Cartilage harvest elevates sCD14 and MMP-3 in the synovial fluid of the autologous chondrocyte implantation (ACI) treated joint

Wright, K. T.; Wilson, E.; Hulme, C.; Kuiper, J. H.; Gallacher, P.; Richardson, J. B.; Roberts, S.

Abstract

Introduction This study aims to examine the impact of the cartilage harvest procedure on synovial fluid biomarkers at the time of autologous chondrocyte implantation (ACI).

Materials and Methods Hyaluronic acid (HA), cartilage oligomeric matrix protein (COMP), ADAMTS-4 activity (n = 40), sCD14 (n = 57), matrix metalloproteinase 3 (MMP-3) (n = 11), lipid content (n = 25) and total protein (n = 12) were measured in the synovial fluid (SF) of patients prior to cartilage harvest (Stage I) and at the time of cell implantation 3–4 weeks later (Stage II). HA and COMP were also measured in the blood plasma (n = 40). We performed the same set of analyses (apart from total protein) in the SF and plasma of 12 patients who were treated using mesenchymal stromal cell (MSC) therapy. This involves an arthroscopy at Stage I, but no cartilage harvest; this represented our ‘control’ group.

Results Our analyses demonstrated that levels of sCD14, MMP-3 and total protein in the SF of patients who had undergone a cartilage harvest were significantly elevated at Stage II, compared to preoperative values. Synovial fluid sCD14 levels were 1328 ± 4 ng/ml versus 2143 ± 5 ng/ml, MMP-3 levels were 610.59 ± 6.75 ng/ml versus 1780.03 ± 11.44 ng/ml and total protein was 6.7 ± 0.61 ng/ml versus 11.46 ± 0.64 ng/ml at Stage I versus Stage II (means±SEM, P < 0.0001, P = 0.005 and P = 0.03 respectively; Wilcoxon matched pairs test). Further, HA levels significantly increased in the blood plasma between Stage I and Stage II from 21.26 ± 0.073 ng/ml to 39.59 ± 1.03 ng/ml (means±SEM, P = 0.001). Interestingly, none of the differences observed in patients who had undergone a cartilage harvest at Stage I were seen in patients who were treated using MSC therapy. In this group, sCD14 levels were 904.52 ± 6.44 ng/ml versus 1043.02 ± 8.3 ng/ml and MMP-3 levels were 535.44 ± 7.29 ng/ml versus 523.16 ± 6.4 ng/ml at Stage I versus Stage II (means±SEM, P = 0.733 and P = 0.937 respectively; Wilcoxon matched pairs test).

Discussion This study suggests that there may be an acute inflammatory response in the knee to the cartilage harvest procedure in ACI, but more patients and additional longitudinally collected samples matched to clinical assessments of knee function are required to assess if this is an acute, transient response and for comparisons to be made with long-term clinical outcome.

Citation

Wright, K. T., Wilson, E., Hulme, C., Kuiper, J. H., Gallacher, P., Richardson, J. B., & Roberts, S. (2017). Cartilage harvest elevates sCD14 and MMP-3 in the synovial fluid of the autologous chondrocyte implantation (ACI) treated joint. International Journal of Experimental Pathology, 97(6), A24

• Journal Article Type: Conference Paper
• Conference Name: British Society for Matrix Biology “The Grey Area – Age and the Extracellular Matrix”
• Online Publication Date: Mar 29, 2017
• Publication Date: Mar 29, 2017
• Deposit Date: Jun 8, 2023
• Journal: International Journal of Experimental Pathology
• Print ISSN: 0959-9673
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 97
• Issue: 6
• Pages: A24
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/iep.12211