PMID- 19797564
OWN - NLM
STAT- MEDLINE
DCOM- 20091029
LR  - 20160512
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 91
IP  - 10
DP  - 2009 Oct
TI  - Diagnostic utility of cytokine biomarkers in the evaluation of acute knee pain.
PG  - 2313-20
LID - 10.2106/JBJS.H.00835 [doi]
AB  - BACKGROUND: The diagnosis of clinically important meniscal tears of the knee 
      remains challenging, and it is unknown why only some injuries become painful. The 
      role of inflammatory cytokines in generating pain following meniscal injury 
      remains unclear. This study aimed to investigate the cytokine profile in patients 
      with acute knee pain believed to be secondary to meniscal damage. METHODS: This 
      prospective cohort study included thirty-two patients without rheumatoid 
      arthritis who had knee pain for less than six months, with either an acute or 
      insidious onset, and elected to have arthroscopic treatment after nonoperative 
      management had failed. Twenty-three of these patients elected to have the 
      contralateral, nonoperatively treated knee lavaged at the time of arthroscopy. 
      Fifteen asymptomatic control subjects also contributed samples of knee joint 
      fluid, for a total of seventy samples from forty-seven subjects. Lavage of the 
      operatively treated, contralateral, and control knees was performed with the 
      patient under regional anesthesia prior to arthroscopy, if applicable, by the 
      infusion of sterile saline solution into the knee followed by the immediate 
      withdrawal into a syringe. The concentrations of seventeen inflammatory cytokines 
      and chemokines were measured with use of a multiplexed immunoassay panel. 
      Preoperative magnetic resonance imaging findings and cytokine assay results were 
      compared with intraoperative findings. RESULTS: Multivariate analysis of variance 
      detected significantly greater concentrations of interferon gamma (IFN-gamma); 
      interleukins 2, 4, 6, 10, and 13 (IL-2, IL-4, IL-6, IL-10, and IL-13); monocyte 
      chemotactic protein-1 (MCP-1); and macrophage inflammatory protein-1 beta 
      (MIP-1beta) in fluid samples from painful knees than in samples from nonpainful 
      knees. Correlation analysis demonstrated a significant positive correlation 
      between patient-reported pain scores and concentrations of IL-6 (Spearman rho = 
      0.7), MCP-1 (rho = 0.8), MIP-1beta (rho = 0.6), and IFN-gamma (rho = 0.6). These 
      four cytokines also demonstrated a positive correlation with each other (rho = 
      0.5 to 0.7). The presence of IFN-gamma, IL-6, MCP-1, or MIP-1beta performed as 
      well as magnetic resonance imaging in the prediction of intraoperative findings. 
      CONCLUSIONS: Intra-articular concentrations of four inflammatory cytokines 
      IFN-gamma, IL-6, MCP-1, and MIP-1beta correlated to pain in patients with 
      symptomatic meniscal tears in the knee but were markedly lower in asymptomatic 
      normal knees and in asymptomatic knees with meniscal tears. These cytokines may 
      be involved in the generation of pain following meniscal injury.
FAU - Cuellar, Jason M
AU  - Cuellar JM
AD  - Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases, 301 East 17th 
      Street, New York, NY 10033, USA.
FAU - Scuderi, Gaetano J
AU  - Scuderi GJ
FAU - Cuellar, Vanessa Gabrovsky
AU  - Cuellar VG
FAU - Golish, S Raymond
AU  - Golish SR
FAU - Yeomans, David C
AU  - Yeomans DC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
RN  - 0 (Biomarkers)
RN  - 0 (Cytokines)
SB  - IM
MH  - Adult
MH  - Arthralgia/*diagnosis
MH  - Biomarkers/blood
MH  - Cytokines/*blood
MH  - Female
MH  - Humans
MH  - *Knee Joint
MH  - Male
MH  - Middle Aged
EDAT- 2009/10/03 06:00
MHDA- 2009/10/30 06:00
CRDT- 2009/10/03 06:00
PHST- 2009/10/03 06:00 [entrez]
PHST- 2009/10/03 06:00 [pubmed]
PHST- 2009/10/30 06:00 [medline]
AID - 91/10/2313 [pii]
AID - 10.2106/JBJS.H.00835 [doi]
PST - ppublish
SO  - J Bone Joint Surg Am. 2009 Oct;91(10):2313-20. doi: 10.2106/JBJS.H.00835.