Orthopaedic surgery elicits a systemic anti-inflammatory signature

Cortney E. Heim, Kelsey J. Yamada, Rachel Fallet, Jessica Odvody, Dana M. Schwarz, Elizabeth R. Lyden, Matthew J. Anderson, Roxanne Alter, Debbie Vidlak, Curtis W. Hartman, Beau S Konigsberg, Chris A. Cornett, Kevin L. Garvin, Naglaa Mohamed, Annaliesa S. Anderson, Tammy L Kielian

Research output: Contribution to journalArticlepeer-review

Abstract

Little information is available on the functional activity of leukocytes after arthroplasty or the expansion of populations with immune suppressive properties during the acute post-operative period. Synovial fluid and matched pre-and post-surgical blood samples were collected from total hip and knee arthroplasty patients (THA and TKA, respectively) to examine the impact of surgery on peripheral blood leukocyte frequency, bactericidal activity, and inflammatory mediator expression. For spinal surgeries, inflammatory mediator production by peripheral blood mononuclear cells (PBMCs) pre-and post-surgery was examined. An expansion of immune suppressive granulocytic myeloid-derived suppressor cells (G-MDSCs) was observed following arthroplasty, which correlated with significantly increased serum interleukin-10 (IL-10) levels. Analysis of synovial fluid from THA and TKAs revealed reduced granulocyte colony-stimulating factor (G-CSF) and soluble CD40 ligand (sCD40L) and increased interleukin-6 (IL-6), monocyte chemoattractant protein 2 (CCL2) and Fms-like tyrosine kinase 3 ligand (Flt-3L) compared to pre-and post-surgical serum. For the spinal surgery cohort, stimulation of PBMCs isolated post-surgery with bacterial antigens produced significantly less pro-inflammatory (IL-1α, IL-1β, interleukin-1 receptor antagonist (IL-1RA), IL-12p40, growth-related oncogene-α/GRO-α (CXCL1) and 6Ckine (CCL21)) and more anti-inflammatory/tissue repair mediators (IL-10, G-CSF and granulocyte-macrophage colony-stimulating factor (GM-CSF)) compared to PBMCs recovered before surgery. The observed bias towards systemic anti-inflammatory changes without concomitant increases in pro-inflammatory responses may influence susceptibility to infection following orthopaedic surgery in the context of underlying co-morbidities or risk factors.

Original languageEnglish (US)
Article number2123
Pages (from-to)1-15
Number of pages15
JournalJournal of Clinical Medicine
Volume9
Issue number7
DOIs
StatePublished - Jul 2020

Keywords

  • Arthroplasty
  • Cytokines
  • Leukocytes
  • Myeloid-derived suppressor cells

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint

Dive into the research topics of 'Orthopaedic surgery elicits a systemic anti-inflammatory signature'. Together they form a unique fingerprint.

Cite this