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Periprosthetic osteolysis
Veigl, David ; Vavřík, Pavel (advisor) ; Vencovský, Jiří (referee) ; Koudela, Karel (referee)
Periprosthetic osteolysis remains the leading complication of total hip arthroplasty. It often results in aseptic loosening of the implant with a requirement for a revision surgery. Wear-generated particular debris is the main cause of initiating this destructive process. The most important cellular target for wear debris is a macrophage, which responds to particle challenge by activatig proinflamatory signals, which contribute to increased bone resorption. The activation of the RANKL/RANK/OPG system is considered to be a likely cause of periprosthetic osteolysis leading to implant failure. The aim of this study was to examine the possible correlation between the clinical extent of osteolysis, the number of wear particles and the expression of the osteoclastic mediator RANKL in the tissues around aseptically loosened cemented and non-cemened total hip replacements. Periprosthetic tissues were harvested from 59 patients undergoing revision hip replacement for aseptic loosening. We had observed RANKL-positive cells in 23 of our 59 patients, their presence was noted predominantly in tissues with a loosened cemented endoprosthesis. We have shown that RANKL is present only in the tissues with a large amount of wear debris and predominantly in the cases involving lacunar type of osteolysis. Key words:...
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Correlation of cytokine gene polymorphisms and bronchoalveolar lavage fluid gene expression profiles in patients with interstitial lung diseases
Slimáčková, Eva ; Vašáková, Martina (advisor) ; Vencovský, Jiří (referee)
Idiopathic pulmonay fibrosis (IPF), extrinsic alergic alveolitis (EAA) and sarcoidosis are interstitial lung diseases (ILD) of distinct pathogenesis. While IPF represents primarily fibrosing lung disorder of unknown etiology with dominant Th2 cytokine milieu, sarcoidosis is a systemic disease presenting with noncaseating granulomas and Th1 cytokine pattern. EAA develops after repeated exposure to inhalation antigens, and can present either with a granulomatous formation or progressive pulmonary fibrosis according to the stage of the disease and relationship between antigen exposure and immune system status. Th1/Th2 imbalance is dominant feature of these ILDs and we suppose that the susceptibility to them could be genetically encoded in cytokine gene polymorphisms. Cytokine gene polymorphisms could influence cytokine protein expression, which might lead to imbalance of Th1/Th2 immune reactions. Enhanced Th2 type cytokine production might induce the alternative activation of alveolar macrophages (AM), with consequent stimulation of colagen production by fibroblasts. the way from gene to protein leads through messenger RNA (mRNA) expression. Results of the pilot studies suggest that expression profiling could help to identify pathways relevant to pathogenesis of these disorders. The aim of our study was to...
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Mechanisms of muscle inflammation and clinical manifestations in patients polymyositis and dermatomyositis
Studýnková-Tomasová, Jana ; Vencovský, Jiří (advisor) ; Bartůňková, Jiřina (referee) ; Hrnčíř, Zbyněk (referee)
Idiopathic inflammatory myopathies (IIM) is a heterogeneous group of acquired diseases with varying course and prognosis nehnisavým caused by inflammation of striated muscle. Clinically they are characterized primarily by proximal muscular weakness. On the basis of specific clinical, histopathological, immunological and demographic features of the breakers can be divided into three subgroups dermatomyositis (DM), polymyositis (PM) and inclusion bodies with myositis (IBM). The aetiology of these diseases is unknown and there is also rooted difficulties with their treatment. The common objective of the project was to try to map out the mechanisms leading to inflammatory infiltration of muscles, muscle tissue edema and tissue damage, and subsequently to clinical manifestations of disease in patients with PM and DM.
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