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Abstract
Aseptic loosening remains the primary cause of failure in total joint arthroplasty. Implant-derived particles are thought to be a main cause of osteolysis that leads to the failure. Substance P (SP) immunoreactive nerve fibers have been detected in the periprosthetic membrane of aseptic loose hip prostheses. We isolated fibroblasts from periprosthetic membrane. Fibroblasts were examined by real-time RT-PCR and enzyme-linked immunosorbent assay for expression of the receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), cyclooxygenase (COX)-1, and COX-2. Experiments were performed in the presence and absence of titanium particles, SP and NS-398 (a selective COX-2 inhibitor). Titanium particles or SP stimulated RANKL and COX-2 expression in fibroblasts, whereas NS-398 inhibited RANKL production, suggesting a COX-2-mediated event. Moreover, SP enhanced COX-2 and RANKL expression by titanium particles-stimulated fibroblasts. Thus, SP and titanium particles acted synergistically to increase RANKL expression.
Acknowledgements
The technical assistance of Yi Yang, Ying Wang, PhD, is most gratefully acknowledged.