1.Mediation effect of inflammatory biomarkers on the association between blood lead levels and blood pressure changes in Chinese adults.
Ying Li QU ; Feng ZHAO ; Sai Sai JI ; Xiao Jian HU ; Zheng LI ; Miao ZHANG ; Ya Wei LI ; Yi Fu LU ; Jia Yi CAI ; Qi SUN ; Hao Can SONG ; Dan Dan LI ; Xu Lin ZHENG ; Bing WU ; Yao Bin LV ; Ying ZHU ; Zhao Jin CAO ; Xiao Ming SHI
Chinese Journal of Preventive Medicine 2022;56(11):1591-1596
Objective: To investigate the role of inflammatory biomarkers in the relationship between blood lead levels and blood pressure changes. Methods: A total of 9 910 people aged 18-79 years who participated in the China National Human Biomonitoring in 2017-2018 were included in this study. A self-made questionnaire was used to collect demographic characteristics, lifestyle and other information, and the data including height, weight and blood pressure were determined through physical examination. Blood and urinary samples were collected for the detection of blood lead and cadmium levels, urinary arsenic levels, white blood cells, neutrophils, lymphocytes, and hypersensitive C-reactive protein (hs-CRP). Weighted linear regression models were used to evaluate the associations between blood lead, inflammatory biomarkers and blood pressure. Mediation analysis was performed to investigate the role of inflammation in the relationship between blood lead levels and blood pressure changes. Results: The median (Q1, Q3) age of all participants was 45.4 (33.8, 58.4)years, including 4 984 males accounting for 50.3%. Multivariate logistic regression model analysis showed that after adjusting for age, gender, residence area, BMI, education level, smoking and drinking status, family history of hypertension, consumption frequency of rice, vegetables, and red meat, fasting blood glucose, total cholesterol, triglycerides, blood cadmium and urinary arsenic levels, there was a positive association between blood lead levels, inflammatory biomarkers and blood pressure (P<0.05). Each 2.71 μg/L (log-transformed) increase of the lead was associated with a 2.05 (95%CI: 0.58, 3.53) mmHg elevation in systolic blood pressure (SBP), 2.24 (95%CI: 1.34, 3.14) mmHg elevation in diastolic blood pressure (DBP), 0.25 (95%CI: 0.05, 0.46) mg/L elevation in hs-CRP, 0.16 (95%CI: 0.03, 0.29)×109/L elevation in white blood cells, and 0.11 (95%CI: 0.02, 0.21)×109/L elevation in lymphocytes, respectively. Mediation analysis showed that the levels of hs-CRP significantly mediated the association of blood lead with SBP, with a proportion about 3.88% (95%CI: 0.45%, 7.32%). The analysis also found that the levels of hs-CRP and neutrophils significantly mediated the association of blood lead with SBP, with a proportion about 4.10% (95%CI: 1.11%, 7.10%) and 2.42% (95%CI: 0.07%, 4.76%), respectively. Conclusion: This study suggests that inflammatory biomarkers could significantly mediate the association of blood lead levels and blood pressure changes.
Adult
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Male
;
Humans
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Blood Pressure/physiology*
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C-Reactive Protein/analysis*
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Lead
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Arsenic/analysis*
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Cadmium
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Biomarkers
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Hypertension/epidemiology*
;
China/epidemiology*
2.Roles of pattern recognition receptors in diabetic nephropathy.
Zhi-Feng ZHOU ; Lei JIANG ; Qing ZHAO ; Yu WANG ; Jing ZHOU ; Qin-Kai CHEN ; Jin-Lei LV
Journal of Zhejiang University. Science. B 2020;21(3):192-203
Diabetic nephropathy (DN) is currently the most common complication of diabetes. It is considered to be one of the leading causes of end-stage renal disease (ESRD) and affects many diabetic patients. The pathogenesis of DN is extremely complex and has not yet been clarified; however, in recent years, increasing evidence has shown the important role of innate immunity in DN pathogenesis. Pattern recognition receptors (PRRs) are important components of the innate immune system and have a significant impact on the occurrence and development of DN. In this review, we classify PRRs into secretory, endocytic, and signal transduction PRRs according to the relationship between the PRRs and subcellular compartments. PRRs can recognize related pathogen-associated molecular patterns (PAMPs) and danger-associated molecular patterns (DAMPs), thus triggering a series of inflammatory responses, promoting renal fibrosis, and finally causing renal impairment. In this review, we describe the proposed role of each type of PRRs in the development and progression of DN.
