title: Time-dependent gene expression and immunohistochemical analysis of the injured anterior cruciate ligament.
abstract: OBJECTIVE
  This study aimed to investigate time-dependent gene expression of injured human anterior cruciate ligament (ACL), and to evaluate the histological changes of the ACL remnant in terms of cellular characterisation.
  
  
  METHODS
  Injured human ACL tissues were harvested from 105 patients undergoing primary ACL reconstruction and divided into four phases based on the period from injury to surgery. Phase I was < three weeks, phase II was three to eight weeks, phase III was eight to 20 weeks, and phase IV was ≥ 21 weeks. Gene expressions of these tissues were analysed in each phase by quantitative real-time polymerase chain reaction using selected markers (collagen types 1 and 3, biglycan, decorin, α-smooth muscle actin, IL-6, TGF-β1, MMP-1, MMP-2 and TIMP-1). Immunohistochemical staining was also performed using primary antibodies against CD68, CD55, Stat3 and phosphorylated-Stat3 (P-Stat3).
  
  
  RESULTS
  Expression of IL-6 was mainly seen in phases I, II and III, collagen type 1 in phase II, MMP-1, 2 in phase III, and decorin, TGF-β1 and α-smooth muscle actin in phase IV. Histologically, degradation and scar formation were seen in the ACL remnant after phase III. The numbers of CD55 and P-Stat3 positive cells were elevated from phase II to phase III.
  
  
  CONCLUSIONS
  Elevated cell numbers including P-Stat3 positive cells were not related to collagens but to MMPs' expressions.
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Naraoka
authors.forename: Y
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: E
authors.initials: E
authors.lastname: Tsuda
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: T
authors.initials: T
authors.lastname: Kusumi
authors.forename: I
authors.initials: I
authors.lastname: Kakizaki
authors.forename: S
authors.initials: S
authors.lastname: Toh
keywords: ACL; Anterior cruciate ligament; Gene expression; Immunohistochemical analysis; Matrix metalloproteinases (MMPs); Stat3; Synovial fibroblast-like cell