Involvement of extracellular Hsp72 in wear particle-mediated osteolysis.

Wear particle-mediated osteolysis is one of the major problems affecting long-term survival of orthopaedic prostheses, frequently progressing to failure of fixation and revision surgery. Upon challenging with wear particles, macrophages and various other types of cells release soluble factors that stimulate the resorptive activity of osteoclasts and impair the function and activity of osteoblasts. Extracellular Hsp72 has been reported to activate macrophages and up-regulate pro-inflammatory cytokine production, although its role in osteolysis has not been established yet. The purpose of our study was to evaluate the involvement of this protein in the inflammatory response to wear particles that leads to periprosthetic osteolysis. To this end, we used interfacial tissues and blood samples from patients undergoing revision surgery due to aseptic loosening of cementless acetabular cups. Confocal microscopy indicated that Hsp72 co-localises with CD14(+) cells of interfacial tissues. Levels of Hsp72 in the culture media from periprosthetic membranes cultured ex vivo decreased along culture time and Hsp72 levels in sera from patients were lower and under the assay detection limit compared with those from age-matched control subjects. This suggests that interfacial tissues are not actively producing the protein but likely recruit it from peripheral circulation. Incubation of human macrophages with titanium (Ti) particles decreased the release of Hsp72 into culture media. Treatment with recombinant human Hsp72 enhanced considerably IL-6 levels in culture media which were not modified after macrophage co-stimulation with Ti particles, while pre-incubation with Hsp72 increased the Ti particle-induced TNF-α and IL-1β production. Altogether, these data indicate that extracellular Hsp72 amplifies the inflammatory response to wear debris by interacting with resident macrophages in periprosthetic tissues.