Preoperative methylprednisolone increases plasma Pentraxin 3 early after total knee arthroplasty: a randomized, double-blind, placebo-controlled trial
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Preoperative methylprednisolone increases plasma Pentraxin 3 early after total knee arthroplasty : a randomized, double-blind, placebo-controlled trial. / Lindberg-Larsen, V.; Kehlet, H.; Pilely, K.; Bagger, J.; Rovsing, M. L.; Garred, P.
I: Clinical and Experimental Immunology, Bind 191, Nr. 3, 2018, s. 356-362.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Preoperative methylprednisolone increases plasma Pentraxin 3 early after total knee arthroplasty
T2 - a randomized, double-blind, placebo-controlled trial
AU - Lindberg-Larsen, V.
AU - Kehlet, H.
AU - Pilely, K.
AU - Bagger, J.
AU - Rovsing, M. L.
AU - Garred, P.
PY - 2018
Y1 - 2018
N2 - Preoperative glucocorticoid administration reduces the systemic inflammatory response. Pentraxin 3 (PTX3) is a novel inflammatory marker belonging to the humoral arm of innate immunity exerting a potentially protective host response. This study evaluated PTX3 and other complement marker changes after preoperative methylprednisolone (MP) early after total knee arthroplasty (TKA). Seventy patients were randomized (1 : 1) to preoperative intravenous (i.v.) MP 125 mg (group MP) or isotonic saline i.v. (group C). The outcomes included change in plasma PTX3, mannose‐binding lectin (MBL), ficolins (ficolin‐1, −2 and −3), complement components (C4 and C3), terminal complement complex (TCC) and C‐reactive protein (CRP) concentrations. Blood samples were analysed at baseline and 2, 6, 24 and 48 h after surgery with complete sampling from 63 patients for analyses. MP resulted in an increase in circulating PTX3 compared to saline from baseline to 24 h postoperatively (P < 0·001), while MP reduced the systemic inflammatory response (CRP) 24 and 48 h postoperatively (P < 0·001). However, the small postoperative changes in MBL, ficolin‐1, −2 and −3, C4, C3 and TCC concentrations did not differ between groups (P > 0·05). In conclusion, preoperative MP 125 mg increased circulating PTX3 and reduced the general inflammatory response (CRP) early after TKA, but did not affect other complement markers.
AB - Preoperative glucocorticoid administration reduces the systemic inflammatory response. Pentraxin 3 (PTX3) is a novel inflammatory marker belonging to the humoral arm of innate immunity exerting a potentially protective host response. This study evaluated PTX3 and other complement marker changes after preoperative methylprednisolone (MP) early after total knee arthroplasty (TKA). Seventy patients were randomized (1 : 1) to preoperative intravenous (i.v.) MP 125 mg (group MP) or isotonic saline i.v. (group C). The outcomes included change in plasma PTX3, mannose‐binding lectin (MBL), ficolins (ficolin‐1, −2 and −3), complement components (C4 and C3), terminal complement complex (TCC) and C‐reactive protein (CRP) concentrations. Blood samples were analysed at baseline and 2, 6, 24 and 48 h after surgery with complete sampling from 63 patients for analyses. MP resulted in an increase in circulating PTX3 compared to saline from baseline to 24 h postoperatively (P < 0·001), while MP reduced the systemic inflammatory response (CRP) 24 and 48 h postoperatively (P < 0·001). However, the small postoperative changes in MBL, ficolin‐1, −2 and −3, C4, C3 and TCC concentrations did not differ between groups (P > 0·05). In conclusion, preoperative MP 125 mg increased circulating PTX3 and reduced the general inflammatory response (CRP) early after TKA, but did not affect other complement markers.
KW - acute-phase proteins
KW - arthroplasty
KW - complement
KW - glucocorticoids
KW - inflammation
U2 - 10.1111/cei.13071
DO - 10.1111/cei.13071
M3 - Journal article
C2 - 29119559
VL - 191
SP - 356
EP - 362
JO - Clinical and Experimental Immunology, Supplement
JF - Clinical and Experimental Immunology, Supplement
SN - 0964-2536
IS - 3
ER -
ID: 194527009