Spang Christoph, Chen Jialin, Backman Ludvig J
Department of Integrative Medical Biology, Anatomy, Umeå University, SE-901 87, Umeå, Sweden.
Dr Alfen Orthopedic Spine Center, 97080, Würzburg, Germany.
BMC Musculoskelet Disord. 2016 Nov 10;17(1):467. doi: 10.1186/s12891-016-1328-9.
The use of corticosteroids (e.g., dexamethasone) as treatment for tendinopathy has recently been questioned as higher risks for ruptures have been observed clinically. In vitro studies have reported that dexamethasone exposed tendon cells, tenocytes, show reduced cell viability and collagen production. Little is known about the effect of dexamethasone on the characteristics of tenocytes. Furthermore, there are uncertainties about the existence of apoptosis and if the reduction of collagen affects all collagen subtypes.
We evaluated these aspects by exposing primary tendon cells to dexamethasone (Dex) in concentrations ranging from 1 to 1000 nM. Gene expression of the specific tenocyte markers scleraxis (Scx) and tenomodulin (Tnmd) and markers for other mesenchymal lineages, such as bone (Alpl, Ocn), cartilage (Acan, Sox9) and fat (Cebpα, Pparg) was measured via qPCR. Cell viability and proliferation was calculated using a MTS Assay. Cell death was measured by LDH assay and cleaved caspase-3 using Western Blot. Gene expression of collagen subtypes Col1, Col3 and Col14 was analyzed using qPCR.
Stimulation with Dex decreased cell viability and LDH levels. Dex also induced a significant reduction of Scx gene expression and a marked loss of fibroblast like cell shape. The mRNA for all examined collagen subtypes was found to be down-regulated. Among non-tendinous genes only Pparg was significantly increased, whereas Acan, Alpl and Sox9 were reduced.
These results indicate a Dex induced phenotype drift of the tenocytes by reducing scleraxis expression. Reduction of several collagen subtypes, but not cell death, seems to be a feature of Dex induced tissue degeneration.
近期有人质疑使用皮质类固醇(如地塞米松)治疗肌腱病,因为临床上观察到破裂风险更高。体外研究报告称,暴露于地塞米松的肌腱细胞(腱细胞)显示细胞活力和胶原蛋白生成减少。关于地塞米松对腱细胞特性的影响知之甚少。此外,关于细胞凋亡的存在以及胶原蛋白减少是否影响所有胶原蛋白亚型也存在不确定性。
我们通过将原代肌腱细胞暴露于浓度范围为1至1000 nM的地塞米松(Dex)中来评估这些方面。通过qPCR测量特定腱细胞标志物硬骨素(Scx)和肌腱调节蛋白(Tnmd)以及其他间充质谱系标志物(如骨(Alpl、骨钙素(Ocn))、软骨(聚集蛋白聚糖(Acan)、性别决定区Y框蛋白9(Sox9))和脂肪(Cebpα、过氧化物酶体增殖物激活受体γ(Pparg))的基因表达。使用MTS法计算细胞活力和增殖。通过LDH测定法测量细胞死亡,并使用蛋白质免疫印迹法检测裂解的半胱天冬酶-3。使用qPCR分析胶原蛋白亚型Col1、Col3和Col14的基因表达。
用Dex刺激降低了细胞活力和LDH水平。Dex还导致Scx基因表达显著降低以及成纤维细胞样细胞形态明显丧失。发现所有检测的胶原蛋白亚型的mRNA均下调。在非肌腱基因中,只有Pparg显著增加,而Acan、Alpl和Sox9减少。
这些结果表明,Dex通过降低硬骨素表达诱导腱细胞发生表型漂移。几种胶原蛋白亚型的减少而非细胞死亡似乎是Dex诱导组织退变的一个特征。