The molecular pathophysiology of subacromial bursitis in rotator cuff disease.
Little information exists on the molecular and biochemical pathophysiology of subacromial bursitis and rotator cuff disease. We investigated the pattern of expression of cytokines (interleukin [IL]-1beta, IL-1, IL-6, tumor necrosis factor [TNF] alpha, small inducible cytokines), metalloproteases, and cyclooxygenases in the subacromial bursa in patients with rotator cuff disease. Subacromial bursa specimens were prepared for molecular and biochemical analysis in patients undergoing shoulder surgery following an institutional review board-approved protocol. Specimens were analyzed for the presence of cytokines, metalloproteases, and cyclooxygenases by use of microarray for gene expression and immunohistocytochemistry. Microarray analysis for gene expression and immunohistochemistry demonstrated that the expression of several cytokine genes (TNF, IL-1alpha, IL-1beta, and IL-6) was increased in patients with subacromial bursitis compared with control specimens. Furthermore, the expression of metalloproteases (MMP-1 and MMP-9) and cyclooxygenases (COX-1 and COX-2) in the bursitis group was found to be increased as compared with controls. Although further investigation is required, these studies suggest that inflammation of the subacromial bursa does occur in patients with rotator cuff disease. These findings support the role of anti-inflammatory agents in the treatment of subacromial impingement and emphasize the importance of subacromial bursectomy to reduce inflammation in rotator cuff disease.
Blaine
Theodore A
TA
Center for Orthopaedic Research, Columbia University College of Physicians and Surgeons, 622 W. 168th Street, PH-1120, New York, NY 10032, USA. tb211@columbia.edu
Kim
Yang-Soo
YS
Voloshin
Ilya
I
Chen
Darwin
D
Murakami
Koko
K
Chang
Seong-Sil
SS
Winchester
Robert
R
Lee
Francis Y
FY
O'keefe
Regis J
RJ
Bigliani
Louis U
LU
D002062:Bursitis / Q000235:genetics / Q000378:metabolism* / Q000503:physiopathology*; D016207:Cytokines / Q000032:analysis / Q000096:biosynthesis* / Q000235:genetics; D015870:Gene Expression; D006801:Humans; D045726:Metalloproteases / Q000032:analysis / Q000096:biosynthesis* / Q000235:genetics; D011451:Prostaglandin-Endoperoxide Synthases / Q000032:analysis / Q000096:biosynthesis* / Q000235:genetics; D017006:Rotator Cuff; D012785:Shoulder Joint
D016207:Cytokines; D011451:Prostaglandin-Endoperoxide Synthases; D045726:Metalloproteases