title: Vascular endothelial growth factor (VEGF) expression in the subacromial bursa is increased in patients with impingement syndrome.
abstract: Vascular endothelial growth factor (VEGF), which is known to be an angiogenetic factor, plays an important role in the inflammation of synovial tissue. To investigate the relationships between VEGF and clinical symptoms in rotator cuff disease, VEGF expression was examined using RT-PCR and immunohistochemical analysis in 50 patients with this disease (26 with full-thickness cuff tear, 12 with partial-thickness tear, and 12 with subacromial bursitis). VEGF mRNA expression was detected in 40 out of 50 patients by RT-PCR. VEGF mRNA expression was found more frequently in the patients with motion pain (39 out of 41) than in those without motion pain (1 out of 9) with statistical significance (Fisher's test, P < 0.001). Thirty-one out of 33 patients with synovial proliferation showed VEGF mRNA expression, whereas the expression of this transcript was found in 9 out of 17 patients without synovial proliferation. This association with synovial proliferation was also significant (Fisher's test, P = 0.0013). Thirty out of 41 patients with motion pain had synovial proliferation but 3 out of 9 patients without motion pain had synovial proliferation. In all these 30 patients with both motion pain and synovial proliferation, VEGF mRNA expression was detected. This association between motion pain and synovial proliferation was also significant (Fisher's test, P < 0.05). The mean vessel count and area in subacromial bursa expressing VEGF was significantly higher than in those without VEGF (Mann Whitney's U test, P < 0.01). These results suggested that VEGF expression is associated with vascularity, synovial proliferation and shoulder motion pain in the rotator cuff disease.
authors.affiliation: Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yanagisawa
authors.forename: K
authors.initials: K
authors.lastname: Hamada
authors.forename: M
authors.initials: M
authors.lastname: Gotoh
authors.lastname: TokunagaT
authors.forename: Y
authors.initials: Y
authors.lastname: Oshika
authors.forename: M
authors.initials: M
authors.lastname: Tomisawa
authors.forename: Y H
authors.initials: YH
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Handa
authors.forename: H
authors.initials: H
authors.lastname: Kijima
authors.forename: H
authors.initials: H
authors.lastname: Yamazaki
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.forename: Y
authors.initials: Y
authors.lastname: Ueyama
authors.forename: N
authors.initials: N
authors.lastname: Tamaoki
authors.forename: H
authors.initials: H
authors.lastname: Fukuda
mesh_terms: D000174:Acromion; D000368:Aged; D002061:Bursa, Synovial / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D017931:DNA Primers / Q000737:chemistry; D016228:Endothelial Growth Factors / Q000096:biosynthesis* / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008222:Lymphokines / Q000096:biosynthesis* / Q000235:genetics; D008875:Middle Aged; D010147:Pain Measurement; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017006:Rotator Cuff / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D000070636:Rotator Cuff Injuries; D019534:Shoulder Impingement Syndrome / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D020069:Shoulder Pain / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D017931:DNA Primers; D016228:Endothelial Growth Factors; D008222:Lymphokines; D012333:RNA, Messenger; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors