IL-17 cytokines in bone healing of diabetic Charcot arthropathy patients: a prospective 2 year follow-up study

Journal of Foot and Ankle Research

Jean Cassuto⁴  Jan Göthlin⁵  Ylva Aurell⁵  Jesper Fowelin¹  Susanne Asteberg³  Martin Ålund³  Agnetha Folestad² 

[1] Diabetes Care Unit, Department of Medicine, Frölunda Specialist Hospital, Västra Frölunda, Göteborg, Sweden;Department of Orthopaedics, CapioLundby Hospital, Göteborg, Sweden;Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden;Orthopaedic Research Unit, Sahlgrenska University Hospital, Staben, Hus U1, 431 80 Mölndal, Sweden, Göteborg University, Göteborg, Sweden;Department of Radiology, Sahlgrenska University Hospital, Mölndal, Sweden

关键词: Diabetes;    Interleukin-17;    Offloading;    Bone healing;    Charcot arthropathy;   

Others  :  1224860
DOI  :  10.1186/s13047-015-0096-3

 received in 2015-03-03, accepted in 2015-08-04,  发布年份 2015

【 摘 要 】

Background

Little is currently known of the pathophysiological mechanisms triggering Charcot arthropathy and regulating its recovery although foot trauma has been proposed as a major initiating factor by activation of proinflammatory cytokines leading to increased osteoclastogenic activity and progressive bone destruction. Several members of the IL-17 family of proinflammatory cytokines have been shown to play a key role in the pathogenesis of inflammatory conditions affecting bone and joints but none has previously been studied in Charcot foot patients. The aim of this study was to investigate the role of IL-17A, IL-17E and IL-17F in patients presenting with Charcot foot.

Methods

Twenty-six consecutive Charcot patients were monitored during 2 years by repeated foot radiographs, MRI and circulating levels of IL-17A, IL-17E and IL-17F. Analysis of cytokines was done by ultra-sensitive chemiluminescence technique and data were analyzed by one-way repeated measures ANOVA. Neuropathic diabetic patients (n = 20) and healthy subjects (n = 20) served as controls.

Results

Plasma IL-17A and IL-17E in weight-bearing Charcot patients at diagnosis were at the level of diabetic controls, whereas IL-17F was significantly lower than diabetic controls. A significant increase in IL-17A and IL-17E reaching a peak 2–4 months after inclusion and start of offloading treatment in Charcot patients was followed by a gradual decrease to the level of diabetic controls at 2 years postinclusion. In contrast, IL-17F increased gradually from inclusion to a level not significantly different from diabetic controls after 2 years.

Conclusions

Charcot patients display a significant elevation of all three IL-17 cytokines during the follow-up period relative values at diagnosis and values in control patients supporting a role in the bone repair and remodeling activity during the recovery phase. The rapid increase of IL-17A and IL-17E shortly after initiating off-loading treatment could suggest this to be a response to immobilization and stabilization of the diseased foot.

【 授权许可】

   
2015 Folestad et al.

【 图 表 】

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