Abstract
The α-defensins (AD) present in synovial fluid have been regarded as constituting the most accurate periprosthetic joint infection (PJI) biomarker. The methods most commonly used for estimating AD as a biomarker are the qualitative Synovasure® PJI tests, based on the technique of lateral flow, and quantitative enzyme-linked immunosorbent assay (ELISA). Here, we propose a novel test based on detecting α-defensins in synovial fluid by high-performance liquid chromatography (HPLC). Synovial fluid was collected from 157 patients diagnosed with PJI, infectious arthritis (IA), arthrosis, reactive arthritis, and rheumatoid arthritis. AD concentrations in the fluid were determined by HPLC, and these same samples were used for additional diagnostic analyses. The results were statistically processed to calculate cutoff concentrations for PJI and IA. HPLC testing showed a sensitivity of 94% and a specificity of 92% for diagnosis of PJI, and a sensitivity of 97% and a specificity of 87% for diagnosis of IA. Using HPLC, we detected in synovial fluid a combination of three α-defensins: human neutrophil peptides HNP1, HNP2, and HNP3. All measured AD concentration values shown in this work refer to the sum of these three individual concentrations. Our study shows that the HPLC method meets the conditions for measuring precise concentrations of the sum of AD and can be recommended as part of a diagnostic array for PJI and IA diagnostics. By this method, we have verified that higher levels of AD in synovial fluid can also be seen in rheumatoid illnesses, crystal arthropathies, and reactive arthritis.
Highlights
Diagnosis of infectious complications in orthopedics and traumatology is essential, for deciding the course of treatment, and for improving the outcome of the treatment itself.Diagnosis of periprosthetic joint infections (PJI) and infectious arthritis (IA) requires a comprehensive approach
The components eluted in the peak at 24.7 min were identified by electrospray ionization mass spectrometry the combination of three human α-defensins with molecular masses of Diagnostics 2019, 9,(ESI-MS)
We have shown that a>].Human α-defensins (AD) concentration in synovial fluid can be determined by high-performance liquid chromatography (HPLC) technique
Summary
Diagnosis of infectious complications in orthopedics and traumatology is essential, for deciding the course of treatment, and for improving the outcome of the treatment itself.Diagnosis of periprosthetic joint infections (PJI) and infectious arthritis (IA) requires a comprehensive approach. The examination of synovial fluid has been recognized as essential for diagnosing PJI [1,2]. Diagnostics 2020, 10, 33 neutrophil peptides (HNP1, HNP2, and HNP3) belonging to the group of human α-defensins [2,3,4,5,6]. HNP1–3 are cationic peptides composed of 29 or 30 amino acids, and each contains three internal disulfide bridges [7,8,9]. They are produced by activated neutrophils in response to various microbial agents or proinflammatory cytokines in the locomotor region and secreted in synovial fluid [3,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
