[Differential gene expression in the wear particle induced and infectious periprosthetic membrane of loosened knee-endoprostheses].
About 5 to 12 % of hip endoprostheses will loosen after ten years. The periprosthetic membran between bone and prosthesis plays a crucial role in prosthesis loosening. Different pathomechanisms lead to the growth of such a membran, which can be discriminated by different histomorphologies: wear particle induced type, infectious type, combined type, indifferent type. 8 hybridizations were performed on PIQOR cDNA arrays. Objects of the study were periprosthetic interface tissue samples from 3 patients with particle induced and 2 patients with infectious prosthesis loosening. Tissue parts directly adjacent to the site of RNA-isolation were analyzed immuno-/ histopathologically in order to overcome the problem of tissue heterogeneity. 34 genes were found constantly differentially expressed, among which were cd9, cd11b, cd18, cd68, osteopontin, ferritin heavy-chain upregulated in the particle induced membrane and collagen types 1alpha-1, 3alpha-1, integrin alpha-1, thrombospondin 2 and nidogen upregulated in the infectious membrane. The most striking finding was the strong upregulation (from 20 fold to 323 fold) of megakaryocyte stimulating factor (msf) in all wear particle cases and 1 out of 2 infectious cases, which was confirmed by real-time RT-PCR. The upregulation of msf suggests an important pathogenetic role: The msf splice product lubricin is responsible for the lubrification of healthy joints, but its excellent lubrification ability may disturb the tight interaction between bone and prosthesis and thereby contribute to prosthesis loosening.
Morawietz
L
L
Institut für Pathologie, Universitätsklinikum Charité, Berlin.
Friederich
M
M
Frommelt
L
L
Gehrke
T
T
Bosio
A
A
Classen
R A
RA
Gerstmayer
B
B
Krenn
V
V
D015703:Antigens, CD / Q000032:analysis; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003094:Collagen / Q000032:analysis / Q000235:genetics; D003937:Diagnosis, Differential; D005786:Gene Expression Regulation; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology; D011475:Prosthesis Failure; D012313:RNA / Q000235:genetics / Q000302:isolation & purification
D015703:Antigens, CD; D012313:RNA; D003094:Collagen