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EN
Macrophages remove foreign material from the body and are recruited to sites were there are particles present. Multinucleate giant cells from by the fusion of macrophages. In the presence of particles, macrophages produce various chemical mediators, known as cytokines, as well as enzymes. Some of the cytokines are pro-inflammatory (for example, IL1Beta, IL6 and TNFalpha) while others promote giant cell formation (GM-CSF, M-CSF, TGF). The presence of these cellular products can be shown by examining tissue sections with immunohistochemistry and by western blotting. The message (mRNA) for the synthesis of these molecules can be demonstrated by in situ hybridization and the polymerase chain reaction. Macrophages process ingested material and present it as antigen to lymphocytes. Antigen-presenting macrophages play an important part in the initiation of metal sensitization. Surface receptors and their counterligands are expressed on macrophages and lymphocytes during antigen presentation. The particles present in tissues around joint prostheses have been isolated and characterized. Over 95% of these are less than 1 micron (ECD) in size. Transmission electron microscopy has revealed nanoparticles of metal in the range 15-20 nm. Such particles are too small to be phagocytosed. Hydroxyapatite, diamond-like carbon (nano-diamond) and metal particles are being studied and results compared with those of particles in the micrometer range. There is a different response to different nanoparticles.
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