单核细胞系统阻碍了感染关节置换的准确诊断
Robert Manasherob1,2, Shay I Warren1, Prerna Arora1
1Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street, Redwood City, CA, 94025, USA.
Journal of translational medicine
|November 20, 2024
概括
休眠关节置换感染抑制中性粒细胞反应,因此可能被误诊. 单核细胞系统 (MPS) 的反应在休眠感染中不同,影响诊断和当前的预后测试.
科学领域:
- 免疫学 免疫学 免疫学
- 整形外科 整形外科 整形外科
- 微生物学 微生物学
背景情况:
- 诊断受感染的关节置换通常依赖于中性粒细胞对细菌的反应,这些细菌形成难以培养的生物膜.
- 生物膜可以逃避抗生素和细胞分裂,改变免疫反应和巨细胞的功能.
- 休眠感染可能会抑制中性粒细胞,需要对单核细胞系统 (MPS) 进行评估.
研究的目的:
- 通过分析MPS反应,研究是否可以将休眠关节置换感染与未感染和活跃感染的关节区分开来.
- 识别特定的细胞和分子标记物,区分休眠感染.
主要方法:
- 单细胞RNA测序和OLink对匹配的血液,突液和关节周组织样本的蛋白质定位.
- 分析来自患有活跃感染,没有感染和先前感染 (被认为无感染) 的患者的样本.
主要成果:
- 在休眠感染中,MPS反应与未感染关节有显著差异,尽管缺少急性阶段反应物和中性粒细胞招募.
- 休眠感染显示出不同的细胞组成,包括减少的M1/M2巨细胞和增加的单细胞,髓状树突细胞,调节性T细胞,NK细胞和血细胞状树突细胞.
- 在休眠感染中,TNF和IL17通路的激活和中性粒细胞外细胞陷 (NETs) 的非激活被建议,同时在突液和血中改变了炎症标志物.
结论:
- 目前对植入物相关感染的诊断标准可能有限,因为它们假定中性粒细胞的反应均.
- 单核细胞系统 (MPS) 的状态对于准确诊断至关重要.
- 通过MPS调解的中性粒细胞招募和功能减少,可能导致休眠感染被误认为未感染.
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