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Enzymes and cytokines disease in total hip arthroplasty: promoters of immune loosening
Enfermedad de las enzimas y citocinas en la artroplastia total de cadera: promotores en el aflojamiento inmunológico
DOI:
https://doi.org/10.15446/revfacmed.v66n3.61525Palabras clave:
Hip Prosthesis, Hip Replacement Arthroplasty, Prosthesis Failure, Cytokines, Graft Rejection (en)Prótesis de cadera, Artroplastia de reemplazo de cadera, Falla de prótesis, Citocinas, Rechazo de injerto (es)
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Introduction: An important cause of hip prosthesis failure is loosening related to cytokine-mediated release of enzymes that produces lysis of the bone that supports the implant.
Objective: This paper aims to describe the biological interaction mechanisms of the molecules that promote total hip prosthesis loosening, the most frequent problem observed during the process.
Materials and methods: The authors conducted a literature search in the PubMed and Scopus databases for original articles and clinical cases with no filters by publication date. MeSH terms hip prosthesis loosening, aseptic loosening, cytokines, and hip arthroplasty failure were used. Data were extracted from 250 studies, of which 66 were representative for this review and were selected for writing purposes.
Results: The most representative molecules involved in hip prosthesis loosening are described, and the interactions between them are presented.
Conclusions: Enzymes and cytokines have been widely studied for four decades, although their interaction mechanisms are still misunderstood. In consequence, an interaction mechanism, which may be called “enzymes and cytokines disease” or “immune loosening”, is proposed.
Introducción. Una de las causas más importantes de falla de la prótesis de cadera lo constituye el fenómeno de aflojamiento, el cual se relaciona con la liberación de enzimas mediada por citocinas y produce la lisis del hueso que soporta el implante.
Objetivo. Describir los mecanismos de interacción biológica de las moléculas promotoras del aflojamiento de la prótesis total de cadera que con mayor frecuencia están presentes en el proceso.
Materiales y métodos. Se realizó una búsqueda de artículos originales y casos clínicos en las bases de datos PubMed y Scopus, sin límite de fecha de publicación, utilizando los términos MeSH “hip prosthesis loosening”, “aseptic loosening”, “cytokines” y “hip arthroplasty failure”. La extracción de datos se hizo mediante la lectura de 250 estudios, de los cuales se seleccionaron 66 para fines de redacción.
Resultados. Los autores describen las moléculas más representativas implicadas en el aflojamiento de la prótesis de cadera, además se presentan las interacciones entre ellas.
Conclusiones. Enzimas y citocinas han sido ampliamente estudiadas por cuatro décadas, aunque sus mecanismos de interacción son poco conocidos. Los autores proponen un mecanismo de interacción, proceso que podría denominarse “enfermedad de las enzimas y citocinas” o “aflojamiento inmunológico”.
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