Department of Orthopaedic Surgery M. Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health Sciences, Institute of Sports Medicine Copenhagen, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen NV, Denmark.
Eur J Appl Physiol. 2013 Aug;113(8):2101-9. doi: 10.1007/s00421-013-2638-3. Epub 2013 Apr 16.
Although histology data favour the view of a degenerative nature of tendinopathy, indirect support for inflammatory reactions to loading in affected tendons exists. The purpose of the present study was to elucidate whether inflammatory signalling responses after acute mechanical loading were more pronounced in tendinopathic versus healthy regions of human tendon and if treatment with non-steroidal anti-inflammatory medications (NSAID's) reduces this response. Twenty-seven tendinopathy patients (>6 months) were randomly assigned to a placebo (n = 14) or NSAID (Ibumetin NYCOMED GmbH Plant Oranienburg Germany (600 mg) × 3/day/1 week) group (n = 13) in a double-blinded-fashion. Tendon biopsies were taken from the painful and a healthy region of the same tendon 2 h after 1 h running. Gene-expression of several targets was analysed in the sampled Achilles tendon biopsies. The mRNA for TGF-β, collagen-I and collagen-III were significantly higher expressed, and decorin, CTGF, IL-6 and IL-10 were significantly lower expressed in the tendinopathic versus healthy tendon area. Only IL-10 was lower in expression in experiments with NSAID administration, while all other determined parameters were unaffected by NSAID. All ultrasonographic outcomes were unchanged in response to acute exercise and not influenced by NSAID. The signalling for collagen and TGF-beta was upregulated after acute loading in tendinopathic tendon. In contrast to the hypothesis, inflammatory signalling was not exaggerated in tendinopathic tendon 2 h after acute mechanical loading.
尽管组织学数据支持肌腱病的退行性本质，但间接证据表明，受影响的肌腱在受到负荷时会发生炎症反应。本研究旨在阐明急性机械负荷后，肌腱病和健康区域的炎症信号反应是否更为明显，以及非甾体抗炎药 (NSAID) 的治疗是否会降低这种反应。27 名肌腱病患者（>6 个月）被随机分为安慰剂组（n = 14）或 NSAID 组（Ibumetin NYCOMED GmbH Plant Oranienburg Germany（600mg）×3/天/1 周）（n = 13），采用双盲设计。在 1 小时跑步后 2 小时，从同一肌腱的疼痛和健康区域采集肌腱活检。分析了取自跟腱活检样本的几个靶基因的表达。与健康肌腱区域相比，TGF-β、胶原-I 和胶原-III 的 mRNA 表达显著升高，而 decorin、CTGF、IL-6 和 IL-10 的表达显著降低。只有 IL-10 的表达在 NSAID 给药实验中降低，而其他所有确定的参数不受 NSAID 影响。所有超声结果均未因急性运动而改变，也不受 NSAID 影响。在肌腱病肌腱中，急性负荷后胶原蛋白和 TGF-β的信号转导被上调。与假设相反，炎症信号在急性机械负荷后 2 小时并未在肌腱病肌腱中被夸大。
