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Journal of Orthopaedic Surgery and... Dec 2019Synovial fluid proteins had been applied as diagnostic biomarkers for periprosthetic joint infection (PJI) in recent research papers. Thus, this meta-analysis aimed to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Synovial fluid proteins had been applied as diagnostic biomarkers for periprosthetic joint infection (PJI) in recent research papers. Thus, this meta-analysis aimed to estimate the diagnostic efficiency of synovial fluid α-defensin and leukocyte esterase (LE) for PJI.
METHODS
We conducted our systematic review by searching the keywords in online databases such as PubMed, Embase, Cochrane, Elsevier, Springer, and Web of Science from the time of database inception to October 2018. Inclusion criteria were as follows: patients who have undergone knee, hip, or shoulder joint replacements; α-defensin or leukocyte esterase (LE strip) of synovial fluid was detected as the biomarker for PJI diagnosis; and Musculoskeletal Infection Society (MSIS) or utilizing a combination of clinical data was considered as the gold standard. Diagnostic parameters including sensitivity, specificity, diagnostic odds ratio (DOR), and area under the summary of receiver operating characteristics curve (AUSROC) were calculated for the included studies to evaluate the synovial fluid α-defensin and LE for PJI diagnosis.
RESULTS
After full-text review, 28 studies were qualified for this systematic review, 16 studies used α-defensin and the other 12 were conducted using LE strip. The pooled sensitivity, specificity, and DOR of LE strip were 87% (95% CI 84-90%), 96% (95% CI 95-97%), and 170.09 (95% CI 97.63-296.32), respectively, while the pooled sensitivity, specificity, and DOR of α-defensin were 87% (95% CI 83-90%), 97% (95% CI 96-98%), and 158.18 (95% CI 74.26-336.91), respectively. The AUSROC for LE strip and α-defensin were 0.9818 and 0.9685, respectively.
CONCLUSION
Both LE strip and α-defensin of synovial fluid provide rapid and convenient diagnosis for PJI. Sensitivity of α-defensin and LE strip are the same, while both these two methods have high specificity in clinical practice.
Topics: Carboxylic Ester Hydrolases; Hip Prosthesis; Humans; Knee Prosthesis; Prosthesis-Related Infections; Reproducibility of Results; Shoulder Prosthesis; Synovial Fluid; alpha-Defensins
PubMed: 31856885
DOI: 10.1186/s13018-019-1395-3 -
BMC Medical Genetics Sep 2019Rotator cuff disease is a widespread musculoskeletal pathology and a major cause of shoulder pain. Studies on familial predisposition suggest that genetic plays a role... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Rotator cuff disease is a widespread musculoskeletal pathology and a major cause of shoulder pain. Studies on familial predisposition suggest that genetic plays a role in the pathogenesis of rotator cuff disease. Several genes are responsible for rotator cuff disease. The aim of this study was to perform a systematic review on genetic association between rotator cuff disease and genes variations.
METHODS
A systematic review of the literature was performed, in accordance with the PRISMA guidelines. PubMed, Medline, CINAHL, Cochrane, Embase and Google Scholar databases were searched comprehensively using the keywords: "Rotator cuff", "Gene", "Genetic", "Predisposition", "Single-nucleotide polymorphism" and "Genome-wide association".
RESULTS
8 studies investigating genes variations associated with rotator cuff tears were included in this review. 6 studies were case-control studies on candidate genes and 2 studies were GWASs. A significant association between SNPs and rotator cuff disease was found for DEFB1, FGFR1, FGFR3, ESRRB, FGF10, MMP-1, TNC, FCRL3, SASH1, SAP30BP, rs71404070 located next to cadherin8. Contradictory results were reported for MMP-3.
CONCLUSION
Further investigations are warranted to identify complete genetic profiles of rotator cuff disease and to clarify the complex interaction between genes, encoded proteins and environment. This may lead to individualized strategies for prevention and treatment of rotator cuff disease.
LEVEL OF EVIDENCE
Level IV, Systematic Review.
