Chronic inflammation in biomaterial-induced periprosthetic osteolysis: NF-κB as a therapeutic target

Acta Biomater. 2014 Jan;10(1):1-10. doi: 10.1016/j.actbio.2013.09.034. Epub 2013 Oct 1.

Abstract

Biomaterial-induced tissue responses in patients with total joint replacement are associated with the generation of wear particles, which may lead to chronic inflammation and local bone destruction (periprosthetic osteolysis). Inflammatory reactions associated with wear particles are mediated by several important signaling pathways, the most important of which involves the transcription factor NF-κB. NF-κB activation is essential for macrophage recruitment and maturation, as well as the production of pro-inflammatory cytokines and chemokines such as TNF-α, IL-1β, IL-6 and MCP1. In addition, NF-κB activation contributes to osteoclast differentiation and maturation via RANK/RANKL signaling, which increases bone destruction and reduces bone formation. Targeting individual downstream cytokines directly (such as TNF-α or IL-1β) may not effectively prevent wear particle induced osteolysis. A more logical upstream therapeutic approach may be provided by direct modulation of the core IκB/IKKα/β/NF-κB signaling pathway in the local environment. However, the timing, dose and strategy for administration should be considered. Suppression of chronic inflammation via inhibition of NF-κB activity in patients with malfunctioning joint replacements may be an effective strategy to mitigate wear particle induced periprosthetic osteolysis.

Keywords: Biomaterials; Chronic inflammation; NF-κB; Periprosthetic osteolysis.

Publication types

  • Review

MeSH terms

  • Animals
  • Biocompatible Materials / adverse effects*
  • Chronic Disease
  • Humans
  • Inflammation / etiology*
  • Joint Prosthesis / adverse effects*
  • NF-kappa B / metabolism*
  • Osteolysis / etiology*
  • Osteolysis / therapy*
  • Signal Transduction / drug effects

Substances

  • Biocompatible Materials
  • NF-kappa B