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Macrophage Polarization and the Osteoimmunology of Periprosthetic Osteolysis

. 2022 Feb ; 20 (1) : 43-52. [epub] 20220208

Language English Country United States Media print-electronic

Document type Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review

Grant support
R01 AR063713 NIAMS NIH HHS - United States
AZV NU21-06-00370. Ministerstvo Zdravotnictví Ceské Republiky
R01 AR073145 NIAMS NIH HHS - United States

Links

PubMed 35133558
DOI 10.1007/s11914-022-00720-3
PII: 10.1007/s11914-022-00720-3
Knihovny.cz E-resources

PURPOSE OF REVIEW: Joint replacement has revolutionized the treatment of end-stage arthritis. We highlight the key role of macrophages in the innate immune system in helping to ensure that the prosthesis-host interface remains biologically robust. RECENT FINDINGS: Osteoimmunology is of great interest to researchers investigating the fundamental biological and material aspects of joint replacement. Constant communication between cells of the monocyte/macrophage/osteoclast lineage and the mesenchymal stem cell-osteoblast lineage determines whether a durable prosthesis-implant interface is obtained, or whether implant loosening occurs. Tissue and circulating monocytes/macrophages provide local surveillance of stimuli such as the presence of byproducts of wear and can quickly polarize to pro- and anti-inflammatory phenotypes to re-establish tissue homeostasis. When these mechanisms fail, periprosthetic osteolysis results in progressive bone loss and painful failure of mechanical fixation. Immune modulation of the periprosthetic microenvironment is a potential intervention to facilitate long-term durability of prosthetic interfaces.

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