Elevation of Inflammatory Cytokines and Proteins after Intra-Articular Ankle Fracture: A Cross-Sectional Study of 47 Ankle Fracture Patients
Table 2
Cytokine level in implant removal compared to fractured and healthy contralateral ankles.
Implant removal ankles pg/mL median (IQR)
Fractured ankles pg/mL median (IQR)
Contralateral ankles pg/mL median (IQR)
Cytokine ratio (fracture/implant removal)
Cytokine ratio (implant removal/contralateral)
value (fractured vs implant removal)
value (implant removal vs contralateral)
Proinflammatory
IL-1α
0.0135 (0.000)
0.0012 (0.013)
0.0071 (0.0000)
0.6
1.9
0.070
0.0003
IL-1β
0.67 (0.00)
4.98 (7.96)
0.13 (0.000)
185.0
2.0
<0.0001
<0.0001
IL-2
0.71 (0.00)
3.30 (5.36)
0.48 (0.00)
6.3
1.4
0.006
<0.0001
IL-6
0.48 (2.74)
1914.6 (1357.2)
0.22 (0.00)
72.0
5.4
<0.0001
0.0019
IL-8
1.16 (2.73)
490.8 (905.5)
1.06 (1.37)
171.2
1.3
<0.0001
0.84
IL-12p70
0.72 (0.00)
7.07 (13.08)
0.93 (0.00)
18.0
0.7
<0.0001
0.001
TNF-α
0.56 (0.10)
7.47 (11.66)
0.40 (0.12)
19.4
1.2
<0.0001
0.0004
TNF-β
0.000042 (0.00000)
0.000042 (0.000011)
0.000046 (0.00000)
1.0
0.9
0.012
<0.0001
IFN-y
4.78 (0.00)
29.15 (44.01)
3.82 (0.00)
7.5
1.3
0.008
<0.0001
MMP-1
224.7 (704.1)
289571.1 (216061.4))
47.28 (1144.9)
573.5
0.2
<0.0001
0.90
MMP-3
1325.0 (2536.9)
289571.4 (356207.6)
7966.8 (16260.4)
216.5
0.1
<0.0001
0.01
MMP-9
52.5 (2052.5)
106324.0 (193994.9)
122.5 (4907.7)
150.8
0.3
<0.0001
0.08
Anti-inflammatory
IL-1RA
0.47 (7.30)
1616.2 (3956.9)
0.30 (6.10)
559.9
0.5
<0.0001
0.56
IL-4
0.11 (0.00)
0.72 (1.21)
0.06 (0.00)
6.0
2.2
0.002
0.0001
IL-10
0.32 (0.00)
3.08 (5.47)
0.09 (0.03)
375.6
0.1
<0.0001
0.0001
IL-13
4.44 (0.00)
48.35 (49.60)
4.53 (0.00)
12.8
1.0
<0.0001
0.06
Cartilage degradation
ACG
1033.0 (316.0)
1829.0 (1062.0)
1084.0 (733.0)
1.9
0.9
0.020
0.86
CTX-2
61.8 (0.0)
281.1 (240.1)
161.3 (56.0)
5.0
0.4
0.003
0.0025
Metabolic
bFGF
24.7 (5.1)
64.1 (149.1)
43.2 (53.4)
7.4
0.4
0.091
0.23
TGF-β1
53.0 (234.7)
2541.3 (4289.5)
344.6 (408.3)
34.9
0.2
<0.0001
0.0085
TGF-β2
1.96 (2.83)
53.9 (49.5)
17.5 (26.1)
10.9
0.2
<0.0001
0.0004
TGF-β3
0.86 (0.30)
3.22 (5.96)
6.35 (0.00)
4.7
0.2
<0.0001
0.75
Abbreviation: IQR: interquartile range. Data in bold indicate a significant difference in cytokine levels. Acute fractured ankles had significantly elevated levels of nearly all cytokines except from IL-1α and TGF-β1 compared to levels in implant removal ankles. The cytokine levels in implant removal and healthy contralateral ankles were overall significantly different. However, the ratio illustrated a double directional pattern. The cytokine levels in implant removal and healthy contralateral ankles were nearly all below the lower limit of detection, as illustrated in Additional file 1.
