Intra-Articular Cytokine Levels in Adolescent Patients after Anterior Cruciate Ligament Tear

Abstract

The treatment of anterior cruciate ligament (ACL) injuries in children and adolescents is challenging. Preclinical and clinical studies investigated ACL repairing techniques in skeletally immature subjects. However, intra-articular bioenvironment following ACL tear has not yet been defined in skeletally immature patients. The aim of this study was to measure cytokine concentrations in the synovial fluid in adolescent population. Synovial levels of IL-1β, IL-1ra, IL-6, IL-8, IL-10, and TNF-α were measured in 17 adolescent patients (15 boys) with ACL tears who underwent ACL reconstruction including acute (5), subacute (7), and chronic (5) phases. Femoral growth plates were classified as “open” in three patients, “closing” in eight, and “closed” in six. Eleven patients presented an ACL tear associated with a meniscal tear. The mean Tegner and Lysholm scores (mean ± SD) of all patients were 8 ± 1 and 50.76 ± 26, respectively. IL-8, TNF-α, and IL-1β levels were significantly greater in patients with “open” physes. IL-1ra and IL-1β levels were significantly higher in patients with ACL tear associated with a meniscal tear. Poor Lysholm scores were associated with elevated IL-6 and IL-10 levels. IL-10 levels positively correlated with IL-6 and IL-8 levels, whereas TNF-α concentration negatively correlated with IL-6 levels. Skeletally immature patients with meniscal tears and open growth plates have a characteristic cytokine profile with particularly elevated levels of proinflammatory cytokines including IL-8, TNF-α, and IL-1β. This picture suggests that the ACL tear could promote an intra-articular catabolic response in adolescent patients greater than that generally reported for adult subjects. The study lacks the comparison with synovial samples from healthy skeletally immature knees due to ethical reasons. Overall, these data contribute to a better knowledge of adolescent intra-articular bioenvironment following ACL injuries.

COMP in the Infrapatellar Fat Pad—Results of a Prospective Histological, Immunohistological, and Biochemical Case–Control Study

“…We found no differences in the staining intensity scores of IL‐1β and IL‐6 between OA and control samples from the young with a rupture of the ACL. Previous studies indicate that the rupture of the ACL leads to an increase of intra‐articular inflammatory cytokines like IL‐1 and IL‐6 . We speculate that also in our control group, the rupture of the ACL results in an increase of IL‐1β and IL‐6 in the IPFP.…”

“…Previous studies indicate that the rupture of the ACL leads to an increase of intra-articular inflammatory cytokines like IL-1 and IL-6. 49,50 We speculate that also in our control group, the rupture of the ACL results in an increase of IL-1β and IL-6 in the IPFP. Furthermore, the number of CD206-positive cells did not differ between the groups.…”

Characterization of Synovial Cytokine Patterns in Bucket-Handle and Posterior Horn Meniscal Tears

“…TNF- α is a proinflammatory cytokine of the acute phase of inflammation: in fact, the production of this cytokine is extremely rapid following the damaging event [ 39 , 40 ]. It also plays a key role in regulating the inflammatory response: for example, it stimulates the production of adhesion molecules on the endothelial cells of the postcapillary venules (e.g., ICAM-1, VCAM-1, and E-selectin) [ 41 ].…”

Clinical Significance of Inflammatory Factors Within the Synovial Fluids in Patients With Knee Osteoarthritis for Predicting Meniscus Degeneration Progression

“…These ndings further con rmed the role of various in ammatory factors in the pathogenesis of meniscus degeneration of the knee OA. Levels of in ammatory mediators are signi cantly related to severity and can be widely used to predict the clinical outcome of patients [29].…”