Research Article
Volume 3 Issue 1 - 2020
Validation of a LC-MS Assay Applied to Synovial Fluid for Detection for Periprosthetic Joint Infection
Riccardo Dall’Anese1*, Giuseppe Bartolini1, Fiamma Balboni1, Massimo Quercioli2, Giovanni Balato3, Paola Pezzati2 and Andrea Baldini4
1Istituto Fiorentino Cura ed Assistenza Firenze (iFCA), Laboratorio Analisi Chimico-Cliniche, Via Del Pergolino, Florence, Italy
2Centro Regionale di Riferimento SOD Sicurezza e Qualità. Azienda Ospedaliero Universitaria Careggi, Via delle Oblate, Florence, Italy
3Università Federico II di Napoli, Scuola di Medicina e Chirurgia, Dipartimento di Sanità Pubblica, Via Pansini, Naples, Italy
4Istituto Fiorentino Cura ed Assistenza Firenze (iFCA), UO Ortopedia, Via Del Pergolino, Florence, Italy
*Corresponding Author:Riccardo Dall’Anese, Istituto Fiorentino Cura ed Assistenza Firenze (iFCA), Laboratorio Analisi Chimico-Cliniche, Via Del Pergolino, Florence, Italy.
Received: November 25, 2019; Published: December 18, 2019




Abstract

The presence of Alpha defensin in synovial fluids are a potential biomarker for identification of periprosthetic infections: the identification method are based on proteomic test after enzymatic digestion of synovial fluid. The method can be used as screening method on all patients undergoing prosthetic review to distinguish cases of inflammation from infection with alternative methods (clinical or ELISA test). The preliminary step of research it’s the check of uniqueness of possible peptide derived from trypsin digestion of alpha denesin. This step of work was performed on real positive sample (compared with negative sample to confirm): after a sample preparation, the detection of peptide was carried out by liquid chromatography - time of flight mass spectrometry (LC-QTOF). The obtained data have been developed by proteomic software to identify the uniqueness biomarker peptide for alpha defensin and ensure that aren’t any other human proteins able to generate identical or similar peptide after tryptic digestion. The analytical method was subsequently validated according to the CLSI and FDA guidelines in order to verify the method specifications in accordance with the requirements for the application of the method in diagnostic protocols.

Keywords: Synovial Fluid (SF); LC-MS Assay; Periprosthetic Joint Infection

References

  1. Blewis ME., et al. “A model of synovial fluid lubricant composition in normal and injured joints”. European Cells and Materials 13 (2007): 26-39.
  2. Watterson JR and Esdaile JM. “Viscosupplementation: therapeutic mechanisms and clinical potential in osteoarthritis of the knee”. The Journal of the American Academy of Orthopaedic Surgeons 8 (2000): 277-284.
  3. Mazzucco D., et al. “Composition of joint fluid in patients undergoing total knee replacement and revision arthroplasty: correlation with flow properties”. Biomaterials 25 (2004): 4433-4445.
  4. ME Margaretten., et al. “Does this adult patient have septic arthritis?” Journal of the American Medical Association 297 (2007): 1478-1488.
  5. E Pascual and V Jovaní. “Synovial fluid analysis”. Best Practice and Research: Clinical Rheumatology 19 (2005): 371-386.
  6. J Parvizi., et al. “New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society”. Clinical Orthopaedics and Related Research 469 (2011): 2992-2994.
  7. PJ Monaghan., et al. “Biomarker development targeting unmet clinical needs”. Clinica Chimica Acta 460 (2016): 211-219.
  8. C Deirmengia., et al. “Diagnosing periprosthetic joint infection: has the era of the biomarker arrived?” Clinical Orthopaedics and Related Research 472 (2014): 3254-3262.
  9. J Bingham., et al. “The Alpha Defensin-1 Biomarker Assay can be Used to Evaluate the Potentially Infected Total Joint Arthroplasty”. Clinical Orthopaedics and Related Research 472 (2014) 4006-4009.
  10. Lehrer RI and Ganz T. “Defensins: endogenous antibiotic peptides from human leukocytes”. Ciba Found Symptoms 171 (1992): 276-293. 
  11. Selsted ME., et al. “Structure, function, and membrane integration of defensins”. Current Opinion in Structural Biology 5 (1995): 521-527.
  12. Bowdish DM1., et al. “Immunomodulatory properties of defensins and cathelicidins”. Current Topics in Microbiology and Immunology 306 (2006): 27-66.
  13. Shahi A., et al. “The alpha-defensin test for periprosthetic joint infections is not affected by prior antibiotic administration”. Clinical Orthopaedics and Related Research 47 (2016): 1610-1615.
  14. Drago L., et al. “α-Defensin point-of-care test for diagnosis of prosthetic joint infections: neglected role of laboratory and clinical pathologists”. Clinical Chemistry and Laboratory Medicine 56.1 (2017): 19-24.
  15. Bonanzinga T., et al. “How Reliable Is the Alpha-defensin Immunoassay Test for Diagnosing Periprosthetic Joint Infection? A Prospective Study”. Clinical Orthopaedics and Related Research 475 (2017): 408-415.
  16. Suen K., et al. “Quick test” is not as accurate as the laboratory-based alpha defensin immunoassay: a systematic review and meta-analysis”. The Bone and Joint Journal 100-B.1 (2018): 66-72.
  17. Yuan J., et al. “Diagnostic accuracy of alpha-defensin in periprosthetic joint infection: a systematic review and meta-analysis”. International Orthopaedics 41 (2017): 2447-2455.
  18. Goebel C., et al. “Determination of defensin HNP-1, HNP-2 and HNP-3 in human saliva by using LC/MS”. Peptides 21 (2000): 757-765.
  19. MRC Marques., et al. “Simulated biological fluids with possible application in dissolution testing”. Dissolution Tech (2011): 15-28.
  20. EL Bortel., et al. “Development of a synthetic synovial fluid for tribological testing”. Lubricants 3 (2015): 664-686.
  21. CLSI EP15-A3. “User verification of precision and estimation of bias approved guidelines”. Third Edition (2014).
  22. CLSI EP 17-A2 “Evaluation of detection capability for clinical laboratory measurement procedures approved guidelines”. Second edition (2012). 
  23. Bingham J., et al. “The alpha defensin-1 biomarker assay can be used to evaluate the potentially infected total joint arthroplasty”. Clinical Orthopaedics and Related Research 472 (2014): 4006-4009.
  24. Deirmengian C., et al. “Combined measurement of synovial fluid α-defensin and C-reactive protein levels: highly accurate for diagnosing periprosthetic joint infection”. Journal of Bone and Joint Surgery 96 (2014): 1439-1445.
  25. Bossuyt PM. “Clinical validity: defining biomarker performance”. Scandinavian Journal of Clinical and Laboratory Investigation 242 (2010): 46-52.
  26. Kasparek MF., et al. “Intraoperative diagnosis of periprosthetic joint infection using a novel alpha-defensin lateral flow assay”. The Journal of Arthroplasty 31 (2016): 2871-2874.
  27. Bossuyt PM., et al. “STARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies”. Clinical Chemistry 61.12 (2015): 1446-1452.
  28. Whiting PF., et al. “QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies”. Annals of Internal Medicine 155.8 (2011): 529-536.
Citation: Riccardo Dall’Anese., et al. “Validation of a LC-MS Assay Applied to Synovial Fluid for Detection for Periprosthetic Joint Infection”. EC Clinical and Medical Case Reports 3.1 (2020): 01-14.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


April Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the April issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before April 22, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk