Abstract
Osteoarthritis (OA) pain implies an indication for joint replacement in patients with end-stage OA. However, chronic postoperative pain is observed in 10–40% of patients with OA. Here, we identified genes whose expression in the peripheral blood before surgery could denote the risk of postoperative pain development. We examined the peripheral blood of 26 healthy subjects and 50 patients with end-stage OA prior to joint replacement surgery. Pain was evaluated before surgery using the visual analog scale (VAS) index and neuropathic pain questionnaires, Douleur Neuropathique 4 Questions (DN4) and PainDETECT questionnaires. Functional activity was assessed using the Western Ontario and McMaster Universities osteoarthritis index (WOMAC). Three and six months after surgery, pain indices according to VAS of 30% and higher were considered. Metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)1 protein levels were measured using ELISA in the peripheral blood mononuclear cells (PBMCs). Total RNA isolated from whole blood was analysed using quantitative real-time RT-PCR for caspase-3, MMP-9, TIMP1, cathepsins K and S, tumour necrosis factor (TNF)α, interleukin (IL)-1β, and cyclooxygenase (COX)-2 gene expression. Seventeen patients reported post-surgical pain. Expression of cathepsins K and S, caspase-3, TIMP1, IL-1β, and TNFα genes before surgery was significantly higher in these patients compared to pain-free patients with OA. Receiver-operating characteristic (ROC) curve analyses confirmed significant associations between these gene expressions and the likelihood of pain development after arthroplasty. High baseline expression of genes associated with extracellular matrix destruction (cathepsins S and K, TIMP1), inflammation (IL-1β, TNFα), and apoptosis (caspase-3) measured in the peripheral blood of patients with end-stage OA before knee arthroplasty might serve as an important biomarker of postoperative pain development.
Highlights
Osteoarthritis (OA) is a systemic disease that involves single or multiple joints
We suggest using the baseline peripheral blood expression of genes associated with extracellular matrix turnover, apoptosis, and inflammation (TNFα and IL-1β) as prognostic markers of post-surgical pain
The high predictive values of the abovementioned gene expressions in the development of pain after knee replacement surgery were confirmed by the Receiver-operating characteristic (ROC) curve profiles for expressions of these genes and could be used in clinical settings for prediction of post-surgical pain development
Summary
Osteoarthritis (OA) is a systemic disease that involves single or multiple joints. It produces articular cartilage degradation, remodelling of the subchondral bone, and is associated with synovialLife 2020, 10, 224; doi:10.3390/life10100224 www.mdpi.com/journal/lifeLife 2020, 10, 224 inflammation [1]. Osteoarthritis (OA) is a systemic disease that involves single or multiple joints. It produces articular cartilage degradation, remodelling of the subchondral bone, and is associated with synovial. Pain in OA is the main clinical symptom that limits a patient’s working capacity and everyday self-care. Because there are currently no disease-modifying drugs for OA therapy, the treatment comprises of pain control using basic anti-inflammatory drugs (NSAIDs), glucocorticoids, and chondroprotectors. Severe pain is one of the most important indications for joint replacement in patients with end-stage OA. Knee joint arthroplasty is the most common OA treatment worldwide, with an annual increase in the number of cases, and it is inspected expected to increase seven-fold by
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