Alarmins/physiology*
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C-Reactive Protein/physiology*
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Diabetic Nephropathies/etiology*
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Endocytosis
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Humans
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Immunity, Innate
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Mannose-Binding Lectin/physiology*
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Pathogen-Associated Molecular Pattern Molecules
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Receptors, Pattern Recognition/physiology*
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Serum Amyloid P-Component/physiology*
;
Signal Transduction
3.Early Warning of Acute Altitude Sickness by Physiological Variables and Noninvasive Cardiovascular Indicators.
Zong Bin LI ; Chun Wei LIU ; Jun GUO ; Ya Jun SHI ; Yang LI ; Jin Li WANG ; Jing WANG ; Yun Dai CHEN
Chinese Medical Sciences Journal 2020;35(1):13-19
Objective To examine if the variations at sea level would be able to predict subsequent susceptibility to acute altitude sickness in subjects upon a rapid ascent to high altitude. Methods One hundred and six Han nationality male individuals were recruited to this research. Dynamic electrocardiogram, treadmill exercise test, echocardiography, routine blood examination and biochemical analysis were performed when subjects at sea level and entering the plateau respectively. Then multiple regression analysis was performed to construct a multiple linear regression equation using the Lake Louise Score as dependent variable to predict the risk factors at sea level related to acute mountain sickness (AMS). Results Approximately 49.05% of the individuals developed AMS. The tricuspid annular plane systolic excursion (22.0±2.66 vs. 23.2±3.19 mm, t=1.998, P=0.048) was significantly lower in the AMS group at sea level, while count of eosinophil [(0.264±0.393)×109/L vs. (0.126±0.084)×109/L, t=-2.040, P=0.045], percentage of differences exceeding 50 ms between adjacent normal number of intervals (PNN50, 9.66%±5.40% vs. 6.98%±5.66%, t=-2.229, P=0.028) and heart rate variability triangle index (57.1±16.1 vs. 50.6±12.7, t=-2.271, P=0.025) were significantly higher. After acute exposure to high altitude, C-reactive protein (0.098±0.103 vs. 0.062±0.045 g/L, t=-2.132, P=0.037), aspartate aminotransferase (19.7±6.72 vs. 17.3±3.95 U/L, t=-2.231, P=0.028) and creatinine (85.1±12.9 vs. 77.7±11.2 mmol/L, t=-3.162, P=0.002) were significantly higher in the AMS group, while alkaline phosphatase (71.7±18.2 vs. 80.6±20.2 U/L, t=2.389, P=0.019), standard deviation of normal-to-normal RR intervals (126.5±35.9 vs. 143.3±36.4 ms, t=2.320, P=0.022), ejection time (276.9±50.8 vs. 313.8±48.9 ms, t=3.641, P=0.001) and heart rate variability triangle index (37.1±12.9 vs. 41.9±11.1, t=2.020, P=0.047) were significantly lower. Using the Lake Louise Score as the dependent variable, prediction equation were established to estimate AMS: Lake Louise Score=3.783+0.281×eosinophil-0.219×alkaline phosphatase+0.032×PNN50. Conclusions We elucidated the differences of physiological variables as well as noninvasive cardiovascular indicators for subjects after high altitude exposure compared with those at sea level. We also created an acute high altitude reaction early warning equation based on the physiological variables and noninvasive cardiovascular indicators at sea level.
Acute Disease
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Adolescent
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Adult
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Alkaline Phosphatase/blood*
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Altitude
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Altitude Sickness/physiopathology*
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Aspartate Aminotransferases/blood*
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Blood Pressure/physiology*
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C-Reactive Protein/analysis*
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Creatinine/blood*
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Electrocardiography/methods*
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Exercise Test/methods*
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Heart Rate/physiology*
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Humans
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Leukocyte Count
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Male
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Risk Factors
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Young Adult
4.Inhibitory Role of Pentraxin-3 in Esophageal Squamous Cell Carcinoma.
Dan MA ; ; Ye ZONG ; ; Sheng-Tao ZHU ; ; Yong-Jun WANG ; ; Peng LI ; ; Shu-Tian ZHANG ; ;
Chinese Medical Journal 2016;129(18):2233-2240
BACKGROUNDEsophageal cancer is the sixth leading cause of cancer-related death worldwide. Pentraxin-3 (PTX3) is a member of the PTX superfamily. Here, we investigated the role of PTX3 in esophageal squamous cell carcinoma (ESCC).
