Low molecular weight heparin aggravates infectious arthritis triggered by Staphylococcus aureus.
OBJECTIVE
Staphylococcus aureus is responsible for the majority of wound infections in clean surgical procedures that involve implantation of foreign material, grafts or prosthetic devices. The aim of the study was to assess the effect of low molecular weight heparin on the development and progression of S. aureus arthritis.


METHODS
The murine model of hematogenously acquired septic arthritis was used injecting intravenously toxic shock syndrome toxin-1 (TSST-1) producing S. aureus of LS-1 strain. Mice lacking prosthetic implants were treated with intraperitoneal injections of low molecular weight heparin, used routinely as anti-thrombotic prophylaxis following joint prosthetic surgery. Evaluation of arthritis was performed clinically and histopathologically. In addition, the effect of low molecular weight heparin on T cell dependent and independent inflammation was assessed.


RESULTS
Seven days after inoculation with bacteria 18 out of 19 low molecular weight heparin treated mice displayed clinical symptoms of arthritis as compared to 9 out of 23 control animals (p < 0.05), and the severity of arthritis, expressed as arthritic index, was 2.6+/-0.5 versus 1.6+/-0.5 (p = 0.05). The histopathological examination confirmed the clinical findings showing that both inflammation and joint destruction were more substantial in heparin treated animals.


CONCLUSIONS
Our findings indicate that the routine anti-coagulation treatment with heparin contributes to more severe course of joint infection.
Sakiniene
Egidija
E
Department of Rheumatology University of Gothenburg, Sweden. egidija.sakiniene@immuno.gu.se
Tarkowski
Andrzej
A
D000818:Animals; D001170:Arthritis, Infectious / Q000139:chemically induced* / Q000382:microbiology / Q000473:pathology; D004195:Disease Models, Animal; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006968:Hypersensitivity, Delayed / Q000188:drug therapy; D007596:Joints / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D008297:Male; D051379:Mice; D008815:Mice, Inbred Strains; D013203:Staphylococcal Infections / Q000473:pathology; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000502:physiology; D013585:Synovitis / Q000139:chemically induced / Q000382:microbiology / Q000473:pathology; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology
D006495:Heparin, Low-Molecular-Weight