BACKGROUND: Periprosthetic osteolysis and subsequent aseptic loosening are most common reasons forrevision after total joint replacements. Recently studies found that calcineurin/activated T cell nuclear factor (CN/NFAT) signaling pathway plays important roles in the pathogenic process of wear-induced inflammation and osteolysis. OBJECTIVE: To summarize CN/NFAT effects on wear particles-induced osteolysis, and to provide new ideas and newtheories for osteolysis-related diseases. METHODS: We retrieved PubMed for studies published from January 1980 to June 2016. The key words were CN/NFAT, CN/NFAT signaling pathways, wear particles, osteolysis, osteoclasts, osteoblast. Finally, 72 studies were analyzed and explored according to inclusion and exclusion criteria.RESULTS AND CONCLUSION: The pathogenesis of osteolysis involves the activation of macrophages by wear particles and the release of various proinflammatory cytokines. Bone is continuously renewed through a dynamic balance between bone resorption and formation and is the fundamental basis for maintaining normal bone mass andarchitecture by osteoclasts and osteoblasts. In this process, CN/NFAT signaling pathway is the signal transduction pathway involved in the differentiation of Ca2+ and nuclear factor kappa B receptor ligand. Osteoclasts play a significant role in both physiological and pathological bone resorption, and receptor activator of nuclear factor-κB ligand is the key cytokine that induces osteoclastogenesis.

The traditional-immunological strategies for clinical laboratories often rely on large and expensive instruments and skilled operators, and the measurement time is also long. However, the sensitivity of these strategies is still unsatisfactory. It is urgent to research and develop the point-of-care testing (POCT) featured as a highly sensitive, accurate, and rapid/POCT diagnosis. The Microfluidic chips have multi-advantages that are suitable for the clinical POCT diagnosis: high sensitivity, throughput, and automation. Recently, the Microfluidic-immune chips developed based on the microfluidic technology combined with immune detection have considered not only hotspots in the related research but also benefit to the tumor marker detection, antigen and antibody detection of infectious diseases, autoantibody detection, hormone detection, and other fields. However, there are still many challenges to be overcome during the application of chips, such as more effective microfluidic manipulation, more sensitive collection, and analysis of reaction signals.