Post-Traumatic Arthritis: The Role of Cytokine Levels in Serum and Synovial Fluid

Abstract

Background and Objectives: Inflammatory processes play an important role in intra-articular fractures. The present study aimed to examine the relationship between chemerin, high-sensitivity C-reactive protein (hs-CRP), and Interleukin 17 (IL-17) serum and synovial fluid levels of osteoarthritis patients and individuals with intra-articular fractures. Method:In this case-control study, all osteoarthritis patients and individuals with intra-articular fractures who visited the Imam Khomeini Orthopedic Clinic of Ahvaz were examined. Blood samples (5 cc) were collected prior to surgery to measure chemerin Interleukin 17, and hs-CRP serum levels. Synovial fluid samples (2 cc) were collected during the surgery. Results:Measuring the levels of IL-17, chemerin and hs-CRP indicated a significant statistical difference between the serum and synovial fluids of osteoarthritis patients, individuals with intra-articular fractures, and the control group (p < .001). Post-hoc analyses showed statistically significant differences in all conditions except for hs-CRP levels between osteoarthritis patients and individuals with intra-articular fractures.Conclusion: Discovering ways to stop or slow down osteoarthritis is a matter of great concern. The findings on osteoarthritis indicate diverse, complex, and multidimensional processes involving cytokines. Information on cytokines that effect diseases can help develop efficient therapy methods.

An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

“…Most studies were cross-sectional studies in which only one sample was taken from each patient. The type of reported knee trauma was mostly caused by anterior cruciate ligament (ACL) and medial collateral ligament injuries [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 38 ] or intra-articular fracture [ 21 , 22 , 23 , 28 , 33 , 36 ]. Fewer injuries were due to patellar dislocation, rotational knee trauma, knee contusion, medial meniscus injury, or posterior cruciate ligament injury [ 23 , 27 , 28 , 36 , 39 ].…”

“…A few studies also investigated the contralateral uninjured knee joints or included OA, post-meniscectomy, hydrarthrosis, or chronic arthritis samples for comparisons. Most of the studies consisted of a larger percentage of males (range 59–100%) [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 31 , 32 , 34 , 35 , 36 , 37 , 38 ] rather than female subjects, with only a few studies having a majority of females in their cohort that reached up to 55% [ 33 , 39 ]. The age of patients having a knee injury varied from 13 to 70 years old [ 21 , 22 , 23 , 24 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] and had a mean age of 29 years [ 21 , 22 , 23 , 24 , 25 , 26 , 28 , 30 , 31 , 34 , 35 , 36 , 37 , 38 ].…”

“…Other studies have also shown that local inflammation persists and develops into chronic inflammation [ 26 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. Thus, IL-17 concentrations were significantly higher in the SF for 3 or more months after injury compared to healthy controls [ 26 ].…”

“…Sarafan et al showed that IL-17 was present in the serum (and SF as already discussed) three or more months after knee trauma. OA patients had significantly higher serum IL-17 concentrations than patients with intra-articular knee joint fractures, with the healthy control group exhibiting the lowest IL-17 values [ 33 ]. Other studies have similarly shown both circulating and SF IL-17 in patients diagnosed with early- or late-stage knee OA compared to healthy controls and that synovia IL-17 levels correlate with knee OA severity [ 35 , 55 , 56 , 57 , 58 , 59 , 60 ].…”

“…Multiple studies showed that CRP concentrations in the serum significantly exceeded the levels in SF, beginning 2 to 3 months following knee injury [ 27 , 28 , 33 ]. CRP levels were equally present in the serum and SF of patients having either OA or an intra-articular fracture with associated pain for at least three months and, in both cases, CRP levels were significantly higher than in the controls [ 33 ]. Catterall et al showed that, while CRP levels decreased over time in both the serum and SF from 15.2 ± 7.2 days to 47.6 ± 12.4 days after injury, there was a significant correlation between SF and serum CRP [ 27 ].…”