Yoshihara Y, Hamada K, Nakajima T, Fujikawa K, Fukuda H
Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
J Orthop Res. 2001 Jul;19(4):573-9. doi: 10.1016/S0736-0266(00)00063-2.
It is known that rotator cuff tears are sometimes accompanied by joint destruction. Our purpose was to elucidate the pathology with this condition. Thirty-two synovial fluid (SF) samples aspirated from the glenohumeral joints of patients with rotator cuff tears, including 7 with partial-thickness and 25 with full-thickness tears of the rotator cuff (10 massive and 15 isolated supraspinatus tendon (SSp) tears), were examined. Collagenase (MMP-1), stromelysin 1 (MMP-3), tissue inhibitor of metalloproteinases-1 (TIMP-1) and carboxy-terminal type II procollagen peptide (pCOL Il-C) were measured in the SF using the respective sandwich enzyme immunoassays. Glycosaminoglycan (GAG) was also quantified with a cationic dye binding method using 1,9-dimethylmethylene blue. Levels of any molecules except pCOL II-C in the SF appeared to be higher in full-thickness tears than those in partial-thickness tears. Moreover, levels of MMP-1, MMP-3 and GAG in the SF were significantly higher in massive tears of the rotator cuff in comparison with those in isolated SSp tears. Such significance was not observed in the levels of TIMP-1 or pCOL II C in the SF. We examined the relation of those levels with operative findings or clinical parameters from full-thickness tears, and observed significant correlations of the tear size with the levels of MMP-1, MMP-3 and GAG in the SF. Although these marker molecules in SF do not always originate from cartilage, our results may indicate the potential for accelerated cartilage-degrading activity in the glenohumeral joint in massive tears of the rotator cuff.
众所周知，肩袖撕裂有时会伴有关节破坏。我们的目的是阐明这种情况的病理。从肩袖撕裂患者的盂肱关节抽取了32份滑液（SF）样本进行检查，其中包括7例部分厚度撕裂和25例全层撕裂的肩袖（10例巨大撕裂和15例孤立的冈上肌腱（SSp）撕裂）。使用各自的夹心酶免疫测定法在滑液中测量胶原酶（MMP-1）、基质溶解素1（MMP-3）、金属蛋白酶组织抑制剂-1（TIMP-1）和羧基末端II型前胶原肽（pCOL Il-C）。还使用1,9-二甲基亚甲基蓝通过阳离子染料结合法对糖胺聚糖（GAG）进行定量。全层撕裂的滑液中除pCOL II-C外的任何分子水平似乎都高于部分厚度撕裂。此外，与孤立的SSp撕裂相比，肩袖巨大撕裂的滑液中MMP-1、MMP-3和GAG水平显著更高。滑液中TIMP-1或pCOL II C的水平未观察到这种显著差异。我们研究了这些水平与全层撕裂的手术结果或临床参数之间的关系，观察到撕裂大小与滑液中MMP-1、MMP-3和GAG水平之间存在显著相关性。尽管滑液中的这些标志物分子并不总是来源于软骨，但我们的结果可能表明在肩袖巨大撕裂时盂肱关节中软骨降解活性加速的可能性。
