Proinflammatory biomarkers' level and functional genetic polymorphisms in periprosthetic joint infection

Abstract

Objective: The aims of this study were 1) to identify the level of inflammatory biomarkers interleukin(IL)-1a, IL-1b, IL-6, IL-8, IL-17, C-reactive protein (CRP), granulocyte colony-stimulating factor (GCSF),ferritin, and tumor necrosis factor (TNF)-ain serum and synovialfluid samples of patients who underwent revision arthroplasty surgery; 2) to establish the relationship between serum and synovialfluidlevels; 3) to determine if any of the 11 genetic polymorphisms of TNFa, IL-1, IL-6, IL-8, IL-17, and GCSF onthe encoding genes was associated with periprosthetic joint infection (PJI).Methods: Synovialfluid and serum was collected from 88 patients who underwent revision arthroplastysurgery. The Musculoskeletal Infection Society deŞnition was used to classify these patients into 2groups: 36 PJIs and 52 aseptic failures. Synovialfluid and serum samples were tested for 9 biomarkersusing a micro enzyme-linked immunosorbent assay. Genetic polymorphisms were evaluated with polymerase chain reaction and restriction endonuclease analysis.Results: Synovialfluid-derived IL-1a, IL-1b, IL-8, IL-17, CRP, GCSF, TNFa, and serum-derived IL-6, IL-17,ferritin, CRP were found suitable to classify PJI and aseptic failure. In addition, IL-17 and CRP levelsdemonstrated a positive correlation between synovialfluid and serum. TNFa-238, IL6-174, GCSF3R, andIL1 RN-VNTR genetic polymorphisms occurred more frequently in individuals with septic failure.Conclusion: SigniŞcant differences between the two groups were observed in the functional polymorphisms of the genes encoding the cytokines investigated. These differences could be interpreted asindicating that there is an association between PJI and genetic polymorphisms.Level of evidence: Level III, diagnostic study.