Abstract
BackgroundObesity increases the risk for knee and hip joint implantation and negatively contributes to wound healing. In this study, in 52 patients undergoing hip and knee arthroplasty the amount of peripheral immune effector cells pre- and post-operative, as well as the expression of certain soluble factors affecting the functions of immune effector cells were investigated.MethodsThe peripheral immune cells and the expression of the soluble factors were determined by flow cytometry and correlated to each other in dependency of the BMI, the sex, and the kind of arthroplasty.ResultsThe pre-operative amounts of peripheral NK cells and cytotoxic T cells significantly decreased with increasing BMI. Furthermore, the expression of the immunomodulatory adipokine leptin nicely correlated to the BMI. These effects were stronger in males than in females. Furthermore, the correlation of the activation marker sTNF-R and peripheral T cells strongly decreased with increasing BMI. While IL-6, CD40L, and MPO were significantly induced after surgery, there were no correlations to the BMI.ConclusionsThe known wound-healing problems in obese patients and the osteoarthritis per se can be linked to the BMI. While obese patients exerted reduced peripheral NK cells and cytotoxic T cells (CTLs), IL-6 showed no involvement. However, the adipokine leptin strongly increased with the BMI strengthening its role as immunomodulatory molecule negatively interfering the functions of immune effector cells.
Highlights
Obesity increases the risk for knee and hip joint implantation and negatively contributes to wound healing
Our group could demonstrate that natural killer (NK) cells express the functional isoform of the leptin receptor (ObRb) [9] and a short-term stimulation of NK cells with
While IL-2 is mainly expressed in T helper (Th) cells, IL-15 is constitutively expressed by certain immune cell populations including monocytes, macrophages, and dendritic cells [15]
Summary
Obesity increases the risk for knee and hip joint implantation and negatively contributes to wound healing. In 52 patients undergoing hip and knee arthroplasty the amount of peripheral immune effector cells pre- and post-operative, as well as the expression of certain soluble factors affecting the functions of immune effector cells were investigated. Recent studies demonstrated the correlation between obesity and the prevalence of the arthrosis mediated need for an artificial hip and knee joint implantation [2]. It could be demonstrated that obesity is linked with postoperative wound healing complications of hip and knee arthroplasty [3]. Our group could demonstrate that natural killer (NK) cells express the functional isoform of the leptin receptor (ObRb) [9] and a short-term stimulation of NK cells with
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