title: Cathepsin K in aseptic hip prosthesis loosening: expression in osteoclasts without polyethylene wear particles.
abstract: OBJECTIVE
  To investigate the expression of the bone matrix degrading cysteine proteinase cathepsin K and to determine the colocalization of cathepsin K with polyethylene (PE) particles in tissue specimens of patients with aseptic hip prosthesis loosening (AHPL).
  
  
  METHODS
  The expression of cathepsin K was studied by immunohistochemistry in tissue specimens of 9 patients with aseptically loosened acetabular components of failed cementless total hip replacements. The expression of cathepsin K was compared to that of the macrophage marker CD68 by serial section analysis. Double labeling of the expression of cathepsin K or CD68 by immunohistochemistry and of PE particles by modified Oil Red staining method was performed.
  
  
  RESULTS
  Cathepsin K could be predominantly detected in osteoclasts attached to the bone tissue, while only a few (CD68+) mononuclear and multinucleated foreign body giant cells (MGC) were positive for this enzyme. By double labeling with Oil Red staining we found the majority of CD68 positive cells of the periprosthetic tissue that were colocalized with PE particles. However, cathepsin K-expressing osteoclasts could not be stained with Oil Red.
  
  
  CONCLUSIONS
  The present data suggest that in AHPL neither mononuclear cells nor MGC but rather osteoclasts are mainly involved in cathepsin K mediated bone matrix destruction. Using double labeling of immunohistochemistry and Oil Red staining we observed that the cathepsin K-expressing osteoclasts did not include PE particles.
authors.affiliation: Institute of Pathology and the Clinic of Orthopedics, University of Mainz, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Hansen
authors.forename: M
authors.initials: M
authors.lastname: Otto
authors.forename: A
authors.initials: A
authors.lastname: Gaumann
authors.forename: A
authors.initials: A
authors.lastname: Eckardt
authors.forename: P K
authors.initials: PK
authors.lastname: Petrow
authors.forename: K S
authors.initials: KS
authors.lastname: Delank
authors.forename: C J
authors.initials: CJ
authors.lastname: Kirkpatrick
authors.forename: J
authors.initials: J
authors.lastname: Kriegsmann
mesh_terms: D000077:Acetabulum / Q000473:pathology; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D056657:Cathepsin K; D002403:Cathepsins / Q000032:analysis*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007150:Immunohistochemistry; D066298:In Vitro Techniques; D008297:Male; D010010:Osteoclasts / Q000201:enzymology* / Q000473:pathology; D020959:Polyethylene; D011475:Prosthesis Failure; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D056657:Cathepsin K; D002403:Cathepsins; D020959:Polyethylene; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C534130:CTSK protein, human