Abate Michele, Salini Vincenzo, Schiavone Cosima, Andia Isabel
a Department of Medicine and Science of Aging , University G. d'Annunzio, Chieti-Pescara , Chieti Scalo , Italy.
b BioCruces Health Research Institute , Cruces University Hospital , Barakaldo , Spain.
Expert Opin Drug Saf. 2017 Mar;16(3):341-349. doi: 10.1080/14740338.2017.1276561. Epub 2016 Dec 28.
local glucocorticoids injections are widely administered for the treatment of tendinopathies. positive results have been observed in some tendinopathies but not in others. moreover, worsening of symptoms, and even spontaneous tendon ruptures has been reported. the characteristics of the tendinopathies, the clinical peculiarities of the patient, and the technique used to administer glucocorticoids, can influence the therapeutic response. Areas covered: After reviewing the pertinent literature on the clinical results, basic information, both on the pathogenesis of tendinopathies and the effects of glucocorticoids on tendons, is reported. The pharmacological properties of glucocorticoids are useful to counteract some pathogenetic mechanisms of tendinopathies. However, several experimental studies suggest that the direct action of glucocorticoids on tendons is detrimental. Loss of collagen organization, impaired viability of fibroblasts, depletion of stem cells pool, and reduced mechanical properties have been observed. Expert opinion: Drawbacks of local glucocorticoids injections could be predicted on an individual basis, after a careful appraisal of patient characteristics and concomitant medications, along with the specific stage of tendon disease.
局部注射糖皮质激素被广泛用于治疗肌腱病。在某些肌腱病中观察到了积极效果，但在其他肌腱病中则不然。此外，还报道了症状恶化甚至自发性肌腱断裂的情况。肌腱病的特征、患者的临床特点以及注射糖皮质激素的技术，都会影响治疗效果。涵盖领域：在回顾了有关临床结果的相关文献后，报告了关于肌腱病发病机制以及糖皮质激素对肌腱影响的基本信息。糖皮质激素的药理特性有助于对抗肌腱病的一些发病机制。然而，多项实验研究表明，糖皮质激素对肌腱的直接作用是有害的。已观察到胶原组织丧失、成纤维细胞活力受损、干细胞池耗竭以及力学性能降低。专家意见：在仔细评估患者特征、伴随用药以及肌腱疾病的具体阶段后，可以针对个体预测局部注射糖皮质激素的弊端。
