26dkou392
10.3205/26dkou392
urn:nbn:de:0183-26dkou3926
Meeting Abstract
Systemic metal exposure is associated with elevated circulating cytokines and distinct immune signatures in arthroplasty patients
Tavakina
Tavakina
Anastasia
A
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Kasabji
Kasabji
Feras
F
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Rackow
Rackow
Anastasia
A
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Alsadat Hosseini
Alsadat Hosseini
Behnaz
B
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Sendler
Sendler
Mathias
M
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Huesker
Huesker
Katrin
K
IMD Institut für Medizinische Diagnostik Berlin-Potsdam, Berlin, Deutschland
author
Völker
Völker
Uwe
U
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Wassilew
Wassilew
Georgi
G
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Bröker
Bröker
Barbara
B
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Ameling
Ameling
Sabine
S
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
Schoon
Schoon
Janosch
J
Universitätsmedizin Greifswald, Greifswald, Deutschland
author
German Medical Science GMS Publishing House
Düsseldorf
610
20261020
engl
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung).
M0659
392
Deutsche Gesellschaft für Orthopädie und Unfallchirurgie
Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie
Deutsche Gesellschaft für Unfallchirurgie
Berufsverband für Orthopädie und Unfallchirurgie
Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026)
Grundlagenforschung | Implantate & Biomaterialien
Berlin
20261020
20261023
DKOU26_Abs_2180
TextObjectives and questions: Arthroplasty substantially improves patients’ quality of life, yet wear and corrosion of metallic implant components can result in the release of metal ions and particles, potentially triggering immune responses. Although local and systemic effects of metal release have been described, the systemic consequences of metal exposure in arthroplasty patients remain poorly understood, particularly regarding their potential impact on systemic inflammation. Reliable systemic biomarkers to assess metal-related immune alterations are still lacking. This study aimed to quantify metal levels and cytokines in peripheral blood to investigate how arthroplasty-related metal exposure alters systemic inflammatory patterns. The objective was to identify systemic cytokine signatures that may serve as candidate markers of metal-associated immune activation.Material and methods: In the course of this single-center observational study, peripheral blood samples from 150 patients scheduled for primary or revision arthroplasty (hip, knee or shoulder) were analysed. Patients without any pre-existing implant (N=39) and patients undergoing revision arthroplasty (N=111), including septic (N=16) and aseptic (N=95) revision cases, were assigned. Whole blood levels of 10 arthroplasty-relevant metals were quantified by mass spectrometry, and plasma levels of 47 cytokines were measured using a multiplex immunoassay. Cytokine patterns were assessed by clustering and correlated with metal levels. Associations were evaluated using multivariable linear regression adjusting for age, sex, prosthetic joint infection, lymphocyte count, CRP, and season.Results: Systemic levels of cobalt, chromium, titanium, niobium, and zirconium were significantly higher in patients with arthroplasty implants compared with implant-naïve patients. Selective associations were observed, most notably between cobalt and IL-8 and between several metals and IL-15. Cytokine clustering revealed four distinct immune modules, including a proinflammatory cluster enriched in patients with implants. Multivariate linear regression demonstrated that metal exposure was associated with IL-1RA, IL-8, IL-15, and the proinflammatory cluster, while age, CRP levels, PJI status, and seasonal variation additionally contributed to IL-8, IL-15, and cluster variability. IL-1RA levels were not significantly influenced by these predictors.Discussion and conclusions: Arthroplasty-related metal exposure was associated with selective systemic cytokine elevations, most prominently IL-8, IL-15, and IL-1RA. These mediators reflect neutrophil chemotaxis (IL-8), adaptive lymphocyte activation (IL-15), and compensatory anti-inflammatory regulation (IL-1RA), indicating a low-grade but measurable systemic immune response in exposed patients. Blood-based cytokine signatures may therefore serve as complementary biomarkers of implant-related immune activation.
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