Differences in the Synovial Fluid Proteome of Septic and Aseptic Implant Failure

• Main Authors: Andrea Sowislok (Author), André Busch (Author), Farnusch Kaschani (Author), Markus Kaiser (Author), Marcus Jäger (Author)
• Format: Book
• Published: MDPI AG, 2024-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Implant loosening is a severe complication after total joint replacement. Here, differential diagnosis between septic and aseptic cases is crucial for further surgical treatment, but low-grade periprosthetic joint infections (PJIs) in particular remain a challenge. In this study, we analyzed the synovial fluid proteome of 21 patients undergoing revision surgery for septic (eight cases) or aseptic (thirteen cases) implant failure using LC-MS/MS to identify potential new biomarkers as future diagnostic tools. <i>Staphylococci</i> were found in four cases, <i>Streptococci</i> in two cases, <i>Serratia marcescens</i> and <i>Cutibacterium acnes</i> in one case. Proteomic analysis of the synovial fluid resulted in the identification of 515 different proteins based on at least two peptides. A statistical comparison revealed 37 differentially abundant proteins (<i>p</i> < 0.05), of which 17 proteins (46%) showed a higher abundance in the septic group. The proteins with the highest fold change included the known marker proteins c-reactive protein (7.57-fold) and the calprotectin components protein <i>S100-A8</i> (4.41-fold) and protein S100-A9 (3.1-fold). However, the protein with the highest fold change was leucine-rich alpha-2-glycoprotein 1 (<i>LRG1</i>) (9.07-fold), a currently discussed new biomarker for inflammatory diseases. Elevated <i>LRG1</i> levels could facilitate the diagnosis of PJI in the future, but their significance needs to be further investigated.

Item Description

10.3390/antibiotics13040346
2079-6382