METHODSThe effect of PTX3 on ESCC cell proliferation, colony formation, apoptosis, migration, and invasion was investigated using cell viability assays, colony formation assays, flow cytometry, and migration and invasion assays. The effect of PTX3 on the tumorigenicity of ESCC in vivo was investigated with xenograft studies in nude mice.
RESULTSPTX3 overexpression in ESCC cells reduced cellular proliferation and colony formation (P < 0.05) and increased the rate of apoptosis (P < 0.05). PTX3 expression had no significant effect on the migratory or invasive potential of ESCC cells. In our mouse model of human ESCC, we achieved 100% successful tumor establishment. Compared with the control and empty vector-expressing groups, the PTX3-expressing group formed significantly smaller tumors (P < 0.05).
CONCLUSIONSThis study indicates that PTX3 might play an inhibitory role in ESCC.
Animals ; Apoptosis ; genetics ; physiology ; C-Reactive Protein ; genetics ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; genetics ; physiology ; Cell Survival ; genetics ; physiology ; Esophageal Neoplasms ; metabolism ; pathology ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Serum Amyloid P-Component ; genetics ; metabolism ; Xenograft Model Antitumor Assays
5.Soluble Suppression of Tumorigenicity 2 and Echocardiography in Sepsis.
Hyun Suk YANG ; Mina HUR ; Hanah KIM ; Laura MAGRINI ; Rossella MARINO ; Salvatore DI SOMMA
Annals of Laboratory Medicine 2016;36(6):590-594
Soluble suppression of tumorigenicity 2 (sST2) has emerged as a biomarker of cardiac stretch or remodeling, and has demonstrated a role in acutely decompensated heart failure. However, its role in sepsis-induced cardiac dysfunction is still unknown. We explored whether sST2 serum concentration reflects either systolic or diastolic dysfunction as measured by Doppler echocardiography. In a total of 127 patients with sepsis, correlations between sST2 and blood pressure, left ventricular (LV) ejection fraction, LV diastolic filling (ratio of early transmitral flow velocity to early diastolic mitral annulus velocity), and resting pulmonary arterial pressure were evaluated. Correlations between sST2 and other sepsis biomarkers (high-sensitivity C-reactive protein [hs-CRP] and procalcitonin) were also examined. sST2 showed a moderate correlation with mean arterial pressure (r=-0.3499) but no correlation with LV ejection fraction, diastolic filling, or resting pulmonary hypertension. It showed moderate correlations with hs-CRP and procalcitonin (r=0.2608 and r=0.3829, respectively). sST2 might have a role as a biomarker of shock or inflammation, but it cannot reflect echocardiographic findings of LV ejection fraction or diastolic filling in sepsis.
Aged
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Aged, 80 and over
;
Biomarkers/blood
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Blood Pressure/physiology
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C-Reactive Protein/analysis
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Calcitonin/blood
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Echocardiography, Doppler
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Female
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Humans
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Interleukin-1 Receptor-Like 1 Protein/*blood
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Male
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Middle Aged
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Sepsis/diagnostic imaging/metabolism/*physiopathology
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Ventricular Function, Left/physiology
6.Exploration of the mechanism of xinfeng capsule in the treatment of ankylosing spondylitis based on B and T lymphocyte attenuator and oxidative stress.
Ya-Jun QI ; Jian LIU ; Li ZHENG ; Yun-Xiang CAO ; Lei WAN
Chinese Journal of Integrated Traditional and Western Medicine 2015;35(1):25-32
OBJECTIVETo explore changes of B and T lymphocyte attenuator (BTLA), superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAOC), reactive oxygen species (ROS), reactive nitrogen species (RNS), malondialdehyde (MDA) in ankylosing spondylitis (AS) patients, and the effect of Xinfeng Capsule (XFC) on them.
METHODSTotally 120 AS patients were assigned to two groups according to random digit table method, the XFC group (3 XFC pills each time, 3 times a day) and the SASP group (4 SASP tablets each time, twice a day), 60 in each group. All patients were treated for 3 months. Another 60 healthy subjects were recruited as a healthy control group. The expression frequency and activation levels of BTLA were detected using flow cytometry. Serum oxidative stress indices (such as SOD and CAT, TAOC, ROS, RNS, MDA) and contents of cytokines [tumor necrosis factor α (TNF-α), IL-1β, IL-4, and IL-10] were detected using enzyme-linked immunoassay (ELISA). Erythrocyte sedimentation rate (ESR) was detected using Westergren method. High-sensitivity C-reactive protein (Hs-CRP) was detected using HITACHI 7060 type automatic biochemical analyzer. Clinical efficacies of ASAS 20 and BASDAI50 were assessed using VAS. Correlation analysis between scoring for quality of life and BTLA expression frequency was performed.
