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Differences between infected and noninfected synovial fluid.

Pouya Akhbari1, Matthew K Jaggard1, Claire L Boulangé2

  • 1Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, London, UK.

Bone & Joint Research
|January 27, 2021
PubMed
Summary

Nuclear magnetic resonance (NMR) spectroscopy identified distinct small molecule metabolites in infected synovial fluid (SF). These findings may lead to improved diagnostic tests for joint infections, enhancing accuracy and speed.

Keywords:
InfectionMetabolic profilingMetabonomicsNuclear magnetic resonance spectroscopySynovial fluid

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Area of Science:

  • Biochemistry
  • Metabolomics
  • Orthopedics

Background:

  • Diagnosing joint infections relies on imprecise methods like inflammatory markers and synovial fluid (SF) analysis.
  • Small molecule metabolites in SF show potential as accurate and rapid infection biomarkers.

Purpose of the Study:

  • To utilize nuclear magnetic resonance (NMR) spectroscopy for identifying small molecule differences in infected versus noninfected human SF.
  • To explore potential novel biomarkers for joint infection diagnosis.

Main Methods:

  • Collected 16 SF samples: eight from infected joints (native and prosthetic) and eight from noninfected joints.
  • Analyzed metabolites using NMR spectroscopy.
  • Applied principal component analysis and univariate statistics to identify metabolic differences.

Main Results:

  • Identified 16 metabolites with significantly different concentrations between infected and noninfected SF.
  • Infected SF showed higher concentrations of lipids, cholesterol, and N-acetylated molecules.
  • Infected SF exhibited lower concentrations of 13 metabolites, including citrate, glycine, and glucose.

Conclusions:

  • Specific metabolites in infected SF are indicative of inflammation and infection, impacting lipid and inflammatory pathways.
  • Reduced metabolites in infected SF relate to carbohydrate metabolism, oxidative stress, and cartilage breakdown.
  • This study presents the first metabolic profile differences in infected vs. noninfected SF, suggesting potential diagnostic biomarkers.