Ko Jih-Yang, Wang Feng-Sheng, Huang Hsuan-Ying, Wang Ching-Jen, Tseng Shin-Ling, Hsu Chin
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan, Republic of China.
J Orthop Res. 2008 Aug;26(8):1090-7. doi: 10.1002/jor.20631.
We evaluated whether proinflammatory cytokine expression and myofibroblast recruitment in subacromial bursa was linked to rotator cuff lesions with shoulder stiffness. We analyzed expressions of IL-1beta, IL-6, and TNF-alpha in subacromial bursa and joint fluid collected from 14 patients with cuff tears with stiffness as a study group (Group I) and 14 patients with rotator cuff tears without shoulder stiffness as a control group (Group II) using real-time RT-PCR, immunohistochemistry, and ELISA. Myofibroblast apoptosis in subacromial bursa was analyzed using terminal deoxynucleotidyl transferase -mediated deoxyuridine triphosphate-biotin nick end-labeling (TUNEL) and alpha-smooth muscle actin immunofluorescence staining. Shoulder function was evaluated using the Constant score. Group I had higher mRNA expression (p < 0.001) and immunoreactivities (p < 0.001) of IL-1beta. They also had higher levels of IL-1beta, IL-6, and TNF-alpha in joint fluid. Increased IL-1beta mRNA expression in the subacromial bursa and IL-1beta levels in joint fluid were correlated with a preoperative deficit in shoulder motion (p < 0.001) and preoperative Constant scores (p < 0.001). Immunofluorescence observations showed that Group I subjects had more myofibroblasts (p < 0.001) than Group II. In Group II, a significant correlation was found between apoptotic myofibroblasts and total myofibroblasts (p = 0.002), but not in Group I (p = 0.510). Increased expression of IL-1beta and myofibroblast recruitment in the subacromial bursa in rotator cuff lesions are linked to shoulder stiffness.
我们评估了肩峰下滑囊中促炎细胞因子表达及肌成纤维细胞募集是否与伴有肩部僵硬的肩袖损伤有关。我们使用实时逆转录聚合酶链反应、免疫组织化学和酶联免疫吸附测定法，分析了从14例伴有僵硬的肩袖撕裂患者（研究组，I组）和14例无肩部僵硬的肩袖撕裂患者（对照组，II组）收集的肩峰下滑囊和关节液中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的表达。使用末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸生物素缺口末端标记法（TUNEL）和α-平滑肌肌动蛋白免疫荧光染色分析肩峰下滑囊中肌成纤维细胞凋亡情况。使用Constant评分评估肩部功能。I组IL-1β的信使核糖核酸表达（p<0.001）和免疫反应性（p<0.001）更高。他们关节液中IL-1β、IL-6和TNF-α水平也更高。肩峰下滑囊中IL-1β信使核糖核酸表达增加及关节液中IL-1β水平升高与术前肩部活动度缺损（p<0.001）和术前Constant评分（p<0.001）相关。免疫荧光观察显示，I组受试者的肌成纤维细胞比II组更多（p<0.001）。在II组中，凋亡肌成纤维细胞与总肌成纤维细胞之间存在显著相关性（p=0.002），但在I组中未发现（p=0.510）。肩袖损伤时肩峰下滑囊中IL-1β表达增加及肌成纤维细胞募集与肩部僵硬有关。
