基于Wntβ-catenin通路探讨巨噬细胞对全髋关节置换术后骨溶解的影响  

Study on the effects of macrophages on osteolysis after total hip arthroplasty based on Wntβ-catenin pathway

作　　者：韩杰[1] 斯焱[1] 张鹏[1] 陈果 毕梦娜[1] 李钟[1] 朱江伟[1] 张上上[1] 陈经勇[1] HAN Jie;SI Yan;ZHANG Peng(Department of Geriatric Orthopedics 1,Sichuan Orthopedic Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省骨科医院老年骨科,成都610041

出　　处：《临床外科杂志》2022年第6期586-588,共3页Journal of Clinical Surgery

摘　　要：目的基于Wnt/β-catenin通路探讨巨噬细胞对全髋关节置换术(THA)后骨溶解的影响。方法2018年12月~2020年12月间股骨颈骨折后期继发股骨头坏死行二期THA手术病人115例,根据术后是否出现骨溶解分为两组,对照组60例,未出现骨溶解,研究组55例,出现骨溶解。检测两组白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、骨代谢因子β胶联降解产物(β-CTX)的浓度,以及CD206、CD68和β-catenin蛋白表达量。通过Pearson对连续变量进行相关性分析。结果研究组的IL-6为(79.16±14.35)pg/ml,TNF-α为(101.86±15.34)ng/ml,β-CTX为(0.38±0.07)pg/L,对照组分别为(22.84±3.57)pg/ml,(49.62±7.11)ng/ml,(0.17±0.04)pg/L,两组比较差异有统计学意义(P<0.05)。研究组的CD206蛋白和CD206/CD68比值高于对照组,而CD68和β-catenin蛋白低于对照组,差异有统计学意义(P<0.05)。β-catenin蛋白表达量与CD206的表达量负相关,与CD68的表达量正相关,差异有统计学意义(P<0.05)。β-catenin蛋白表达量与CD206/CD68比值负相关,差异有统计学意义(P<0.05)。CD206蛋白表达量与IL-6、TNF-α、β-CTX正相关;CD68蛋白表达量与上述指标负相关;CD206/CD68比值与IL-6、TNF-α、β-CTX正相关,差异均有统计学意义(P<0.05)。结论在THA病人中,β-catenin通路的抑制会促进巨噬细胞向M1型极化引起炎性反应,从而导致骨溶解。Objective Based on the Wntβ-catenin signaling pathway,the effect of macrophages on osteolysis after artificial hip replacement was investigated.Methods 60 patients without osteolysis and 55 patients with osteolysis after secondary femoral head necrosis in the later stage of femoral neck fracture were collected as the control group and the study group respectively.The concentration of IL-6,TNF-α,β-CTX,CD206,CD68,β-catenin protein were detected.Correlation analysis of continuous variables were tested by Pearson.Results The levels of IL-6,TNF-αandβ-CTX,CD206 protein expression and the CD206/CD68 ratio of the study group were significantly higher than those of the control group(P<0.05),while the CD68 andβ-catenin protein expressions were significantly lower than the control group(P<0.05).β-catenin was negatively correlated with CD206,positively correlated with CD68,negatively correlated with CD206/CD68 ratio(P<0.05).IL-6,TNF-α,β-CTX were positively correlated with CD206 and CD206/CD68,negatively correlated with CD68(P<0.05).Conclusion In THA patients,inhibition of theβ-catenin pathway promotes the polarization of macrophages to M1 type,causing an inflammatory response,leading to osteolysis.

关 键 词：全髋关节置换术 骨溶解 巨噬细胞 WNT/Β-CATENIN通路 

分 类 号：R687.4[医药卫生—骨科学]