Morten R Blichfeldt-Eckhardt, Claus Varnum, Jørgen T Lauridsen, Lasse E Rasmussen, Winnie C P Mortensen, Hanne I Jensen, Henrik B Vaegter, Kate L Lambertsen
{"title":"疼痛性骨关节炎患者全髋关节置换术后12个月的术后预后与低度全身性炎症有关，而非神经炎症。","authors":"Morten R Blichfeldt-Eckhardt, Claus Varnum, Jørgen T Lauridsen, Lasse E Rasmussen, Winnie C P Mortensen, Hanne I Jensen, Henrik B Vaegter, Kate L Lambertsen","doi":"10.1302/2046-3758.1312.BJR-2024-0103.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Better prediction of outcome after total hip arthroplasty (THA) is warranted. Systemic inflammation and central neuroinflammation are possibly involved in progression of osteoarthritis and pain. We explored whether inflammatory biomarkers in blood and cerebrospinal fluid (CSF) were associated with clinical outcome, and baseline pain or disability, 12 months after THA.</p><p><strong>Methods: </strong>A total of 50 patients from the Danish Pain Research Biobank (DANPAIN-Biobank) between January and June 2018 were included. Postoperative outcome was assessed as change in Oxford Hip Score (OHS) from baseline to 12 months after THA, pain was assessed on a numerical rating scale, and disability using the Pain Disability Index. Multiple regression models for each clinical outcome were included for biomarkers in blood and CSF, respectively, including age, sex, BMI, and Kellgren-Lawrence score.</p><p><strong>Results: </strong>Change in OHS was associated with blood concentrations of tumour necrosis factor (TNF), interleukin-8 (IL-8), interleukin-6 receptor (IL-6R), glycoprotein 130 (gp130), and IL-1β (R<sup>2</sup> = 0.28, p = 0.006), but not with CSF biomarkers. Baseline pain was associated with blood concentrations of lymphotoxin alpha (LTα), TNFR1, TNFR2, and IL-6R (R<sup>2</sup> = 0.37, p < 0.001) and CSF concentrations of TNFR1, TNFR2, IL-6, IL-6R, and IL-1Ra (R<sup>2</sup> = 0.40, p = 0.001). Baseline disability was associated with blood concentrations of TNF, LTα, IL-8, IL-6, and IL-1α (R<sup>2</sup> = 0.53, p < 0.001) and CSF concentrations of gp130, TNF, and IL-1β (R<sup>2</sup> = 0.26, p = 0.002). Thus, preoperative systemic low-grade inflammation predicted 12-month postoperative outcome after THA, and was associated with preoperative pain and disability.</p><p><strong>Conclusion: </strong>This study highlights the importance of systemic inflammation in osteoarthritis, and presents a possible path for better patient selection for THA in the future. Preoperative central neuroinflammation was associated with preoperative pain and disability, but not change in OHS after THA.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 12","pages":"741-749"},"PeriodicalIF":4.7000,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620800/pdf/","citationCount":"0","resultStr":"{\"title\":\"Low-grade systemic inflammation, but not neuroinflammation, is associated with 12-month postoperative outcome after total hip arthroplasty in patients with painful osteoarthritis.\",\"authors\":\"Morten R Blichfeldt-Eckhardt, Claus Varnum, Jørgen T Lauridsen, Lasse E Rasmussen, Winnie C P Mortensen, Hanne I Jensen, Henrik B Vaegter, Kate L Lambertsen\",\"doi\":\"10.1302/2046-3758.1312.BJR-2024-0103.R1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Better prediction of outcome after total hip arthroplasty (THA) is warranted. Systemic inflammation and central neuroinflammation are possibly involved in progression of osteoarthritis and pain. We explored whether inflammatory biomarkers in blood and cerebrospinal fluid (CSF) were associated with clinical outcome, and baseline pain or disability, 12 months after THA.</p><p><strong>Methods: </strong>A total of 50 patients from the Danish Pain Research Biobank (DANPAIN-Biobank) between January and June 2018 were included. Postoperative outcome was assessed as change in Oxford Hip Score (OHS) from baseline to 12 months after THA, pain was assessed on a numerical rating scale, and disability using the Pain Disability Index. Multiple regression models for each clinical outcome were included for biomarkers in blood and CSF, respectively, including age, sex, BMI, and Kellgren-Lawrence score.