Protective effect of ischaemic preconditioning in total knee arthroplasty

To investigate the genomic response induced by ischaemic preconditioning (IPC) in muscle biopsies taken from the operative leg of total knee arthroplasty patients.

The gene expression profile GSE21164 was extracted from Gene Expression Omnibus (GEO) database. Patients undergoing primary knee arthroplasty were randomized to control and treatment (IPC) groups. Muscle biopsies were taken from the quadriceps muscle of the operative knee at the immediate onset of surgery (T0) and at 1 hour into surgery (T1). Limma package of R language was used to identify the differentially expressed genes (DEGs) between control and treatment group. To find out specific genes, DEGs at T0 were compared with DEGs at T1. Scansite was used to find out the binding domain for specific DEGs. Functional enrichment analysis was done by DAVID.

Of the genes queried on the Affymetrix Human Genome U133 Plus 2.0 microarray, we identified 263 (T0) and 266 (T1) DEGs compared to the control group. Down-regulation of DEGs related with regulation neuron apoptosis was observed at T1. The most significant function of DEGs at T0 was related with neurological system process. The most specific DEG was FAM125B at T0 and T1 time points. Its common binding domain was SH3.

The protective effect of IPC was associated with altered expression of genes involved in neurological system process and regulation of neuron apoptosis. The dynamic expression of FAM125B can be a supervised marker during the surgery. IPC may be of potential benefit in this and other musculoskeletal conditions.