from calvaria cultured in conditioned media from pressurised monocytes, and an increase in tartate-resistant acid phosphatase-positive osteoclasts was observed microscopically. As particulate wear debris is important in implant loosening, ultra high molecular weight polyethylene particles were also added to the pressurized cell cultures. The experiments compared the effect of atmospheric pressure, cyclic pressure alone, particles alone, and particles and cyclic pressure combined. A combination of ultra high molecular weight polyethylene particles and cyclic pressure at 0.017 MPa resulted in a dramatic synergistic elevation of levels of all three cytokines compared with the levels found with either pressure or particles alone. We propose that monocyte/macrophage activation by cyclic pressure plays a major role in the osteolysis seen in aseptic loosening of implants. The synergistic effect observed between particles and pressure could accelerate implant loosening, and implies that reduction in either cyclic pressure (by improving implant fixation) or wear debris load would reduce osteolysis.
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Affiliation(s)
- A McEvoy
- Musculoskeletal Research Group, Manchester Medical School, University of Manchester, Manchester, UK
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Andersson MK, Anissian L, Stark A, Bucht E, Felländer-Tsai L, Tsai JA. Synovial fluid from loose hip arthroplasties inhibits human osteoblasts. Clin Orthop Relat Res 2000:148-54. [PMID: 10986989 DOI: 10.1097/00003086-200009000-00024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Aseptic loosening of prosthetic components in patients who have undergone total hip arthroplasty is a major clinical problem. Earlier studies on this topic have focused mainly on different aspects of bone resorption. The current study investigated the influence of synovial fluid from patients who underwent revision surgery because of aseptic loosening and synovial fluid from patients with osteoarthritis on the proliferation of primary cultures of human osteoblasts. Incubation of cells with 10% synovial fluid from patients who had revision surgery significantly inhibited [3H]thymidine incorporation into deoxyribonucleic acid in human osteoblasts compared with control conditions, whereas 10% synovial fluid from patients with osteoarthritis had a significant stimulatory effect. These findings correlate well with clinical features seen in these diseases, such as increased net bone resorption around the prosthesis in patients with loosening, and increased periarticular bone formation in patients with osteoarthritis.
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Affiliation(s)
- M K Andersson
- Department of Molecular Medicine, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden
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