
Elena T Chetina
Nasonova Research Institute of Rheumatology, Russian FederationTitle: Gene expression biomarkers in the peripheral blood of osteoarthritic patients for postoperative pain prediction prior to knee or hip arthroplasty
Abstract
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).
Biography
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.