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Correlation of systemic metabolic inflammation with knee osteoarthritis

Hormones (2022)Cite this article

Abstract

Purpose

The aim of this study was to analyze local and systematic inflammatory status in knee osteoarthritis (KOA), focusing on intra-articular and remote adipose tissue depots, and to explore its potential association with metabolic syndrome (MetS).

Methods

Patients (n = 27) with end-stage KOA were enrolled in the study and samples from infrapatellar fat pad (IFP), synovium, subcutaneous adipose tissue (SAT), synovial fluid (SF), and serum were collected. In homogenates from the tissues, mRNA expression of developmental endothelial locus-1 (DEL-1) was determined. Interleukin 6 (IL-6) and interleukin 8 (IL-8) were measured in tissues and SF and serum samples by enzyme-linked immunosorbent assay.

Results

Fifteen patients fulfilled MetS criteria (w-MetS group) and 12 did not (non-MetS). In the entire population, IL-6 levels were significantly higher in IFP compared to synovium (median (interquartile range), 26.05 (26.16) vs. 15.75 (14.8) pg/mg of total protein, p = 0.043), but not to SAT (17.89 (17.9) pg/mg); IL-8 levels were significantly higher in IFP (17.3 (19.3) pg/mg) and SAT (24.2 (26) pg/mg) when compared to synovium (8.45 (6.17) pg/mg) (p = 0.029 and < 0.001, respectively). Significantly higher IL-6 concentrations in SF were detected in w-MetS patients compared to non-MetS (194.8 (299) vs. 64.1 (86.9) pg/ml, p = 0.027). Finally, DEL-1 mRNA expression was higher in IFP compared to synovium (eightfold, p = 0.019).

Conclusions

Our findings support the critical role of IFP in knee joint homeostasis and progression of KOA. Furthermore, in KOA patients w-MetS, SAT is thought to play an important role in intra-knee inflammation via secretion of soluble inflammatory mediators, such as IL-6.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Emmanouil Yiachnakis for his helpful comments on statistical analysis and Smaragda Poulaki and Urania Kolliniati for their assistance.

Funding

Partial financial support was received from a Special Fund for Research Grants (ELKE) of the University of Crete to GK.

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Author notes

  1. Christos Tsatsanis, Maria Venihaki, and George Kontakis are equally contributing corresponding authors.

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, University Hospital of Heraklion, Crete, Greece

    Zacharias Christoforakis, Theodoros H.Tosounidis, Konstantine Ballalis & George Kontakis

  2. Department of Orthopaedics, General Hospital of Agios Nikolaos, Crete, Greece

    Zacharias Christoforakis

  3. Department of Clinical Chemistry, School of Medicine, University of Crete, Heraklion, Crete, Greece

    Zacharias Christoforakis, Eirini Dermitzaki, Eleni Paflioti, Michail Deiktakis, Christos Tsatsanis & Maria Venihaki

  4. Department of Clinical Chemistry-Biochemistry, University Hospital of Heraklion, Crete, Greece

    Marianna Katrinaki

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  1. Zacharias Christoforakis
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Contributions

All authors whose names appear on the submission (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Maria Venihaki.

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Ethics approval

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University Hospital of Heraklion, Crete (protocol code 8382 and date of approval 13–7-2016).

Informed consent statement

Informed consent was obtained from all subjects involved in the study.

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The authors declare no competing interests.

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Christoforakis, Z., Dermitzaki, E., Paflioti, E. et al. Correlation of systemic metabolic inflammation with knee osteoarthritis. Hormones (2022). https://doi.org/10.1007/s42000-022-00381-y

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Keywords

  • Arthritis
  • Inflammation
  • Metabolic syndrome
  • Cytokines
  • DEL-1