Interrelationship of MMP-9, Proteoglycan-4, and Inflammation in Osteoarthritis Patients Undergoing Total Hip Arthroplasty

Osteoarthritis (OA) is a chronic condition marked by joint pain, inflammation and loss of articular cartilage, that can be treated with total joint arthroplasty (TJA) at end stages. TJA is marked by post-operative inflammation, which directly effects levels of cartilage degradation biomarkers, prote...

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Published in:Clinical and applied thrombosis/hemostasis Vol. 27; p. 1076029621995569
Main Authors: Slovacek, Hannah, Khanna, Rajan, Poredos, Pavel, Poredos, Peter, Jezovnik, Mateja, Hoppensteadt, Debra, Fareed, Jawed, Hopkinson, William
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 2021
SAGE PUBLICATIONS, INC
SAGE Publishing
Subjects:
Arthritis
Biomarkers
Cartilage
Inflammation
Joint surgery
Original
Osteoarthritis
Pathogenesis
cartilage degradation
inflammation
matrix metalloproteinase-9
osteoarthritis
proteoglycan-4
ISSN:1076-0296, 1938-2723, 1938-2723
Online Access:Get full text
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Summary:Osteoarthritis (OA) is a chronic condition marked by joint pain, inflammation and loss of articular cartilage, that can be treated with total joint arthroplasty (TJA) at end stages. TJA is marked by post-operative inflammation, which directly effects levels of cartilage degradation biomarkers, proteoglycan-4 (PRG4) and matrix metalloproteinase-9 (MMP-9). PRG4 is a protective glycoprotein that is decreased in individuals with OA. MMP-9 is a matrix metalloproteinase that contributes to articular cartilage loss and is elevated in OA patients. It is upregulated by pro-inflammatory markers, such as IL-1, IL-6 and CRP. This study aims to elucidate the immediate post-operative changes in levels of PRG4, MMP-9, IL-6, CRP, and WBC in patients undergoing TJA to clarify the role of inflammation in recovery after surgery and in the overall pathogenesis of OA. Blood was collected at 3 time points (day 0, day 1 post-operatively, and days 5-7 post-operatively), from 63 patients undergoing TJA due to OA, and levels of these biomarkers were quantified. IL-6, CRP, WBC and MMP-9 were lowest at day 0, highest at day 1, and stabilized at an intermediate level at days 5-7. Meanwhile, PRG4 followed the opposite trend. These studies suggest that IL-6, CRP and WBC showed predictable fluctuations, with pro-inflammatory biomarkers upregulating MMP-9 and downregulating PRG4. Measuring these biomarkers may help expose the role of inflammation in the post-surgical recovery of TJA patients and in long-term pathogenesis of OA. These levels may help risk stratify patients pre-operatively and help develop individualized post-surgical plans.
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ISSN:1076-0296
1938-2723
1938-2723
DOI:10.1177/1076029621995569