Maman Eran, Somjen Dalia, Maman Ettie, Katzburg Sarah, Sharfman Zachary T, Stern Naftali, Dolkart Oleg
a Shoulder Unit, Division of Orthopedic Surgery, Tel-Aviv Medical Center and the Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
b Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Medical Center and the Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
Connect Tissue Res. 2016;57(2):124-30. doi: 10.3109/03008207.2015.1114615. Epub 2015 Dec 8.
The most frequent complications after rotator cuff repair (RCR) are non-healing and re-tear. Age and gender are both proven risk factors for faulty RCR. This study analyzed the effects of female sex steroids and calciotropic hormones on tendon-derived cell characteristics.
Tendon-derived cells from rat supraspinatus were treated with estradiol-17β (E2); soy isoflavones (daidzein, genistein, biochainin A); raloxifene and estrogen receptors α and β agonists and antagonists; and less-calcemic vitamin-D analog, parathyroid hormone, and vehicle control for 24 h. Cell proliferation and mRNA expression of estrogen receptor α and β, vitamin-D receptor (VDR), scleraxis, and collagen-1 were assessed.
E2, Biochainin A, raloxifene, and vitamin-D significantly increased tendon-derived cell proliferation. Estrogen receptor α antagonists neutralized tendon-derived cells response to estradiol 17-β; however, estrogen receptor β antagonists did not have an effect. Scleraxis expression decreased following estradiol 17-β and vitamin-D treatments. Vitamin-D significantly reduced collagen-1 expression, while estradiol 17-β had no effect. Vitamin-D and estradiol 17-β upregulated VDR expression.
Significant tendon-derived cell proliferation can be achieved with commonly prescribed female sex and calciotropic hormones. However, collagen-1 expression remained constant or decreased following the administration of these hormones. Female sex steroids and vitamin-D promoted tendon-derived cell proliferation via estrogen receptor α and VDR, not estrogen receptor β. Amplified cell proliferation was not associated with increased scleraxis and collagen-1 expression. These results have important implications to the properties of healing tendon and possible pharmaceutical therapies for patients with torn RC. Further research is warranted to expose the underling mechanisms of these effects.
肩袖修复术(RCR)后最常见的并发症是不愈合和再撕裂。年龄和性别都是已证实的导致RCR失败的风险因素。本研究分析了女性性激素和钙调节激素对肌腱来源细胞特性的影响。
用17β-雌二醇(E2)、大豆异黄酮(大豆苷元、染料木黄酮、生物链素A)、雷洛昔芬以及雌激素受体α和β激动剂与拮抗剂,还有低钙血症维生素D类似物、甲状旁腺激素和赋形剂对照处理大鼠冈上肌腱来源的细胞24小时。评估细胞增殖以及雌激素受体α和β、维生素D受体(VDR)、硬骨素和胶原蛋白-1的mRNA表达。
E2、生物链素A、雷洛昔芬和维生素D显著增加肌腱来源细胞的增殖。雌激素受体α拮抗剂中和了肌腱来源细胞对17-β雌二醇的反应;然而,雌激素受体β拮抗剂没有效果。17-β雌二醇和维生素D处理后硬骨素表达降低。维生素D显著降低胶原蛋白-1的表达,而17-β雌二醇没有影响。维生素D和17-β雌二醇上调VDR表达。
常用的女性性激素和钙调节激素可显著促进肌腱来源细胞的增殖。然而,给予这些激素后胶原蛋白-1的表达保持不变或降低。女性性激素和维生素D通过雌激素受体α和VDR促进肌腱来源细胞增殖,而非雌激素受体β。细胞增殖增加与硬骨素和胶原蛋白-1表达增加无关。这些结果对愈合肌腱的特性以及肩袖撕裂患者可能的药物治疗具有重要意义。有必要进行进一步研究以揭示这些作用的潜在机制。