Investigating the ‘cardiotoxic’ effects of cobalt in patients with hip replacements
Scotland Grant – Dr Susan Currie, University of Strathclyde
Summary: There is strong evidence of a link between cobalt in hip replacements and the development of heart disease. This project will investigate the effects of cobalt on heart cells and tissues which may help doctors to predict whether and when hip replacement patients will develop heart disease.
The treatment for advanced cases of arthritis of the hip is a hip replacement. However, there is now very strong evidence of a link between hip replacements where metals such as cobalt and chromium are used in the artificial joint bearings, and heart disease. Over time, cobalt levels rise in the bloodstream of patients and the metal accumulates in various organs of the body, including the heart. Left untreated, this can damage the heart and lead to heart failure but doctors cannot tell whether or when hip replacement patients will develop heart disease.
Dr Currie’s team will study the damaging effects of cobalt on the function and growth of heart cells and tissue. They will study whether there is a link between cobalt exposure and changes in the levels and activity of a particular heart protein called ‘CaMKII’. This protein has a central role in regulating heart function and we already know that the levels and activity of this protein change at an early stage of heart disease. They will also look at whether they can interfere with CaMKII, to reduce or reverse the damaging effects of cobalt on the heart.
CaMKII and other related substances could be used as novel ‘biomarkers’ to assess changes happening inside heart cells. The research team will study blood samples from hip replacement patients to see if they can measure biomarkers directly related to altered CaMKII activity.
If successful, the findings may help doctors to more accurately predict whether or when hip replacement patients will develop heart disease. By identifying a protein that changes very early on as the heart starts to react to cobalt, but before there are any significant problems, doctors may be able to either revise surgery or give drugs to prevent progression to heart failure.