DNA extracellular traps as potential biomarker of chronic haemophilic synovitis and therapeutic perspective in patients treated with PRP

ONETO, P; LANDRO, ME; DAFFUNCHIO, C; DOUGLAS PRICE, AL; CARRERA SILVA, EA; SCHATTNER, M; CAVIGLIA, H; ETULAIN, J

Congreso; LXVI REUNIÓN ANUAL DE LA SOCIEDAD ARGENTINA DE INVESTIGACIÓN CLÍNICA (SAIC); 2021

Introduction & aims: Hemarthroses in hemophilia cause chronic hemophilic synovitis (CHS) and the role of neutrophils infiltration on the pathophysiology of CHS is unknown. Neutrophils release extracellular DNA traps (ETs), structures containing DNA fibers and Elastase, which are associated with chronic inflammation. We aim to evaluate the association of ETs with join damage in CHS, the protective effect of platelet rich plasma (PRP) against ETs formation and after intraarticular injections in patients with CHS.Methods: Synovial Fluid (SF), PRP and platelet-poor plasma were obtained from 21 patients with CHS. Joint damage was evaluated with the Haemophilia Joint Health Score and monthly bleeding episodes. Synovial and plasmatic ETs were quantified by fluorometry (DNA level), ELISA, and microscopy (DNA-Elastase complexes) and correlated with clinical parameters by Spearman’s test.Results: Patients with CHS showed DNA level of 0.37±0.06μg/ml and DNA-Elastase of 0.27±0.03OD in SF. Furthermore, the plasma of patients with CHS also showed significant DNA levels (0.17±0.01μg/ml) and DNA-Elastase (0.16±0.03DO) which positively correlated with the synovial level (r=0.7, p>0.05). ETs in plasma of healthy donors were undetectable. Correlations between synovial and plasma DNA-Elastase with joint damage parameters were significant (r=0-5-0.7;p