</p><p><strong>Results: </strong>Change in OHS was associated with blood concentrations of tumour necrosis factor (TNF), interleukin-8 (IL-8), interleukin-6 receptor (IL-6R), glycoprotein 130 (gp130), and IL-1β (R<sup>2</sup> = 0.28, p = 0.006), but not with CSF biomarkers. Baseline pain was associated with blood concentrations of lymphotoxin alpha (LTα), TNFR1, TNFR2, and IL-6R (R<sup>2</sup> = 0.37, p < 0.001) and CSF concentrations of TNFR1, TNFR2, IL-6, IL-6R, and IL-1Ra (R<sup>2</sup> = 0.40, p = 0.001). Baseline disability was associated with blood concentrations of TNF, LTα, IL-8, IL-6, and IL-1α (R<sup>2</sup> = 0.53, p < 0.001) and CSF concentrations of gp130, TNF, and IL-1β (R<sup>2</sup> = 0.26, p = 0.002). Thus, preoperative systemic low-grade inflammation predicted 12-month postoperative outcome after THA, and was associated with preoperative pain and disability.</p><p><strong>Conclusion: </strong>This study highlights the importance of systemic inflammation in osteoarthritis, and presents a possible path for better patient selection for THA in the future. Preoperative central neuroinflammation was associated with preoperative pain and disability, but not change in OHS after THA.</p>\",\"PeriodicalId\":9074,\"journal\":{\"name\":\"Bone & Joint Research\",\"volume\":\"13 12\",\"pages\":\"741-749\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-12-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620800/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bone & Joint Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1302/2046-3758.1312.BJR-2024-0103.R1\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CELL & TISSUE ENGINEERING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/2046-3758.1312.BJR-2024-0103.R1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CELL & TISSUE ENGINEERING","Score":null,"Total":0}
引用次数: 0
摘要
目的：更好地预测全髋关节置换术（THA）后的预后是有保证的。全身性炎症和中枢神经炎症可能参与骨关节炎和疼痛的进展。我们探讨了THA术后12个月，血液和脑脊液（CSF）中的炎症生物标志物是否与临床结局、基线疼痛或残疾相关。方法：纳入2018年1月至6月丹麦疼痛研究生物银行（DANPAIN-Biobank）的50例患者。术后结果评估为牛津髋关节评分（OHS）从基线到THA后12个月的变化，疼痛评估采用数值评定量表，残疾评估采用疼痛残疾指数。每个临床结果分别纳入血液和脑脊液生物标志物的多元回归模型，包括年龄、性别、BMI和kelgren - lawrence评分。结果：OHS的变化与肿瘤坏死因子（TNF）、白细胞介素-8 （IL-8）、白细胞介素-6受体（IL-6R）、糖蛋白130 （gp130）和IL-1β的血药浓度相关（R2 = 0.28, p = 0.006），但与脑脊液生物标志物无关。基线疼痛与血液中淋巴素α (LTα)、TNFR1、TNFR2和IL-6R的浓度（R2 = 0.37, p < 0.001）和CSF中TNFR1、TNFR2、IL-6、IL-6R和IL-1Ra的浓度（R2 = 0.40, p = 0.001）相关。基线残疾与血液中TNF、LTα、IL-8、IL-6和IL-1α的浓度（R2 = 0.53, p < 0.001）和CSF中gp130、TNF和IL-1β的浓度（R2 = 0.26, p = 0.002）相关。因此，术前全身性低度炎症预测THA术后12个月的预后，并与术前疼痛和残疾相关。结论：本研究强调了全身性炎症在骨关节炎中的重要性，并为将来更好地选择THA患者提供了可能的途径。术前中枢神经炎症与术前疼痛和残疾相关，但THA后OHS无变化。
Low-grade systemic inflammation, but not neuroinflammation, is associated with 12-month postoperative outcome after total hip arthroplasty in patients with painful osteoarthritis.
Aims: Better prediction of outcome after total hip arthroplasty (THA) is warranted. Systemic inflammation and central neuroinflammation are possibly involved in progression of osteoarthritis and pain. We explored whether inflammatory biomarkers in blood and cerebrospinal fluid (CSF) were associated with clinical outcome, and baseline pain or disability, 12 months after THA.
Methods: A total of 50 patients from the Danish Pain Research Biobank (DANPAIN-Biobank) between January and June 2018 were included. Postoperative outcome was assessed as change in Oxford Hip Score (OHS) from baseline to 12 months after THA, pain was assessed on a numerical rating scale, and disability using the Pain Disability Index. Multiple regression models for each clinical outcome were included for biomarkers in blood and CSF, respectively, including age, sex, BMI, and Kellgren-Lawrence score.
Results: Change in OHS was associated with blood concentrations of tumour necrosis factor (TNF), interleukin-8 (IL-8), interleukin-6 receptor (IL-6R), glycoprotein 130 (gp130), and IL-1β (R2 = 0.28, p = 0.006), but not with CSF biomarkers. Baseline pain was associated with blood concentrations of lymphotoxin alpha (LTα), TNFR1, TNFR2, and IL-6R (R2 = 0.37, p < 0.001) and CSF concentrations of TNFR1, TNFR2, IL-6, IL-6R, and IL-1Ra (R2 = 0.40, p = 0.001). Baseline disability was associated with blood concentrations of TNF, LTα, IL-8, IL-6, and IL-1α (R2 = 0.53, p < 0.001) and CSF concentrations of gp130, TNF, and IL-1β (R2 = 0.26, p = 0.002). Thus, preoperative systemic low-grade inflammation predicted 12-month postoperative outcome after THA, and was associated with preoperative pain and disability.
Conclusion: This study highlights the importance of systemic inflammation in osteoarthritis, and presents a possible path for better patient selection for THA in the future. Preoperative central neuroinflammation was associated with preoperative pain and disability, but not change in OHS after THA.
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