title: Soluble urokinase-type plasminogen activator receptor (suPAR) as new biomarker of the prosthetic joint infection: correlation with inflammatory cytokines.
abstract: Post-operative prosthetic joint infection (PJI) is the most common cause of failure of total joint arthroplasty, requiring revision surgery, but a gold standard for the diagnosis and the treatment of PIJ is still lacking. PJI is mainly due to Gram-positive bacteria, in particular, Staphylococcus Aureus, and more rarely by Gram-negative bacteria such as Pseudomonas. This study aimed to examine the diagnostic value of SuPAR in post-operative PJI, in order to explore the possible application of this new biomarker in the early diagnosis of PJI. The level of SuPAR has been measured in PJI patients and healthy controls, correlated with canonical inflammatory markers, such as C-reactive protein, IL-6, IL-1 and TNFα and the chemokine CCL2. Serum suPAR displayed a strongly significative increase in PJI patients compared to not infected controls, and a significative positive correlation with C-reactive protein, IL-6, IL-1 and TNFα and the chemokine CCL2. Also serum CCL2 showed statistically significative increase in PJI patients, and it displayed a strong positive correlation with serum suPAR. This study provides a clear indication of the diagnostic potential of suPAR, in association to routine inflammatory parameters such as CRP, in the diagnosis of PJI.
authors.affiliation: Department of Biomedical, Surgical and Oral Science, Università degli Studi di Milano, Milan, Italy; U:O:C SMEL-1 Clinical Pathology, IRCCS Policlinico San Donato, San Donato (Milan) Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Galliera
authors.affiliation: IRCCS Galeazzi Orthopaedic Institute, Milan, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Monica Gioia
authors.initials: MG
authors.lastname: Marazzi
authors.affiliation: U:O:C SMEL-1 Clinical Pathology, IRCCS Policlinico San Donato, San Donato (Milan) Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Romanò
authors.affiliation: IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Vassena
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; U:O:C SMEL-1 Clinical Pathology, IRCCS Policlinico San Donato, San Donato (Milan) Italy.
authors.forename: Massimiliano M
authors.initials: MM
authors.lastname: Corsi Romanelli
mesh_terms: D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000097:blood* / Q000382:microbiology; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D012995:Solubility
chemical_list: D015415:Biomarkers; D016207:Cytokines; D055293:Receptors, Urokinase Plasminogen Activator
keywords: Diagnosis; Prosthetic joint infection; Serum biomarker; suPAR