Association of synovial inflammation and inflammatory mediators with glenohumeral rotator cuff pathology

作者：Abrams Geoffrey D^*; Luria Ayala; Carr Rebecca A; Rhodes Christopher; Robinson William H; Sokolove Jeremy

来源：Journal of Shoulder and Elbow Surgery, 2016, 25(6): 989-997.

DOI：10.1016/j.jse.2015.10.011

• Rotator cuff
• synovium
• synovitis
• inflammation
• cytokine
• MMP

Hypothesis: We hypothesized that patients with full-thickness rotator cuff tears would have greater synovial inflammation compared with those without rotator cuff tear pathology, with gene expression relating to histologic findings.
Methods: Synovial sampling was performed in 19 patients with full-thickness rotator cuff tears (RTC group) and in 11 patients without rotator cuff pathology (control group). Cryosections were stained and examined under light microscopy and confocal fluorescent microscopy for anti-cluster CD45 (common leukocyte antigen), anti-CD31 (endothelial), and anti-CD68 (macrophage) cell surface markers. A grading system was used to quantitate synovitis under light microscopy, and digital image analysis was used to quantify the immunofluorescence staining area. Quantitative polymerase chain reaction was performed for validated inflammatory markers. Data were analyzed with analysis of covariance, Mann-Whitney U, and Spearman rank order testing, with significance set at alpha = .05.
Results: The synovitis score was significantly increased in the RTC group compared with controls. Immunofluorescence demonstrated significantly increased staining for CD31, CD45, and CD68 in the RTC vs control group. CD45+/68-cells were found perivascularly, with CD45+/68+ cells toward the joint lining edge of the synovium. Levels of matrix metalloproteinase-3 (MMP-3) and interleukin-6 were significantly increased in the RTC group, with a positive correlation between the synovitis score and MMP-3 expression.
Conclusions: Patients with full-thickness rotator cuff tears have greater levels of synovial inflammation, angiogenesis, and MMP-3 upregulation compared with controls. Gene expression of MMP-3 correlates with the degree of synovitis. Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.

• 出版日期2016-6