Lymphocyte response to polymethylmethacrylate in loose total hip prostheses

Abstract

We investigated the lymphocyte-mediated immune response to polymethylmethacrylate bone cement in 26 patients who had revision surgery for aseptic loosening of cemented total hip arthroplasties, at a mean time ofseven years after the first replacement. We studied eight patients with cemented total hip arthroplasties which were not loose as controls. Patch tests to polymethylmethacrylate bone cement were positive in 13 patients with loosening, and these patients had higher lymphoblast transformation values against polymethylmethacrylate bone cement patients with a negative skin reaction (p < 0.01) or those in the control group (p < 0.001). Specific monoclonal antibodies were used to assess the percentage of certain cells of the immune system according to their cluster of differentiation (CD). There was a higher number of total I and B lymphocytes (CD2 and CD22) and interleukin-2 receptor-positive lymphocytes (activated cells, CD25) in patients with loose prostheses. More CD25 lymphocytes were found in patients with positive patch tests. The activation of the lymphocyte-mediated immune response was not related to the presence or absence of aggressive granulomatous lesions at the cement-bone interface.

Cellular profile and cytokine production at prosthetic interfaces

“…Thus, the prosthetic interface provides a complex series of interactions of cells, cytokines and other substances which modulate bone remodelling. With cemented implants, differences were also found in the T-lymphocyte subgroups, suggesting a possible role for immunological processes in osteolysis, but this is con- troversial and there are studies which advocate 21,32,[43][44][45][46][47][48] and refute [49][50][51][52][53][54] a role for T-cell modulation of the macrophage response to biomaterials. 55,56 With cementless prostheses there were fewer differences in cell number and cytokine profile in the various groups.…”

Cellular proliferation and cytokine responses to polymethylmethacrylate particles in patients with a cemented total joint arthroplasty

“…The polymethylmethacrylate particles used in our experiments were smaller (1-10 tt compared with 30-50 g), which may facilitate phagocytic uptake, and our culture period was extended (7 days compared with 1-5 days), which may afford activated T ceils the opportunity of cellular division. A recent report from Gil-Albarova et al [31] demonstrated both positive skin patch tests (an indication of immune hypersensitivity) and a proliferative response to PMMA in patients with AL. In this study, the proliferative response to PMMA in the skin test positive population (50% of the AL patients under investigation) was significantly higher than either the normal control group or skin test negative AL patients.…”

Differential Regulation of in Vitro Cytokine Production by Human Blood Cells in Response to Methylmethacrylate

“…Human lymphocyte cultures obtained from patients with loose total hip prostheses were activated by PMMA in vitro in contrast to cells obtained from healthy donors (Kohase et al, 1986;Gil-Albarova et al, 1992). Therefore, it is important to compare cellular responses to MMA in normal and MMA-allergic populations to better elucidate the general immunologic properties of this chemical.…”