Alpha-defensin—novel synovial fluid biomarker for the diagnosis of periprosthetic joint infection

Pupaibool, Jakrapun; Fulnecky, Eric J.; Swords, Robert L.; Sistrunk, William W.; Haddow, Alastair D.

doi:10.1007/s00264-016-3306-0

Cited by 45 publications

(29 citation statements)

References 35 publications

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“…Synovial AD are the most accurate biomarkers currently used in the diagnosis of PJI [6,10,17,18]. In this work, we have shown that AD concentration in synovial fluid can easily be determined by HPLC technique.…”

Section: Discussionmentioning

confidence: 84%

“…HNP1-3 are cationic peptides composed of 29 or 30 amino acids, and each contains three internal disulfide bridges [7][8][9]. They are produced by activated neutrophils in response to various microbial agents or proinflammatory cytokines in the locomotor region and then secreted in synovial fluid [3,10].…”

Section: Introductionmentioning

confidence: 99%

“…In the case of PJI, the Musculoskeletal Infection Society (MSIS) criteria seem to comprise the most objective set of cutoff levels [2,[16][17][18]. For the lateral flow method, the cutoff for AD concentration for PJI is set to 5.2 mg/L [4,5,10].…”

Section: Introductionmentioning

confidence: 99%

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High-Performance Liquid Chromatography as a Novel Method for the Determination of α-Defensins in Synovial Fluid for Diagnosis of Orthopedic Infections

et al. 2020

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The α-defensins (AD) present in synovial fluid have been regarded as constituting the most accurate periprosthetic joint infection (PJI) biomarker. The methods most commonly used for estimating AD as a biomarker are the qualitative Synovasure® PJI tests, based on the technique of lateral flow, and quantitative enzyme-linked immunosorbent assay (ELISA). Here, we propose a novel test based on detecting α-defensins in synovial fluid by high-performance liquid chromatography (HPLC). Synovial fluid was collected from 157 patients diagnosed with PJI, infectious arthritis (IA), arthrosis, reactive arthritis, and rheumatoid arthritis. AD concentrations in the fluid were determined by HPLC, and these same samples were used for additional diagnostic analyses. The results were statistically processed to calculate cutoff concentrations for PJI and IA. HPLC testing showed a sensitivity of 94% and a specificity of 92% for diagnosis of PJI, and a sensitivity of 97% and a specificity of 87% for diagnosis of IA. Using HPLC, we detected in synovial fluid a combination of three α-defensins: human neutrophil peptides HNP1, HNP2, and HNP3. All measured AD concentration values shown in this work refer to the sum of these three individual concentrations. Our study shows that the HPLC method meets the conditions for measuring precise concentrations of the sum of AD and can be recommended as part of a diagnostic array for PJI and IA diagnostics. By this method, we have verified that higher levels of AD in synovial fluid can also be seen in rheumatoid illnesses, crystal arthropathies, and reactive arthritis.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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High-Performance Liquid Chromatography as a Novel Method for the Determination of α-Defensins in Synovial Fluid for Diagnosis of Orthopedic Infections

et al. 2020

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“…It is typically caused by microorganisms with low virulence and considerable delayed diagnosis [22]. It almost presents with pain at the affected joint associated with ambulation, which is often similar to that of aseptic failure [3,8]. Patients may show lessintensive systemic reactions and normal laboratory markers when PJI exists in the form of chronic encapsulated infection [23,24].…”

Section: Discussionmentioning

confidence: 99%

Combined Measurement of D-Dimer and C-Reactive Protein Levels: Highly Accurate for Diagnosing Chronic Periprosthetic Joint Infection

Qin

Gong

et al. 2020

The Journal of Arthroplasty

101

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“…In der Synovia gemessenes Alpha-Defensin gilt ebenfalls als vielversprechender Marker für periprothetische Infektionen. Weitere Untersuchungen mit größeren Kohorten sind jedoch notwendig, um eine gezielte Aussage bezüglich der Signifikanz bei der Diagnostik des periprothetischen Infekts treffen zu können [21].…”

Section: Caveunclassified

Revisionsendoprothetik im Kniegelenk: Symptomatik, Diagnostik und Therapie

Springer¹,

Bechler²,

Böttner³

2019

Orthopädie und Unfallchirurgie up2date

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Alpha-defensin—novel synovial fluid biomarker for the diagnosis of periprosthetic joint infection

Abstract: Synovial fluid alpha-defensin could enhance our ability to identify PJI and incorporate into the diagnostic algorithm in the future. Large-scale studies are needed to provide more data for its significance for the diagnosis of PJI.

Cited by 45 publications

References 35 publications

High-Performance Liquid Chromatography as a Novel Method for the Determination of α-Defensins in Synovial Fluid for Diagnosis of Orthopedic Infections

High-Performance Liquid Chromatography as a Novel Method for the Determination of α-Defensins in Synovial Fluid for Diagnosis of Orthopedic Infections

Combined Measurement of D-Dimer and C-Reactive Protein Levels: Highly Accurate for Diagnosing Chronic Periprosthetic Joint Infection

Revisionsendoprothetik im Kniegelenk: Symptomatik, Diagnostik und Therapie

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