• J. Investig. Med. · Jun 2021

    Assessment of synovial fluid and serum cytokine levels in children with septic arthritis.

    • Walter Dehority, Scott Plaster, Kathryn C Helmig, Nathan Huff, Andrew Parsons, Susan L Tigert, and Selina Silva.
    • Pediatrics, University of New Mexico, Albuquerque, New Mexico, USA WDehority@salud.unm.edu.
    • J. Investig. Med. 2021 Jun 1; 69 (5): 1059-1062.

    AbstractAcute septic arthritis (ASA) is a common orthopedic infection of children which may produce devastating sequelae and chronic morbidity. Improved understanding of the intra-articular inflammatory response in ASA may identify cytokine targets with diagnostic or therapeutic potential, though no detailed investigations to this end have been performed. Given this, we used a multiplex cytokine assay for assessment of levels of 40 different cytokines in the synovial fluid and blood of children with ASA. Twelve children (8 controls undergoing orthopedic surgery for non-infectious conditions and 4 with ASA) were prospectively enrolled. Blood and synovial fluid were collected intraoperatively from each subject, and the levels of 40 cytokines were determined using a multiplex assay. Cytokines were organized by function and structure into 12 groups for analysis. The Benjamini-Hochberg method was used to control for type 1 errors, with an a priori false discovery rate of 10%. Subjects with ASA were younger than controls (mean age 8.0 vs 13.1 years, p=0.0400). Significant elevations were seen in interleukins (IL) with chemokine properties, IL-6 and those in the common-γ chain group in the blood and synovial fluid of children with ASA compared with controls, while significant elevations in 5 additional cytokine groups were seen in synovial fluid from children with ASA compared with controls, most notably IL-6 (median 8294.3 vs 10.7 pg/mL, p=0.0066). Our pilot study is the first to describe in detail the cytokine response in children with ASA, and highlights the need for additional study.© American Federation for Medical Research 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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