Local and systemic chemokine patterns in a human musculoskeletal trauma model

This prospective study aims to identify differences in local and systemic chemokines kinetics within 24 h of a standardised human surgical trauma (total hip arthroplasty) and their impact on systemic polymorphonuclear cells.

We examined seven patients with coxarthrosis, but without comorbidity, who had a total hip arthroplasty. Local drained blood and systemic blood samples were collected at wound closure and at 1, 4, and 24 h after surgery. Chemokines were measured using a multiplex antibody bead kit. Venous whole blood cell counts were taken at the same points in time.

There is a significant postoperative local burst of CCL2 and CXCL8 while systemic levels stay unchanged. The systemic levels of CCL3, CCL4, CCL5, CCL11, CXCL9, and CXCL10 were significantly reduced at 24 h post-surgery, but local levels remain unchanged or had only modest changes. There was a significant postoperative rise in monocytes and neutrophils.

There is fundamental difference between local and systemic chemokine kinetics in the human trauma model studied. High postoperative concentrations of CCL2 and CXCL8 at the site of inflammation form a gradient that contributes to the recruitment of neutrophils and monocytes at the trauma site.