摘要
目的探讨股骨颈骨折的滑膜组织、人工关节无菌性松动和假体周围感染的界膜组织中人β-防御素-3(HBD-3)的表达差异。方法 30例患者,其中因假体周围感染进行髋关节翻修的患者、因无菌性松动接受髋关节翻修的患者以及因股骨颈骨折接受髋关节置换的患者各10例,采用酶联免疫吸附试验(ELISA)、实时定量聚合酶链反应(Realtime PCR)、免疫组化染色分析及免疫印迹分析(Western blot)进行假体周围界膜组织或滑膜组织中HBD-3表达水平的检测并进行统计学分析。结果 Realtime PCR发现,假体周围感染后界膜组织中HBD-3 m RNA的表达,明显高于无菌性松动界膜组织和股骨颈骨折滑膜组织中HBD-3的表达。与创伤性滑膜组织相比,细菌感染刺激引起界膜组织中HBD-3的释放增加约5倍以上;与非感染性的无菌性松动界膜组织相比,HBD-3的释放增加约2倍以上。免疫组化染色显示局部细菌炎症刺激条件下,与无菌性松动界膜组织相比,感染导致界膜组织中的成纤维细胞和成骨细胞分泌HBD-3增加。Westenblot显示,与非炎症组相比,葡萄球菌在局部定植引起组织中HBD-3蛋白水平显著提高。结论 HBD-3在感染性界膜组织和无菌性松动界膜组织之间表达差异显著。未来,HBD-3一个可行的临床应用可以通过术中界膜组织的病理活检,来区别人工关节假体周围感染和无菌性松动。
Objective To investigate the expression of Human β-defensin-3（HBD-3） in human interfacial membranes around periprosthetic joint infection compared with aseptic loosening and synovial samples of the hip joints under fracture conditions. Methods The tissue samples of interfacial membranes were obtained from the tissues around the femoral implants in 10 patients who had undergone revision total hip replacement because of periprosthetic joint infection, 10 patients who had undergone revision total hip replacement because of aseptic loosening of implants and 10 patients who underwent primary hip arthroplasty because of the fresh fracture of the femoral neck. The expression and release of HBD-3 was evaluated using ELISA, Real-time PCR, immunohistochemistry analysis and Western blot, then statistical analysis was carried out. Results By real time-PCR, HBD-3 mR NA transcripts were less detected from the non-infectious interfacial membrane in aseptic loosening and the synovial membrane in femoral neck fracture than the interfacial membrane in periprosthetic joint infection. After bacterial challenge, HBD-3 release was increased approximately five fold in infectious tissues compared with the synovial membranes, and more than 2 times compared with the non-infectious interfacial membranes by ELISA analysis. Immunohistochemistry revealed the staining intensity of HBD-3 localized in fibroblasts and osteocytes in inflamed interfacial membranes significantly higher than not inflamed interface membranes. In case of bacterial colonization with staphylococcus, an significant increase in HBD-3 expression compared with not inflamed tissues by Western blot. Conclusion In the study, the significant difference of the expression of HBD-3 which has been foundbetween inflamed interfacial membranes and not inflamed interfacial membranes. In the future, a feasible application of HBD-3 may even help doctors make a distinction between periprostheticjoint infection and aseptic loosening by intraoperative histological biopsy of the interfac
出处
《生物骨科材料与临床研究》
CAS
2016年第2期12-16,I0004,共6页
Orthopaedic Biomechanics Materials and Clinical Study
基金
国家自然科学基金(No 81401815)
中国博士后科学基金(No2015M582900)
江苏省博士后科学基金(No 1501146C)
关键词
Β-防御素
骨感染
耐药葡萄球菌
植入物
β-defensin
Bone infection
Drug-resistant staphylococcus
Implant
