title: Metal ions activate vascular endothelial cells and increase lymphocyte chemotaxis and binding.
abstract: Metal on metal articulations in hip arthroplasty offer advantages, including lower volumetric wear compared to conventional metalonpolyethylene bearings, and increased resistance to dislocation. Reports described early failures, with histologic features similar to a Type IV immune response. Mechanisms by which metal wear products cause this reaction are not completely understood. We hypothesized a mechanism through direct activation of endothelial cells (ECs) by metal ions, resulting in both vasculitis and accumulation of lymphocytes without prior immune sensitization. Effects of metal ions were evaluated using human ECs in culture. Alterations in chemotactic proteins IL8 and MCP1 were assessed, as was upregulation of the adhesion molecule ICAM-1 and lymphocyte binding to ECs. Cobalt increased secretion of IL8 and MCP1 significantly, and upregulated the expression of ICAM-1 in ECs compared to stimulation by chromium and controls. Binding of lymphocytes to ECs and transEC migration were both significantly increased by cobalt but not chromium. These findings suggest that cobalt contributes more to the activation of ECs and lymphocyte binding than chromium without an allergic response. Some of the adverse tissue reactions to implants with components made of cobalt-chromium-molybdenium alloys may be due in part to activation of the endothelium by metal ions.
authors: Department of Orthopaedic Surgery, Medical College of Wisconsin, PO Box 26099, West Wisconsin Avenue, Milwaukee, Wisconsin 53226, USA. ninja@mcw.edu
authors: James T
authors: JT
authors: Ninomiya
authors: Scott A
authors: SA
authors: Kuzma
authors: Timothy J
authors: TJ
authors: Schnettler
authors: John G
authors: JG
authors: Krolikowski
authors: Janine A
authors: JA
authors: Struve
authors: Dorothee
authors: D
authors: Weihrauch
mesh_terms: D015153:Blotting, Western; D002448:Cell Adhesion; D002470:Cell Survival / Q000187:drug effects; D018932:Chemokine CCL2 / Q000378:metabolism; D002634:Chemotaxis, Leukocyte / Q000187:drug effects* / Q000502:physiology; D002712:Chlorides / Q000633:toxicity*; D017608:Chromium Compounds / Q000633:toxicity*; D003035:Cobalt / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D061307:Human Umbilical Vein Endothelial Cells / Q000166:cytology / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D007477:Ions; D019169:Jurkat Cells; D008214:Lymphocytes / Q000166:cytology / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism; D061825:Metal-on-Metal Joint Prostheses / Q000009:adverse effects; D015854:Up-Regulation / Q000187:drug effects
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D002712:Chlorides; D017608:Chromium Compounds; D016209:Interleukin-8; D007477:Ions; D018799:Intercellular Adhesion Molecule-1; D003035:Cobalt; C017133:chromous chloride; C018021:cobaltous chloride
keywords: endothelium; lymphocytes; metal on metal
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