Surgery for chronic arthropathy in people with haemophilia

Chin, Brian Zhaojie; Wee, Ian; Syn, Nicholas; O’Neill, Gavin Kane; Yap, Eng Soo; Koh, Pei Lin

doi:10.1002/14651858.cd013634.pub2

Cited by 2 publications

(3 citation statements)

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“…Lower limb trauma [ n = 4]) who underwent amputation. In the HA group, the median age of patients was 40.25 ± 11.52 years, spanning from 28 to 59 years; all patients had haemophilia type A, no alloantibodies, and were classified as Grade IV using the Improved Arnold‐Hilgartner classification system 25 . In the control group, the median age of patients was 38.50 ± 2.69 years, spanning from 35 to 42 years.…”

Section: Methodsmentioning

confidence: 99%

“…In the HA group, the median age of patients was 40.25 ± 11.52 years, spanning from 28 to 59 years; all patients had haemophilia type A, no alloantibodies, and were classified as Grade IV using the Improved Arnold-Hilgartner classification system. 25 In the control group, the median age of patients was 38.50 ± 2.69 years, spanning from 35 to 42 years. This study been the second affiliated hospital of Anhui Medical University institutional ethical review committee for approval.…”

Section: Patient Samplesmentioning

confidence: 99%

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Iron overload causes macrophages to produce a pro‐inflammatory phenotype in the synovium of hemophiliac arthritis via the acetyl‐p53 pathway

Pang,

Ding,

Yang

et al. 2023

Haemophilia

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AimHaemophiliac arthritis (HA) is caused by spontaneous intra‐articular hemorrhage and repeated intra‐articular hematomas, leading to iron overload, which, in turn, induces M1 macrophage polarisation and inflammatory cytokine secretion, resulting in synovitis. Here, we explored the mechanism by which iron overload in HA induces the polarisation of M1 macrophages, providing a new approach for the treatment of HA synovitis.MethodsThe synovium from the knee joints of normal amputees and patients with HA was collected. Pathological changes in the synovial tissues were analysed using hematoxylin and eosin staining. Iron tissue deposition was evaluated using the iron assay kit and Prussia Blue staining, while macrophage phenotype was determined using immunofluorescence. The levels of pro‐inflammatory cytokines and p53 acetylation were determine using western blotting. An in vitro iron overload model was established by inducing THP‐1 macrophages with ferric ammonium citrate, and the involvement of acetylated p53 in M1 macrophage polarisation was investigated.ResultsCompared to control samples, the iron content in the synovium of patients with HA was significantly increased. The protein levels of M1 macrophage markers, pro‐inflammatory cytokines, and acetylated p53, were also significantly elevated in the synovial tissues of patients with HA. Similar results were observed in the in vitro iron overload model. Furthermore, the inhibition of p53 acetylation in vitro reversed these iron overload‐induced effects.ConclusionIn patients with HA, iron overload induced synovial p53 acetylation, leading to macrophage polarisation toward the M1 phenotype and increased inflammatory cytokine secretion, resulting in synovitis.Highlights Synovial iron overload is associated with changes in P53 acetylation in hemophiliac arthritis (HA). Acetylated p53, a known regulator of macrophage polarization, is highly expressed in HA synovium, suggesting a potential role in M1 polarization. HA synovial macrophages predominantly polarize into the pro‐inflammatory M1 phenotype, secreting elevated levels of pro‐inflammatory cytokines.

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Section: Methodsmentioning

confidence: 99%

Section: Patient Samplesmentioning

confidence: 99%

Iron overload causes macrophages to produce a pro‐inflammatory phenotype in the synovium of hemophiliac arthritis via the acetyl‐p53 pathway

Pang,

Ding,

Yang

et al. 2023

Haemophilia

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“…However, as the degenerative changes progress, pain and disability increases and conservative management stops being effective (12). Depending on the severity of the disease, different elective procedures may be indicated such as arthroscopic or open synovectomy, arthrodesis and/or arthroplasty (13). A quick overview of these procedures is provided in this article.…”

Section: Hemophilic Arthropathymentioning

confidence: 99%

Primary total knee arthroplasty in hemophilic arthropathy

Beckers,

Massé,

Vendittoli

et al. 2023

EFORT Open Reviews

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Advanced hemophilic knee arthropathy is a frequent and devastating manifestation of severe hemophilia with significant implications for activities of daily living. Hemophilic arthropathy is caused by repeated bleeding, resulting in joint degeneration, pain, deformity and disability. In patients with hemophilia and advanced disease, total knee arthroplasty (TKA) has proven to be the most successful intervention, improves physical function and reduces knee pain. Hemophilic patients carry additional risks for complications and required specific pre/postoperative considerations. Expert treatment center should be used to improve patient outcome. Hemophilic patients present significant surgical challenges such as joint destruction, bone loss, severe ankylosis and oligoarticular involvement. The surgeon performing the arthroplasty must be experienced to manage such problems.

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Surgery for chronic arthropathy in people with haemophilia

Cited by 2 publications

References 50 publications

Iron overload causes macrophages to produce a pro‐inflammatory phenotype in the synovium of hemophiliac arthritis via the acetyl‐p53 pathway

Iron overload causes macrophages to produce a pro‐inflammatory phenotype in the synovium of hemophiliac arthritis via the acetyl‐p53 pathway

Primary total knee arthroplasty in hemophilic arthropathy

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