Background: Osteoarthritis (OA) is widely prevalent, as 14 million people suffer from knee osteoarthritis in the United States alone. Though attention has been paid to inflammation, processes that mediate thrombosis and oxidative stress have become increasingly important pathogenic factors. Integrated data on these 2 processes is not available in patients with osteoarthiritis.

Aims: Therefore, we determined circulating levels of biomarkers of oxidative stress and thromboinflammation in patients undergoing joint arthroplasty compared with normal population.

Methods: Deidentified venous blood was collected at 3 different draw dates (day 0, day 1 post-operatively, and day 5-7 post-operatively) from patients undergoing TJA due to OA (n=73). Venous blood from 5 healthy volunteers were drawn. The samples were collected in vacutainer tubes containing EDTA, plasma was separated from blood via centrifugation, and then were frozen and thawed in batches for analysis. The samples were analyzed using ELISA kits for NLRP-3, Nitrotyrosine, MDA, ADMA; Chlorination assay was used for MPO.   D-dimer, VWF, MPTF, PAI-1, NLP 9, fibronectin and CRP were also measured by using ELISA methods.   
Data was analyzed using GraphPad Prism, and Microsoft Excel. Each variable was correlated using 2-tailed Spearman’s rho correlation. Percent and fold change relative to EDTA control samples were calculated.

Results: Among the oxidative stress biomarkers, nitrotyrosine showed significantly higher levels and other biomarkers showed modest elevation. The thromboinflammatory biomarkers showed markedly higher levels in D-Dimer, CRP, MPTF, PAI-1 and variable modest increase in other biomarkers (Table 1).  In addition, only 3 correlations showed significance (Nitrotyrosine with vWF p=0.042, MDA with PAI-1 p=0.011, and MPO with NLRP-3 p=0.045 – data not shown), however they were very weakly correlated.

Tabulated Data

Conclusions: The substantial elevation in D-dimer and CRP with the role of thrombosis and inflammation in the pathogenesis of OA. In terms of correlating biomarkers, our study suggests three weak yet significant correlations.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/evaluation-of-oxidative-stress-thrombosis-and-inflammation-in-patients-with-end-stage-osteoarthritis/