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Medientyp:
E-Artikel
Titel:
Prospective Clinical Trial for Septic Arthritis: Cartilage Degradation and Inflammation Are Associated with Upregulation of Cartilage Metabolites
Beteiligte:
Schmal, Hagen;
Bernstein, Anke;
Feucht, Matthias J.;
Erdle, Benjamin;
Pestka, Jan M.;
Pham, That Minh;
Kubosch, Eva Johanna
Beschreibung:
<jats:p><jats:italic>Background</jats:italic>. Intra-articular infections can rapidly lead to osteoarthritic degradation. The aim of this clinical biomarker analysis was to investigate the influence of inflammation on cartilage destruction and metabolism.<jats:italic>Methods</jats:italic>. Patients with acute joint infections were enrolled in a prospective clinical trial and the cytokine composition of effusions (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">76</mml:mn></mml:math>) was analyzed. Characteristics of epidemiology and disease severity were correlated with levels of cytokines with known roles in cartilage turnover and degradation.<jats:italic>Results</jats:italic>. Higher synovial IL-1<jats:italic>β</jats:italic>concentrations were associated with clinical parameters indicating a higher disease severity (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn fontstyle="italic">0.03</mml:mn></mml:math>) excluding the incidence of sepsis. Additionally, intra-articular IL-1<jats:italic>β</jats:italic>levels correlated with inflammatory serum parameters as leucocyte counts (LC) and C-reactive protein concentrations (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn fontstyle="italic">0.05</mml:mn></mml:math>) but not with age or comorbidity. Both higher LC and synovial IL-1<jats:italic>β</jats:italic>levels were associated with increased intra-articular collagen type II cleavage products (C2C) indicating cartilage degradation. Joints with preinfectious lesions had higher C2C levels. Intra-articular inflammation led to increased concentrations of typical cartilage metabolites as bFGF, BMP-2, and BMP-7. Infections with<jats:italic>Staphylococcus</jats:italic>species induced higher IL-1<jats:italic>β</jats:italic>expression but less cartilage destruction than other bacteria.<jats:italic>Conclusion</jats:italic>. Articular infections have bacteria-specific implications on cartilage metabolism. Collagen type II cleavage products reliably mark destruction, which is associated with upregulation of typical cartilage turnover cytokines. This trial is registered with<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003536">DRKS00003536</jats:ext-link>, MISSinG.</jats:p>