Do Genetic Susceptibility, Toll-like Receptors, and Pathogen-associated Molecular Patterns Modulate the Effects of Wear?
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Do Genetic Susceptibility, Toll-like Receptors, and Pathogen-associated Molecular Patterns Modulate the Effects of Wear?Edward M. GreenfieldSymposium: ABJS Carl T. Brighton Workshop on Implant Wear and Tribocorrosion of Total Joint ReplacementsDOI:
10.-014-3786-4Cite this article as: Greenfield, E.M. Clin Orthop Relat Res (: 3709. doi:10.-014-3786-4
Overwhelming evidence supports the concept that wear particles are the primary initiator of aseptic loosening of orthopaedic implants. It is likely, however, that other factors modulate the biologic response to wear particles. This review focuses on three potential other factors: genetic susceptibility, Toll-like receptors (TLRs), and bacterial pathogen-associated molecular patterns (PAMPs).Considerable evidence is emerging that both genetic susceptibility and TLR activation are important factors that modulate the biologic response to wear particles, but it remains controversial whether bacterial PAMPs also do so.Detailed understanding of the roles of these other factors may lead to identification of novel therapeutic targets for patients with aseptic loosening.Highest priority should be given to polymorphism replication studies with large numbers of patients and studies to replicate the reported correlation between bacterial biofilms and the severity of aseptic loosening.1.Alley C, Haggard W, Smith R. Effect of UHMWPE particle size, dose, and endotoxin on in vitro macrophage response. J Long Term Eff Med Implants. -56.2.Anonymous. Orthopaedic device forum meeting summation report. 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