Elena T Chetina

Nasonova Research Institute of Rheumatology, Russian Federation

Title: Gene expression biomarkers in the peripheral blood of osteoarthritic patients for postoperative pain prediction prior to knee or hip arthroplasty


We assessed the importance of clinical indices, pain-related protease and proinflammatory cytokine gene expressions in the peripheral blood for prediction of postoperative pain (POP) development in patients with end-stage knee or hip osteoarthritis (OA) prior to arthroplasty.  We examined peripheral blood of 31 hip and 50 knee OA patients undergoing joint replacement surgery and 26 healthy volunteers. Patients were tested before and 6 months after surgery. Pain was assessed prior to surgery using VAS index and neuropathic pain questionnaires DN4 and PainDETECT. Functional activity was evaluated by WOMAC. After surgery pain indices according to VAS of 30% and higher were considered. Total RNA isolated from whole blood was used in expression studies for cathepsin S, interleukin (IL)-1?, tumor necrosis factor (TNF)?, and cyclooxygenase (COX)2 genes using quantitative real-time RT-PCR. After 6 months’ post-surgery pain complaints were obtained from 38.7% patients with hip OA and 34% patients with knee OA. Prior to surgery expression of cathepsin S, IL- 1?, TNF?, and COX2 genes was significantly upregulated in all examined subsets of OA patients compared with healthy controls. Patients with knee and hip OA who developed POP demonstrated significantly higher cathepsin S gene expression compared with painless subjects prior to surgery. In addition, patients with knee OA who developed POP demonstrated significantly higher expression of IL-1? and TNF? compared with painless subjects while no significant differences in the expression of proinflammatory cytokines were observed in both subsets of patients with hip OA. Therefore, cathepsin S gene expression measured in the peripheral blood prior to surgery might serve as a prognostic biomarker of postoperative pain development in patients with knee and hip OA. Differences in prognostic value of IL-1? and TNF? gene expression measured in the peripheral blood prior to surgery might indicate that destruction of the hip and knee in OA is caused by different pathophysiological mechanisms.This study was funded by Russian Ministry of Education and Science (Project no. 1021062512064-0).


Leading Scientist, Principle Investigator, Immunology & Molecular Biology Department, Oct.2006-present. Research in genetics, cellular, and molecular physiology of osteoarthritis, rheumatoid arthritis, and osteoporosis. The importance of metabolic signalling pathways for the disease progression, inflammation, pain perception, joint destruction, and the response to therapy has been investigated in osteoarthritic, rheumatoid arthritis, and osteoporotic patients.