title: The molecular pathophysiology of subacromial bursitis in rotator cuff disease.
abstract: 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.
authors.affiliation: 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
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Blaine
authors.forename: Yang-Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Ilya
authors.initials: I
authors.lastname: Voloshin
authors.forename: Darwin
authors.initials: D
authors.lastname: Chen
authors.forename: Koko
authors.initials: K
authors.lastname: Murakami
authors.forename: Seong-Sil
authors.initials: SS
authors.lastname: Chang
authors.forename: Robert
authors.initials: R
authors.lastname: Winchester
authors.forename: Francis Y
authors.initials: FY
authors.lastname: Lee
authors.forename: Regis J
authors.initials: RJ
authors.lastname: O'keefe
authors.forename: Louis U
authors.initials: LU
authors.lastname: Bigliani
mesh_terms: 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
chemical_list: D016207:Cytokines; D011451:Prostaglandin-Endoperoxide Synthases; D045726:Metalloproteases