RESULTS(1) Clinical efficacies of ASAS 20 and BASDAI50 were significantly better in the XFC group than in the SASP group (P < 0.01). (2) Compared with the healthy control group, BTLA expressions in the peripheral blood of AS patients decreased significantly (P <0. 05); SOD, CAT, and TAOC values significantly decreased (P < 0.01, P < 0.05); ROS, RNS, and MDA values significantly increased (P < 0.01, P < 0.05); TNF-α, IL-1β, ESR, and Hs-CRP values significantly increased (P < 0.01); IL-4 and IL-10 values decreased significantly (P < 0.01, P < 0.05). (3) Compared with pre-treatment in the same group, BTLA/CD19 + B, BTLA/CD24 + B, SOD, TAOC, IL-4, SF-36 [physical functioning (PF), social functioning (SF), role limitation due to physical problems (RP), role limitation due to emotional problems (RE), body pain (BP), mental health (MH), vitality (VT), general health (GH)] were significantly elevated; ROS, MDA, TNF-α, ESR, Hs- CRP, VAS, BASDAI and BASFI, BAS-G were significantly lower in the peripheral blood of the two groups after treatment (P < 0.01, P < 0.05). Better effect was shown in the XFC group in elevating BTLA/CD19+ B, BTLA/CD24 + B, SOD, TAOC, IL-10, BP, MH, VT, and SF; and lowering ROS, IL-1β, MDA, TNF-α, ESR, Hs-CRP, VAS, BASDAI, BASFI, and BAS-G (P < 0.01, P < 0.05). (4) Pearson correlation analysis showed, BTLA/CD19 + B expression of the peripheral blood was positively correlated with SOD, CAT, TAOC, IL-4, IL-10, GH, RP, BP, and SF (r = 0.431, 0.325, 0.318, 0.316, 0.348, 0.314, 0.358, 0.318, 0.326, respectively, P < 0.05, P < 0.01), while it was negative correlated with ROS, MDA, TNF-α, IL-1β, ESR, VAS, and BASDAI (r = -0.342, -0.368, -0.334, -0.354, -0.324, -0.372, -0.342, respectively, P < 0.05, P < 0.01). BTLA/CD24 B expression of the peripheral blood was positively correlated with SOD, TAOC, IL-4, IL-10, GH, RP, BP, SF, RE, MH, VT (r = 0.358, 0.352, 0.372, 0.436, 0.435, 0.326, 0.352, 0.345, 0.326, 0.343, 0.332, respectively, P < 0.05, P < 0.01), while it was negative correlated with ROS, RNS, MDA, ESR, Hs-CRP, VAS, BASDAI, and BASFI (r = -0.447, -0.336, -0.405, -0. 395, -0. 358, -0.436, -0.338, -0.425, respectively, P < 0.05, P < 0.01).
CONCLUSIONXFC could improve BTLA expression in the peripheral blood of AS patients, negatively regulate activation and proliferation of B cells, and reduce abnormal immune responses and oxidative stress injury, thereby effectively alleviating joint stiffness and pain.
B-Lymphocytes ; physiology ; Blood Sedimentation ; C-Reactive Protein ; metabolism ; Capsules ; Catalase ; metabolism ; Cytokines ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Flow Cytometry ; Humans ; Interleukin-10 ; metabolism ; Interleukin-1beta ; metabolism ; Interleukin-4 ; metabolism ; Malondialdehyde ; metabolism ; Oxidative Stress ; Quality of Life ; Reactive Oxygen Species ; Spondylitis, Ankylosing ; drug therapy ; Superoxide Dismutase ; metabolism ; T-Lymphocytes ; physiology ; Tumor Necrosis Factor-alpha ; metabolism
7.Roles of PKCβ/P66Shc oxidative stress signal pathway in mediating hyperoxia-induced ROS production in alveolar epithelial cells.
Zhong-Li CHE ; Wen-Bin DONG ; Qing-Ping LI ; Xiao-Ping LEI ; Lan KANG ; Lin GUO ; Xue-Song ZHAI ; Feng CHEN
Chinese Journal of Contemporary Pediatrics 2015;17(3):275-280
OBJECTIVETo explore the roles of PKCβ/P66Shc oxidative stress signal pathway in mediating hyperoxia-induced reactive oxgen species (ROS) production in alveolar epithelial cells (A549) and the protective effects of PKCβ inhibitor on hyperoxia-induced injuries of alveolar epithelial cells.
