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Human monocyte/macrophage response to cobalt‐chromium corrosion products and titanium particles in patients with total joint replacements
Author(s) -
Lee SH.,
Brennan F. R.,
Jacobs J. J.,
Urban R. M.,
Ragasa D. R.,
Glant T. T.
Publication year - 1997
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100150107
Subject(s) - osteolysis , peripheral blood mononuclear cell , monocyte , prostaglandin e2 , bone resorption , interleukin , chromium , resorption , medicine , stimulation , andrology , endocrinology , chemistry , cytokine , materials science , metallurgy , surgery , biochemistry , in vitro
Abstract The responses of human peripheral blood monocytes of 10 normal volounteers and 14 patients with total hip replacements to particles of commercially pure titanium and chromium orthphosphate (a corrosion product from cobalt‐chromium alloy implants) were studied. In addition, these phagocytosable particles were added to cultured mononuclear cells isolated from the interfacial membrane of 14 patients with failed implants. Peripheral blood monocytes from patients who had had a total hip replacement produced significantly higher levels of interleukin‐1 (both interleukin‐1α and interleukin‐1β) and prostaglandin E 2 follwing particulate stimulation than those from normal volunteers. Supernatants from both titanium and chromium orthophosphate‐stimulated peripheral blood monocytes from the volunteers and patients with total hip replacement induced bone resorption (assayed in organ cultures of newborn mouse calvariae)and the proliferation of human fibroblasts. The levels of bone resorption were significantly higher (p < 0.05) in patients with implants that in normal volunteers. There were no significant differences in the responses of cells between patients with focal osteolysis and those without osteolysis. Interfacial membrane mononuclear cells also produced high levels of interleukin‐1α, interleukin‐1β, and prostaglandin E 2 and expressed bone resorptive activities following stimulation with either titanium or chromium orthophosphate. More importantly, interfacial membrane mononuclear cells “spontaneously” produced high levels of prostaglandin E 2 that were comparable with the response of peripheral blood monocytes stimulated with particulate wear debris. The clinical relevance of this study is 2‐fold. First, mononuclear cells from patients with total hip replacement were some‐how “sensitized” to metal particles in comparison with mononuclear cells from individuals without an implant. Second, the chromium orthophosphate corrosion product was a potent macrophage/monocyte activator and may contribute to macrophage‐mediated osteolysis and aseptic loosening.