Abstract
BackgroundOne means of treating osteoarthritis is with autologous or allogeneic osteochondral grafts. The purpose of this study was to evaluate the innate immunological response in humans toward xeno-derived osteochondral grafts that have been partially or entirely treated by the photooxidation process.MethodsThe antigens tested included bovine, porcine, ovine and equine osteochondral samples that have been treated in successive steps of photooxidation. ELISPOT assays were used to evaluate the production of IL-1, IL-4, IL-6, IL-10, IL-12 and TNF-α by human monocytes in response to the antigens.ResultsResults indicated vigorous production of IL-1, IL-6, IL-10 and TNF-α in response to untreated bovine, porcine and equine specimens. This indicates that these samples are perceived as foreign, or stimulatory, by the human monocytes. There was no induction of IL-4 or IL-12, which is required for Th2 and Th1 immunity, respectively. In contrast, the processed bovine, porcine and equine samples did not induce significant activation of cells of the innate immune system. This occurred after the first step in processing (after cleaning in increasing strengths of ethanol). This suggests that the processing steps dramatically, if not completely, negated the immunostimulatory properties of the test sample. The results for the ovine samples indicate a reverse response.ConclusionThe findings of the study suggest that photooxidized bovine, porcine or equine samples have the potential to be used as an osteochondral graft. Although the first step in processing reduced the immunological response, photooxidation is still necessary to retain the structure and mechanical integrity of the cartilage, which would allow for immediate joint resurfacing.
Highlights
One means of treating osteoarthritis is with autologous or allogeneic osteochondral grafts
This pertains primarily to cytokines involved in induction of a humoral immune response (IL-10), but not of cytokines that are required for Th1 immunity (IL-12) or Th2 immunity (IL4)
It is clearly shown that beyond whatever activation occurs in tissue culture, the graft materials tested induce a variable level of activation. Because activation of such cells of the innate immune system is key to their immunological activity, this study shows that sensitive monitoring of monocytes activity in response to such materials can be done in vitro
Summary
One means of treating osteoarthritis is with autologous or allogeneic osteochondral grafts. There are various methods for repairing cartilage defects in patients with osteoarthritis or other degenerative joint disease One such method is mosaicplasty, which consists of the use of osteochondral grafting with autogenous [13] or allogeneic [4,5,6] implants. BMC Musculoskeletal Disorders 2005, 6:36 http://www.biomedcentral.com/1471-2474/6/36 with the use of both autogenous grafts due to the need to harvest the osteochondral implants from a joint or part of a joint that is otherwise healthy, and for allogeneic materials with respect to disease transmission. Both of these graft types have a limited availability. Cartilage fusion between graft and host was observed for the photooxidized implants, but not for the untreated xenogeneic and autogeneic implants
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