Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
J Appl Physiol (1985). 2017 Nov 1;123(5):1397-1405. doi: 10.1152/japplphysiol.00281.2017. Epub 2017 Aug 31.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat tendinopathy, but evidence for this treatment is lacking, and little is known regarding effects of NSAIDs on human tendinopathic tendon. This study investigated the effects of NSAID treatment (ibuprofen) on human tendinopathic tendon, with changes in gene expression as the primary outcome, and tendon pain, function, and blood flow as secondary outcomes. Twenty-six adults (16 men, 10 women), diagnosed with chronic Achilles tendinopathy, were randomized to 1-wk treatment with ibuprofen (600 mg ×3/day) ( = 13) or placebo ( = 13) (double-blinded). Ibuprofen content in blood, visual analog scale score for tendon pain at rest and activity, Victorian Institute of Sports Assessment-Achilles (VISA-A) scores for tendon function, tendon thickness (with ultrasonography), and color Doppler were measured before and 1 h after treatment. After the last posttreatment test, a full-width tendon biopsy was taken from the affected area. Real-time-RT-PCR was used to assess expression of collagen I, collagen III, transforming growth factor (TGF-β) isoforms, cyclooxygenase-2 (COX-2), angiopoietin-like 4 (ANGPTL4), and cyclic AMP-dependent transcription factor (ATF3) in tendon tissue. Expression of collagens and TGF-β isoforms showed relatively low variation and was unaffected by ibuprofen treatment. Further, no changes were seen in tendon thickness or VISA-A score. The placebo treatment reduced the color Doppler (in tendon plus surrounding tissue) compared with the ibuprofen group and also increased the perception of pain at rest. In conclusion, there was no indication that short-term ibuprofen treatment affects gene expression in human chronic tendinopathic tendon or leads to any clear changes in tendon pain or function. Nonsteroidal anti-inflammatory drugs are widely used in the treatment of tendinopathy, but little is known of the effects of these drugs on tendon tissue. We find that 1 wk of ibuprofen treatment has no effect on gene expression of collagen and related growth factors in adult human tendinopathic tendon in vivo (in spite of relatively low levels of variation in gene expression), suggesting that tendinopathic cells are not responsive to ibuprofen.
非甾体抗炎药（NSAIDs）常用于治疗腱病，但这种治疗方法的证据不足，而且人们对 NSAIDs 对人类腱病肌腱的影响知之甚少。本研究调查了 NSAID 治疗（布洛芬）对人类腱病肌腱的影响，以基因表达的变化为主要结果，以肌腱疼痛、功能和血流为次要结果。26 名成年人（16 名男性，10 名女性）被诊断为慢性跟腱病，随机分为 1 周的布洛芬（600mg×3/天）治疗组（n=13）或安慰剂组（n=13）（双盲）。在治疗前和治疗后 1 小时测量血液中的布洛芬含量、静息和活动时肌腱疼痛的视觉模拟评分、肌腱功能的维多利亚运动评估-跟腱（VISA-A）评分、肌腱厚度（超声）和彩色多普勒，并在最后一次治疗后测试后从受影响的区域取出全宽肌腱活检。实时 RT-PCR 用于评估肌腱组织中胶原 I、胶原 III、转化生长因子（TGF-β）同工型、环氧化酶-2（COX-2）、血管生成素样 4（ANGPTL4）和环磷酸腺苷依赖性转录因子（ATF3）的表达。胶原和 TGF-β 同工型的表达变化相对较小，不受布洛芬治疗的影响。此外，肌腱厚度或 VISA-A 评分没有变化。与布洛芬组相比，安慰剂组的彩色多普勒（肌腱加周围组织）降低，并且静息时疼痛的感觉也增加。总之，没有迹象表明短期布洛芬治疗会影响人类慢性腱病肌腱中的基因表达，也不会导致肌腱疼痛或功能的任何明显变化。非甾体抗炎药广泛用于治疗腱病，但对这些药物对肌腱组织的影响知之甚少。我们发现，1 周的布洛芬治疗对成人腱病肌腱的胶原和相关生长因子的基因表达没有影响（尽管基因表达的变化相对较小），这表明腱病细胞对布洛芬没有反应。
