Universität zu Köln

Zarghooni, Kourosh, Hackenberg, Roslind K., Sander, Gunnar and Mahabir, Esther (2019). Suitability of serum cytokine profiling for early diagnosis of implant-associated infections after orthopaedic surgery: A preliminary prospective study. Cytokine, 116. S. 88 - 97. LONDON: ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD. ISSN 1096-0023

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Abstract

The C-reactive protein (CRP) is still the conventional marker used to diagnose implant-associated infections (IAI) after orthopaedic surgery. However, the CRP level can lead to misdiagnosis since it is up-regulated not only during bacterial infection. In this prospective study, we evaluated the serum cytokine profile before (pre-OP) and after orthopaedic surgery (post-OP) as well as after confirmation of a developed infection (COI) to identify candidate biomarkers for diagnosis of IAI. Sera from 10 controls 7 to 1 days pre-OP and 0 to 22 days post-OP as well as from 5 patients who developed IAI 5 to 1 days pre-OP, 0 to 197 days post-OP and after COI were analyzed for 27 different cytokines using a multiplex cytokine assay. In addition to CRP, 14 cytokines IL-1ra, IL-4, IL-5, IL-6, IL-8, IL-12(p70), IL-13, IL-17, eotaxin, G-CSF, IFN-gamma, IP-10, MCP-1, and MIP-1 beta were significantly altered (P <= 0.05) during the study although some differences were low-fold elevations compared to the pre-OP levels. IL-6 as well as IL-12(p70) were consistently elevated in infected patients. Surgery influenced cytokine production with some overlap of cytokines in both groups, implying that the use of cytokines is maximized when the cytokines are not or no longer affected by surgical trauma. To lend more robustness to the selection of candidate cytokines, in addition to the statistical differences, we applied a threshold cut-off of approximately 2-fold elevations when comparisons were made. This resulted in the selection of 8 cytokines, namely IL-6, IL-1ra, IL-8, IL-12(p70), eotaxin, IP-10, MCP-1, and MIP-1 beta, which may be used in a multiplex assay for detection of IAI after surgery. Furthermore, IL-1ra and IL-8 may be used as prognostic cytokines prior to surgery. The present results imply that the use of cytokines may be a suitable alternative to CRP for IAI diagnosis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zarghooni, Kourosh UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackenberg, Roslind K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sander, Gunnar UNSPECIFIED UNSPECIFIED UNSPECIFIED Mahabir, Esther UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-152590
DOI:	10.1016/j.cyto.2018.12.016
Journal or Publication Title:	Cytokine
Volume:	116
Page Range:	S. 88 - 97
Date:	2019
Publisher:	ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD
Place of Publication:	LONDON
ISSN:	1096-0023
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language C-REACTIVE PROTEIN; PROSTHETIC JOINT INFECTION; ERYTHROCYTE SEDIMENTATION-RATE; TOTAL HIP-ARTHROPLASTY; PERIPROSTHETIC INFECTION; KNEE ARTHROPLASTY; INTERLEUKIN-6; PROCALCITONIN; BIOMARKERS; MARKERS Multiple languages Biochemistry & Molecular Biology; Cell Biology; Immunology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15259