Elevation of Pro-Inflammatory Cytokine Levels Following Intra-Articular Fractures-A Systematic Review

• Published in: Cells (Basel, Switzerland) Switzerland), 2021-04, Vol.10 (4), p.902
• Main Authors: Pham, That Minh, Erichsen, Julie Ladeby, Kowal, Justyna Magdalena, Overgaard, Søren, Schmal, Hagen
• Format: Article
• Language: English
• Subjects: Aggrecan; Arthritis; biomarkers; Cartilage; Cartilage diseases; Cytokines; Enzymes; Fractures; Growth factors; Inflammation; inflammatory; Interferon; Interleukin 1 receptor antagonist; Interleukin 1 receptors; Interleukin 10; Interleukin 12; Interleukin 13; Interleukin 2; Interleukin 6; Interleukin 8; intra-articular fracture; Joint and ligament injuries; joint injury; Knee; Osteoarthritis; Review; Sports injuries; Systematic review; Tumor necrosis factor-TNF; Tumor necrosis factor-α
• ISSN: 2073-4409; 2073-4409
• DOI: 10.3390/cells10040902

Intra-articular fractures are a major cause of post-traumatic osteoarthritis (PTOA). Despite adequate surgical treatment, the long-term risk for PTOA is high. Previous studies reported that joint injuries initiate an inflammatory cascade characterized by an elevation of synovial pro-inflammatory cytokines, which can lead to cartilage degradation and PTOA development. This review summarizes the literature on the post-injury regulation of pro-inflammatory cytokines and the markers of cartilage destruction in patients suffering from intra-articular fractures. We searched Medline, Embase, and Cochrane databases (1960-February 2020) and included studies that were performed on human participants, and we included control groups. Two investigators assessed the quality of the included studies using Covidence and the Newcastle-Ottawa Scale. Based on the surveyed literature, several synovial pro-inflammatory cytokines, including interleukins (IL)-1β, IL-2, IL-6, IL-8, IL-12p70, interferon-y, and tumor necrosis factor-α, were significantly elevated in patients suffering from intra-articular fractures compared to the control groups. A simultaneous elevation of anti-inflammatory cytokines such as IL-10 and IL-1RA was also observed. In contrast, IL-13, CTX-II, and aggrecan concentrations did not differ significantly between the compared cohorts. Overall, intra-articular fractures are associated with an increase in inflammation-related synovial cytokines. However, more standardized studies which focus on the ratio of pro- and anti-inflammatory cytokines at different time points are needed.