Serum markers for immunological response to metal alloys of endoprostheses

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Abstract

A study of solid-phase structures of blood serum using wedge-shaped and marginal dehydration methods (Litos system technology) was conducted in order to find out the causes of an inflammatory reaction followed by fibrosis in the second operated joint in a patient with bilateral knee arthritis. The study was aimed at identifying specific morphological markers that characterize the body’s response to the endoprosthesis material. Its solid-phase structures indicated the activation of a hyperergic reaction with daily incubation of blood serum with an alloy of titanium, aluminum, and vanadium. On the contrary, the immunological activity of blood serum can be suppressed and the structures present in it can be transformed into amorphous detritus with the incubation of an alloy of cobalt, chromium, and molybdenum. It was observed from the study that the nature of the immunological reaction of a sensitized organism depends on the type of metals that are part of the endoprosthesis. The immune response causes inflammation of the periarticular tissue, followed by its fibrosation and the formation of a scar demarcation shell that separates the periarticular tissue from the endoprosthesis and performs the function of an immunological barrier on the alloy of titanium, aluminum, and vanadium. On the other hand, an immunological reaction causes the destruction of inflamed periarticular tissue, followed by gradual destruction of the articular bag on the alloy of cobalt, chromium, and molybdenum.

About the authors

Svetlana N. Shatokhina

M.F. Vladimirsky’s Moscow regional research clinical institute

Author for correspondence.
Email: sv_n@list.ru
ORCID iD: 0000-0001-9441-4383

PhD, professor, head of the Department of clinical laboratory diagnostics

Russian Federation, Moscow

Vadim V. Zar

M.F. Vladimirsky’s Moscow regional research clinical institute, Moscow

Email: vzar@list.ru

MD, leading researcher of the Department of traumatology and orthopedics, associate professor of the Department of traumatology and orthopedics

Russian Federation, Moscow

Mikhail V. Zar

The Institute of general pathology and pathophysiology

Email: vzar@list.ru

clinical resident of the Department of traumatology and orthopedics

Russian Federation, Moscow

Vladimir Nikolaevich Shabalin

Federal State Budget Scientific Research Institute of General Pathology and Pathophysiology;

Email: shabalin.v2011@yandex.ru
ORCID iD: 0000-0002-1861-759X

PhD, MD, Professor, Academician of the Russian Academy of Sciences, Chief Researcher, Laboratory of Biocrystallomics,

Russian Federation, Moscow

References

  1. Hallab N, Merritt K, Jacobs JJ. Metal sensitivity in patients with orthopaedic implants. J Bone Joint Surg Am. 2001;83(3):428-436. https://doi.org/10.2106/00004623-200103000-00017.
  2. Granchi D, Cenni E, Giunti A, Baldini N. Metal hypersensitivity testing in patients undergoing joint replacement: a systematic review. J Bone Joint Surg Br. 2012;94(8):1126-1134. https://doi.org/10.1302/0301-620X.94B8.28135.
  3. Thakur RR, Ast MP, McGraw M, Bostrom MP, Rodriguez JA, Parks ML. Severe persistent synovitis after cobalt-chromium total knee arthroplasty requiring revision. Orthopedics. 2013;36(4):e520-e524. https://doi.org/10.3928/01477447-20130327-34.
  4. Шабалин В.Н., Шатохина С.Н. Функциональная морфология неклеточных тканей человека. М.: РАН; 2019. 356 c. [Shabalin VN, Shatokhina SN. Funktsional’naya morfologiya nekletochnykh tkanei cheloveka. Moscow: RAN; 2019. 356 p. (In Russ.).]
  5. Шатохина С.Н., Шабалин В.Н. Атлас структур неклеточных тканей человека в норме и патологии. Т. 2. Морфологические структуры сыворотки крови. Тверь: Триада; 2013. C. 74-87. [Shatokhina SN, Shabalin VN. Atlas struktur nekletochnykh tkanei cheloveka v norme i patologii. Vol. 2. Morfologicheskie struktury syvorotki krovi. Tver: Triada; 2013. P. 74-87. (In Russ.).]

Supplementary files

Supplementary Files
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2. Fig. 1. Fragments of facies in the blood serum of patient K.: a (sample 1) — markers of inflammation (arrow 1) and sclerosis (arrow 2); b (sample 2) — markers of inflammation (arrow 1) and markers of moderate destruction — double facies, toxic plaques (arrow 3); с (sample 3) — markers of severe destruction and intoxication (multilayer facies, blurred structural boundaries, loss of radial symmetry of cracks). Microscopy in ordinary light ×50

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3. Fig. 2. Anisomorpha blood serum of the patient K. in the samples: a (sample 1) — merge isotropic granular microspherulites with microspherulites (arrow); b (sample 2) — the scattering of small granules (raw microporosity), some of which are associated with microspherulites without damaging its structure; in (sample 3) — an anomalous impregnation of microspheroidal and their fragments in microspherules (arrow), severe destruction of macroporosity. Microscopy in polarized light ×200

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4. Fig. 3. SC Anisomorphons: a (sample 2) — cascade of parallel anisotropic lines (proliferation marker), ×100; b (sample 3) — wavy microspherolite (marker of aggression on xenogenic factor), ×800. Microscopy in polarized light

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