Spang C, Renström L, Alfredson H, Forsgren S
Department of Integrative Medical Biology, Anatomy Section, Umeå University, Umeå, Sweden.
J Musculoskelet Neuronal Interact. 2017 Sep 1;17(3):226-236.
The peritendinous connective tissues can have importance in chronic tendon pain. Recently cytokine TNF-α has been suggested to be involved in tendinopathic processes. It is not known how TNF-α and its receptors TNFR1 and TNFR2 are expressed in peritendinous tissues.
The objective for this study was to immunohistochemically evaluate the expression patterns of these in the peritendinous tissue located between the plantaris and Achilles tendons and the one located superficially to the extensor origin at the elbow region for patients with tendinopathy/tennis elbow.
The nerve fascicles were of two types, one type being homogenously stained for the nerve markers βIII-tubulin and neurofilament and the other showing deficits for these suggesting features of axonal damage. Much more distinct TNFR1/TNFR2 immunoreactions were seen for the latter nerve fascicles. TNFR1 was seen in axons, TNFR2 mainly in Schwann cells. TNFR1 and particularly TNFR2 were seen in walls of parts of blood vessels. The dispersed cells showed frequently TNFR1 and TNFR2 immunoreactivity.
These findings suggest that TNF-α can be related to degenerative events but also attempts for healing concerning the nerve structures. The marked expression of the TNF-α system in the peritendinous tissue suggests an impact of TNF-α in tendinopathy/tennis elbow.
肌腱周围结缔组织在慢性肌腱疼痛中可能具有重要意义。最近有研究表明细胞因子TNF-α参与肌腱病的发病过程。目前尚不清楚TNF-α及其受体TNFR1和TNFR2在肌腱周围组织中的表达情况。
本研究的目的是通过免疫组织化学方法评估这些因子在患有肌腱病/网球肘的患者的跟腱与跖肌腱之间的肌腱周围组织以及肘部伸肌起点表面的肌腱周围组织中的表达模式。
神经束有两种类型，一种对神经标志物βIII-微管蛋白和神经丝呈均匀染色，另一种则显示这些标志物缺失，提示存在轴突损伤特征。在后者的神经束中观察到更明显的TNFR1/TNFR2免疫反应。TNFR1见于轴突，TNFR2主要见于施万细胞。在部分血管壁中可见TNFR1，尤其是TNFR2。散在细胞经常显示TNFR1和TNFR2免疫反应性。
这些发现表明TNF-α可能与退行性病变有关，但也与神经结构的修复尝试有关。TNF-α系统在肌腱周围组织中的显著表达提示TNF-α在肌腱病/网球肘中具有作用。