METHODSA549 cells were cultured in vitro and randomly divided into three groups: control, hyperoxia and PKCβ inhibitor LY333531 treatment. The hyperoxia group was exposed to a mixture of O2 (950 mL/L) and CO2 (50 mL/L) for 10 minutes and then cultured in a closed environment. The LY333531 group was treated with PKCβ inhibitor LY333531 of 10 µmol/L for 24 hours before hyperoxia induction. Cells were collected 24 hours after culture and the levels of PKCβ, Pin1, P66Shc and P66Shc-Ser36 were detected by Western blot. The intracellular translocation of P66Shc, the production of ROS and cellular mitochondria membrane potential were measured using the confocal microscopy.
RESULTSCompared with the control group, the levels of PKCβ, Pin1, P66Shc and P-P66Shc-Ser36 in A549 cells 24 hours after culture increased significantly in the hyperoxia group. These changes in the hyperoxia group were accompanied with an increased translocation rate of P66Shc from cytoplasm into mitochondria, an increased production of mitochondrial ROS, and a reduced mitochondrial membrane potential. Compared with the hyperoxia group, the levels of Pin1, P66Shc and P66Shc-Ser36 in A549 cells, the translocation rate of P66Shc from cytoplasm into mitochondria and the production of mitochondrial ROS decreased significantly, while the mitochondrial membrane potential increased significantly in the LY333531 treatment group. However, there were significant differences in the above mentioned measurements between the LY333531 treatment and control groups.
CONCLUSIONSHyperoxia can increase the expression of PKCβ in alveolar epithelial cells and production of mitochondrial ROS and decrease mitochondrial membrane potential. PKCβ inhibitor LY333531 can partially disrupt these changes and thus alleviate the hyperoxia-induced alveolar epithelial cell injury.
Cell Hypoxia ; Cells, Cultured ; Epithelial Cells ; metabolism ; Humans ; Indoles ; pharmacology ; Maleimides ; pharmacology ; Oxidative Stress ; Protein Kinase C beta ; physiology ; Pulmonary Alveoli ; cytology ; metabolism ; Reactive Oxygen Species ; metabolism ; Shc Signaling Adaptor Proteins ; physiology ; Signal Transduction ; physiology ; Src Homology 2 Domain-Containing, Transforming Protein 1
8.Prevalence of osteoporosis and vertebral fractures and related factors in patients with ankylosing spondylitis.
Mehmet Ali ULU ; İbrahim BATMAZ ; Banu DILEK ; Remzi ÇEVIK
Chinese Medical Journal 2014;127(15):2740-2747
BACKGROUNDOsteoporosis and vertebral factures are well recognized features in patients with ankylosing spondylitis (AS). The aim of this study was to investigate the prevalence and risk factors of osteoporosis and vertebral fractures in patients with AS.
METHODSFifty-nine AS patients and 40 healthy controls were enrolled. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DEXA) at posterior-anterior (PA) lumbar, lateral lumbar and hip regions. Thoracic and lumbar X-rays were obtained for morphometric measurements. Clinical, biological and radiological statuses were evaluated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Radiology Index-total (BASRI-t), erythrocyte sedimentation rate (ESR) and the C-reactive protein levels.
RESULTSOsteoporosis was present in 32% of patients and 5% of controls according to lateral vertebral BMD measurements. Fracture was present in 31% of patients. The effect of some clinical and laboratory parameters on BMD status and vertebral fractures was analyzed in the patient group. Osteoporosis in lateral lumbar DEXA was associated with higher BASMI, BASFI, BASRI-t scores and ESR level. Low hip BMD was associated with low BMI and high BASFI and BASRI-t scores. Vertebral fractures were associated with advanced age, longer disease duration, longer duration since diagnosis, higher BASMI and BASRI-t scores, higher ESR level, reduced femoral and lateral lumbar BMD. Logistic regression analysis revealed that only BASRI-t score was significantly associated with low lateral spinal BMD and BMI and BASFI score were independently associated with low hip BMD. The presence of compression fractures was independently associated with BASRI-t score and low lateral lumbar BMD.
CONCLUSIONSOsteoporosis and vertebral fractures in AS seem to be related to the extent of radiological involvement. A low lateral lumbar BMD is an important risk factor for vertebral fractures.
