Bring Daniel K-I, Reno Carol, Renstrom Per, Salo Paul, Hart David A, Ackermann Paul W
Section of Orthopaedics and Sports Medicine, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
J Orthop Res. 2009 Feb;27(2):274-80. doi: 10.1002/jor.20657.
Healing after mobilization versus immobilization was assessed in a model of rat Achilles tendon rupture, by RT-PCR at 8 and 17 days and by histological analyses at 14 and 28 days postrupture. The expression of mRNA for extracellular matrix (ECM) molecules (collagen type I and type III, versican, decorin, and biglycan), and the subjective histological maturation of the healing area were analyzed. Effects of immobilization on healing were related to changes in the peripheral expression of substance P (NK(1))- and calcitonin gene-related peptide (CRLR and RAMP-1)- receptors. At 8 days postinjury, mRNA levels for ECM molecules were equal in both groups. However, by day 17, the ECM mRNA expression in the mobilized group had increased up to approximately 14x that of the immobilized group, which were comparable to intact tendon values. Histological analysis confirmed a higher regenerating activity in the mobilized group, with an increased amount of blood vessels, fibroblasts, and new collagen. The expression of sensory neuropeptide receptors in the mobilized group exhibited a significant increase from 8 to 17 days postinjury similar to the increased ECM mRNA expression, whereas the immobilized group at 17 days exhibited levels comparable to the intact tendon values. Therefore, immobilization postrupture appears to hamper tendon healing, a process which may prove to be directly linked to a downregulated peripheral sensitivity to sensory neuropeptide stimulation.
在大鼠跟腱断裂模型中，通过在损伤后8天和17天进行逆转录聚合酶链反应（RT-PCR）以及在损伤后14天和28天进行组织学分析，评估了活动与固定后的愈合情况。分析了细胞外基质（ECM）分子（I型和III型胶原蛋白、多功能蛋白聚糖、核心蛋白聚糖和双糖链蛋白聚糖）的mRNA表达以及愈合区域的主观组织学成熟度。固定对愈合的影响与P物质（NK(1)）和降钙素基因相关肽（CRLR和RAMP-1）受体外周表达的变化有关。在损伤后8天，两组中ECM分子的mRNA水平相等。然而，到第17天，活动组中ECM mRNA的表达增加到固定组的约14倍，与完整肌腱的值相当。组织学分析证实活动组具有更高的再生活性，血管、成纤维细胞和新胶原蛋白的数量增加。活动组中感觉神经肽受体的表达在损伤后8天到17天显著增加，类似于ECM mRNA表达的增加，而固定组在17天时的水平与完整肌腱的值相当。因此，损伤后固定似乎会阻碍肌腱愈合，这一过程可能直接与对感觉神经肽刺激的外周敏感性下调有关。
