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Cellular proliferation and cytokine responses to polymethylmethacrylate particles in patients with a cemented total
H S Chadha1, P H Wooley, S Sud
1Department of Orthopaedic Surgery, Wayne State University School of Medicine, Hutzel Hospital, Detroit, MI 48201, USA.
Abstract:
The in vitro response of peripheral blood mononuclear cells (MNC) from patients with cemented total hip or knee arthroplasties, and control individuals, to polymethylmethacrylate (PMMA) was assessed by cell proliferation, cytokine production, and molecular techniques. After seven days in culture, a dose-dependent proliferative response to PMMA stimulation was observed in MNC from fifteen normal individuals. A concomitant dose-dependent production of both IL-1 beta and IL-2 in response to PMMA stimulation was detected. Reverse transcription-polymerase chain reactions (RT-PCR) indicated that both IL-1 beta and IL-2 mRNA was present after 48 hours in culture with PMMA. Cellular proliferation and cytokine production (both IL-1 beta and IL-2) in 10 patients with stable, painless, well-functioning, cemented arthroplasties was significantly lower (p < 0.025) than normal controls and patients with aseptically loosened, painful, arthroplasties. The findings suggest that patients with stable cemented total joint arthroplasties are either inherently or adaptively less responsive to PMMA at a cellular level.
Insights
Peripheral blood mononuclear cells (MNC) from patients with stable cemented joint arthroplasties show a reduced response to polymethylmethacrylate (PMMA). This suggests a lower cellular reactivity in patients with well-functioning implants.
Area of Science:
- Immunology
- Biomaterials Science
- Orthopedic Surgery
Background:
- Polymethylmethacrylate (PMMA) is widely used as bone cement in cemented total hip and knee arthroplasties.
- The in vitro immune response to PMMA can influence implant performance and patient outcomes.
- Understanding cellular responses to PMMA is crucial for evaluating implant stability and patient health.
Purpose of the Study:
- To assess the in vitro immune response of peripheral blood mononuclear cells (MNC) to PMMA.
- To compare the cellular response in individuals with stable cemented arthroplasties versus controls and patients with loosened arthroplasties.
- To investigate the relationship between PMMA exposure and cellular proliferation and cytokine production.
Main Methods:
- Peripheral blood mononuclear cells (MNC) were isolated from patients with cemented arthroplasties and healthy controls.
- Cells were stimulated with PMMA in vitro.
- Cell proliferation was measured.
- Cytokine production (IL-1 beta and IL-2) was assessed using ELISA and RT-PCR.
Main Results:
- Normal individuals showed a dose-dependent proliferative response and cytokine production (IL-1 beta, IL-2) to PMMA.
- MNC from patients with stable, painless cemented arthroplasties exhibited significantly lower proliferation and cytokine production compared to controls (p < 0.025).
- Patients with aseptically loosened arthroplasties showed a higher response than those with stable implants.
Conclusions:
- Patients with stable cemented total joint arthroplasties demonstrate reduced in vitro cellular responsiveness to PMMA.
- This diminished response may be an inherent characteristic or an adaptive mechanism in patients with successful, well-functioning implants.
- The findings suggest a potential link between cellular hypo-responsiveness to PMMA and implant longevity.