Topics: Cadherins; Databases, Factual; Fibroblast Growth Factor 10; Genetic Variation; Genome-Wide Association Study; Humans; Matrix Metalloproteinase 1; Nuclear Proteins; Polymorphism, Single Nucleotide; Receptor, Fibroblast Growth Factor, Type 1; Receptor, Fibroblast Growth Factor, Type 3; Receptors, Estrogen; Receptors, Immunologic; Rotator Cuff; Rotator Cuff Injuries; Tenascin; Transcription Factors; Tumor Suppressor Proteins; beta-Defensins
PubMed: 31477042
DOI: 10.1186/s12881-019-0883-y -
Archives of Orthopaedic and Trauma... Mar 2020Two methods are currently available for the assay of α-defensin: the enzyme-linked immunosorbent assay (ELISA) and the lateral flow test. We aimed to assess the... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Two methods are currently available for the assay of α-defensin: the enzyme-linked immunosorbent assay (ELISA) and the lateral flow test. We aimed to assess the diagnostic accuracy of synovial fluid α-defensin and to compare the accuracy of the laboratory-based test and the qualitative assessment for the diagnosis of hip and knee prosthetic infection.
MATERIALS AND METHODS
We searched (from inception to May 2018) MEDLINE, Scopus, EMBASE, Web of Science, and Cochrane for studies on α-defensin in the diagnosis of periprosthetic joint infection (PJI). Sensitivity, specificity, positive and negative likelihood ratio (LR), and diagnostic odds ratio were analyzed using the bivariate diagnostic random-effects model. The receiver-operating curve for each method was calculated.
RESULTS
We included 13 articles in our meta-analysis, including 1170 patients who underwent total hip and knee arthroplasties revision; 368 (31%) had a joint infection according to MSIS and MSIS-modified criteria. Considering the false-positive result rate of 8% and false-negative result rate of 3%, pooled sensitivity and specificity were 0.90 (95% CI 0.83-0.94) and 0.95 (0.92-0.96), respectively. The area under the curve (AUC) was 0.94 (0.92-0.94). No statistical differences in terms of sensitivity and specificity were found between the laboratory-based and qualitative test. The pooled sensitivity and specificity of the two alpha-defensin assessment methods were: laboratory-based test 0.97 (95% CI 0.93-0.99) and 0.96 (95% CI 0.94-0.98), respectively; qualitative test 0.83 (95% CI 0.73-0.91) and 0.94 (95% CI 0.89-0.97), respectively. The diagnostic odds ratio of the α-defensin laboratory based was superior to that of the qualitative test (1126.085, 95% CI 352.172-3600.702 versus 100.9, 95% CI 30.1-338.41; p < 0.001). The AUC for immunoassay and qualitative tests was 0.97 (0.95-0.99) and 0.91 (0.88-0.99), respectively.
CONCLUSION
Detection of α-defensin is an accurate test for diagnosis of hip and knee prosthetic infections. The diagnostic accuracy of the two alpha-defensin assessment methods is comparable. The lateral flow assay is a valid, rapid, and more available diagnostic tool, particularly to rule out PJI.
Topics: Biomarkers; Hip Joint; Hip Prosthesis; Humans; Knee Joint; Knee Prosthesis; Prosthesis-Related Infections; Sensitivity and Specificity; Synovial Fluid; alpha-Defensins
PubMed: 31300864
DOI: 10.1007/s00402-019-03232-5 -
Journal of Periodontal Research Dec 2019The purpose of this systematic review was to establish if patients suffering from periodontal diseases present differences in the expression or production of cationic...
The purpose of this systematic review was to establish if patients suffering from periodontal diseases present differences in the expression or production of cationic antimicrobial peptides in saliva, gingival fluid, and periodontal tissues. Periodontal diseases are among the most common chronic diseases worldwide and share similar etiological or risk factors (genetic and/or environmental) with other systemic disorders. Over the last decade, an increasing number of publications have suggested the implication of antimicrobial peptides (AMPs) in periodontal and oral tissues conditions. Literature searches were conducted through MEDLINE-PubMed and EMBASE databases which identified 1267 publications. Only clinical studies that focused on assays of the expression and/or production of AMPs in human adult oral fluids (gingival crevicular fluid or saliva) or in oral tissues were retained and finally seventy-four publications meeting inclusion criteria were included. Cathelicidin, α- and β-defensins 1-3 are the most documented AMPs regarding periodontal status. Significant correlations between clinical periodontal indexes (PD, CAL) and/or bacteriological index and LL37 level were retrieved. Data remain inconsistent between the studies for hBDs mainly due to heterogeneity of the results, periodontal disease diagnostic criteria and assaying technique employed. Given their role in innate immunity and their antimicrobial functions, LL-37 and α-defensins may be eligible as periodontal clinical biomarkers and could be an interesting way for therapeutic development.
Topics: Antimicrobial Cationic Peptides; Gingival Crevicular Fluid; Humans; Periodontal Diseases; Periodontal Index; Saliva
PubMed: 31215656
DOI: 10.1111/jre.12676