Assessment of synovial fluid and serum cytokine levels in children with septic arthritis

Acute septic arthritis (ASA) is a common orthopedic infection of children which may produce devastating sequelae and chronic morbidity. Improved understanding of the intra-articular inflammatory response in ASA may identify cytokine targets with diagnostic or therapeutic potential, though no detaile...

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Bibliographic Details
Published in:Journal of investigative medicine 2021-06, Vol.69 (5), p.1059-1062
Main Authors: Dehority, Walter, Plaster, Scott, Helmig, Kathryn C, Huff, Nathan, Parsons, Andrew, Tigert, Susan L, Silva, Selina
Format: Article
Language:English
Subjects:
Adolescent
Arthritis
Arthritis, Infectious - diagnosis
Bone surgery
Chemokines
Child
Cytokines
Cytokines - analysis
Cytokines - blood
Granulocytes
Humans
Immunocompetence
Interleukin-6
Orthopedics
Pilot Projects
Synovial Fluid - chemistry
Tumor necrosis factor-TNF
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Summary:Acute septic arthritis (ASA) is a common orthopedic infection of children which may produce devastating sequelae and chronic morbidity. Improved understanding of the intra-articular inflammatory response in ASA may identify cytokine targets with diagnostic or therapeutic potential, though no detailed investigations to this end have been performed. Given this, we used a multiplex cytokine assay for assessment of levels of 40 different cytokines in the synovial fluid and blood of children with ASA. Twelve children (8 controls undergoing orthopedic surgery for non-infectious conditions and 4 with ASA) were prospectively enrolled. Blood and synovial fluid were collected intraoperatively from each subject, and the levels of 40 cytokines were determined using a multiplex assay. Cytokines were organized by function and structure into 12 groups for analysis. The Benjamini-Hochberg method was used to control for type 1 errors, with an a priori false discovery rate of 10%. Subjects with ASA were younger than controls (mean age 8.0 vs 13.1 years, p=0.0400). Significant elevations were seen in interleukins (IL) with chemokine properties, IL-6 and those in the common-γ chain group in the blood and synovial fluid of children with ASA compared with controls, while significant elevations in 5 additional cytokine groups were seen in synovial fluid from children with ASA compared with controls, most notably IL-6 (median 8294.3 vs 10.7 pg/mL, p=0.0066). Our pilot study is the first to describe in detail the cytokine response in children with ASA, and highlights the need for additional study.
ISSN:1081-5589
1708-8267
DOI:10.1136/jim-2020-001526