Grases Felix, Muntaner-Gimbernat Lorenzo, Vilchez-Mira Mar, Costa-Bauzá Antonia, Tur Fernando, Prieto Rafel Maria, Torrens-Mas Margalida, Vega Fabiana Gisela
Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISPa), Universitat de les Illes Balears, Palma de Mallorca, Spain; CIBERobn (CB06/03), Instituto de Salud Carlos III, Spain.
J Orthop Res. 2015 Apr;33(4):475-82. doi: 10.1002/jor.22801. Epub 2015 Jan 21.
Calcific tendinopathy of the tendons of the rotator cuff is common in adults. These calcifications tend to be reabsorbed after a period of acute pain. This study evaluated the morphologic characteristics of calcific deposits and the participation of phytate and osteopontin (OPN) in their development. Calcific deposits were removed from 21 patients with calcific tendinopathy by ultrasound-guided needle puncture under local anesthesia. The removed deposits were evaluated by scanning electron microscopy, X-ray diffraction and Fourier transform infrared spectroscopy. The amounts of calcium and phosphorus in the deposits were semi-quantitatively determined by energy dispersive X-ray analysis. Phytate was determined in 2 h urine samples, and OPN was extracted from a pool of deposits. The calcific deposits consisted of amorphous and poorly crystalline carbonated hydroxyapatite containing molecular water and organic matter. OPN was associated with the hydroxyapatite deposits. Phytate concentrations were significantly lower in the urine of patients with calcific tendinopathy than in healthy controls. The deficit in crystallization inhibitors such as phytate, and the presence of regulators such as OPN, may play important roles in the development of calcific tendinopathy.
肩袖肌腱钙化性肌腱病在成年人中很常见。这些钙化物在一段急性疼痛期后往往会被重新吸收。本研究评估了钙化沉积物的形态特征以及植酸盐和骨桥蛋白（OPN）在其形成过程中的作用。在局部麻醉下，通过超声引导下的针刺从21例钙化性肌腱病患者中取出钙化沉积物。通过扫描电子显微镜、X射线衍射和傅里叶变换红外光谱对取出的沉积物进行评估。通过能量色散X射线分析半定量测定沉积物中的钙和磷含量。在2小时尿液样本中测定植酸盐，并从一组沉积物中提取OPN。钙化沉积物由含有分子水和有机物的无定形和结晶性差的碳酸羟基磷灰石组成。OPN与羟基磷灰石沉积物相关。钙化性肌腱病患者尿液中的植酸盐浓度明显低于健康对照组。植酸盐等结晶抑制剂的缺乏以及OPN等调节剂的存在可能在钙化性肌腱病的发生发展中起重要作用。
