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Substance P (SP) is involved in neurogenic inflammation and in the pathogenesis of several inflammatory diseases, demonstrating that there is a narrow interrelationship between the nervous system and immunity. Macrophage functions are altered in stress, therefore, since SP is a macrophage activator, its biological effect has been intimately linked to stress. In fact, SP enhances LPS-induced macrophage TNFα production from stressed animals and stimulates the production of IL-8 CXC chemokine response in a mast cell line in vitro. The stress-induced cytokines from macrophage also alter and contribute to inflammation. Understanding the pathophysiology of inflammation and the role of the chemical mediator SP may improve inflammation management. Copyright © by BIOLIFE, s.a.s.

Knowledge of post-operative clinical and laboratory changes in the uncomplicated course of ACL reconstruction could assist orthopaedic surgeons in making a timely diagnosis of septic arthritis. A total of 58 candidates to ACL reconstruction were enrolled in this study according to inclusion/exclusion criteria. Pre- and post-operative changes on 1st, 3rd, 7th, 15th, and 30thday were collected for skin body temperature (SBT), knee pain (KP), white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Post-operative joint effusion was recorded when inhibiting quadriceps contraction. The post-operative changes were compared with baseline values at each time point in the whole sample and in the subgroups of patients receiving bone-patellar-tendon-bone (BPTP) or hamstring tendon (HT) autograft. Follow-up at six month was considered adequate to rule out surgery-related septic arthritis. Mean SBT significantly increased on 1st, 3rdand 7thpost-operative day and returned to values not differing from baseline on 15thand 30thday. Median KP was significantly elevated during the first month. Joint effusion was observed on 7thpost-operative day in 52% of patients. Mean WBC count significantly increased on 1st, 7thand 15thday while no difference from baseline was observed on 3rdand 30thday. Mean ESR was significantly elevated on 1stday, increased on 3rdday and peaked on 7thday. ESR decreased on 15thand 30thday but remained significantly higher than baseline. Mean CRP significantly increased on 1stday, peaked on 3rdday and decreased on 7thday, while levels on 15thand 30thday did not differ from baseline. The SBT, KP, WBC count, ESR and CRP changes stratified in relation to the type of autograft showed the same variation trend as in the whole sample. Close clinical surveillance may be advisable when SBT, occurrence of joint effusion and CRP levels deviate from the described reference trend two weeks after surgery.