Absorptiometry, Photon ; Adult ; Blood Sedimentation ; Bone Density ; physiology ; C-Reactive Protein ; metabolism ; Female ; Humans ; Male ; Osteoporosis ; epidemiology ; metabolism ; Spinal Fractures ; epidemiology ; metabolism ; Spondylitis, Ankylosing ; epidemiology ; metabolism ; physiopathology
9.Combined action of C-reactive protein and lipid profiles on risk of hypertension and prehypertension in Mongolian adults in Inner Mongolia, China.
Shihui ZHANG ; Tian XU ; Yanbo PENG ; Hao PENG ; Aili WANG ; Guiyan WANG ; Dali WANG ; Yonghong ZHANG
Chinese Medical Journal 2014;127(11):2016-2020
BACKGROUNDMany studies have suggested that C-reactive protein (CRP) and blood lipids are associated with hypertension and cardiovascular disease (CVD). However, few studies discussed the combined action of CRP and blood lipids on the risk of hypertension and prehypertension. This study aimed to investigate the combined action of CRP and lipid profiles on the risk of hypertension and prehypertension in Mongolian adults from Inner Mongolia, China.
METHODSThe systolic and diastolic blood pressure, height, weight and waist circumference were measured and factors such as smoking, alcohol intake, family history of hypertension, etc., were investigated and CRP, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) were tested for 2 534 Mongolian adults aged ≥ 20 years. The subjects were divided into four subgroups, namely CRP
RESULTSThe multivariate adjusted ORs (95%CIs) of hypertension/prehypertension were 1.389 (0.979-1.970)/1.151(0.865-1.531), 1.666 (1.159-2.394)/1.431 (1.060-1.930), 1.756 (1.242-2.484)/ 1.770 (1.321-2.372), for CRP
CONCLUSIONSSubjects with both CRP >median and LDL-C (TG) >median had highest risks of hypertension and prehypertension among all subjects. This study appeared to indicate that the combined action of elevated CRP and elevated LDL-C (TG) further increase the risks of hypertension and prehypertension among Mongolian population.
Adult ; Body Height ; physiology ; Body Weight ; physiology ; C-Reactive Protein ; metabolism ; China ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; blood ; epidemiology ; metabolism ; Lipids ; blood ; Male ; Middle Aged ; Multivariate Analysis ; Waist Circumference ; physiology
10.Value of knee skin temperature measured by infrared thermography and soluble intercellular adhesion molecule-1 in the diagnosis of peri-prosthetic knee infection in Chinese individuals following total knee arthroplasty.
Yishake MUMINGJIANG ; Xindie ZHOU ; Rongxin HE
Chinese Medical Journal 2014;127(17):3105-3109
BACKGROUNDTotal knee arthroplasty (TKA) is a successful and frequently performed procedure in orthopedic surgery. The diagnosis of peri-prosthetic joint infection following TKA remains challenging. The present study estimated the usefulness of knee skin temperature (measured by infrared thermography) and serum soluble intercellular adhesion molecule-1 (sICAM-1) in the diagnosis of post-operative knee peri-prosthetic infection.
METHODSPatients were divided into three groups: 21 patients undergoing uncomplicated TKAs, seven with prosthesis infection, and three undergoing TKA revisions. The serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and sICAM-1 as well as the local knee skin temperature were measured pre-operatively and on Days 1 and 7 and at 1, 3, and 6 months post-operatively in Groups 1 and 3. The same parameters were measured in Group 2 at the time of prosthesis infection diagnosis.
RESULTSIn Group 1, the levels of IL-6, CRP, ESR, and knee skin temperature were significantly elevated post-operatively, but returned to baseline levels within 6 months. The sICAM-1 levels were not significantly different. The mean differential temperature (MDT) and levels of siCAM-1, IL-6, CRP, and ESR differed significantly between Groups 1 and 2. The MDT had returned to normal in Group 3 by 6 months post-operatively.
CONCLUSIONSElevations in IL-6, CRP, ESR, and MDT in patients undergoing TKA could be a normal response to surgical trauma, but sustained elevations may be indicative of complications. The knee skin temperature and sICAM-1 may be used as indicators in the diagnosis of knee prosthesis infection following TKA.
Adult ; Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Blood Sedimentation ; C-Reactive Protein ; metabolism ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; metabolism ; Interleukin-6 ; blood ; Knee Joint ; immunology ; surgery ; Male ; Middle Aged ; Prospective Studies ; Skin Temperature ; physiology ; Thermography ; methods

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