Fibronectin, MMP‐1 and histologic changes in rotator cuff disease

Tillander, Bo; Franzén, Lennart; Norlin, Rolf

doi:10.1016/s0736-0266(02)00057-8

Cited by 59 publications

(46 citation statements)

References 32 publications

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“…While other potential mechanisms exist that could lead to transient effects of tendon detachment to muscle (and to the tendon), the high correlation between muscle and tendon remodeling and the scar formation leads us to conclude that the most likely basis for our observations are due to the return of load to the muscle-tendon complex via scar adhesions. The accumulation of fibrotic tissue and fat in the supraspinatus muscle is a problem that plagues individuals with rotator cuff injuries [6,11,14,23,29]. We hypothesized that there would be an increase in collagen and fat with time post-detachment.…”

Section: Discussionmentioning

confidence: 99%

Rat supraspinatus muscle atrophy after tendon detachment

Barton

Gimbel

Williams

et al. 2005

Journal Orthopaedic Research

107

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Rotator cuff tears are one of the most common tendon disorders found in the healthy population. Tendon tears not only affect the biomechanical properties of the tendon, but can also lead to debilitation of the muscles attached to the damaged tendons. The changes that occur in the muscle after tendon detachment are not well understood. A rat rotator cuff model was utilized to determine the time course of changes that occur in the supraspinatus muscle after tendon detachment. It was hypothesized that the lack of load on the supraspinatus muscle would cause a significant decrease in muscle mass and a conversion of muscle fiber properties toward those of fast fiber types. Tendons were detached at the insertion on the humerus without repair. Muscle mass, morphology and fiber properties were measured at one, two, four, eight, and 16 weeks after detachment. Tendon detachment resulted in a rapid loss of muscle mass, an increase in the proportion of fast muscle fibers, and an increase in the fibrotic content of the muscle bed, concomitant with the appearance of adhesions of the tendon 10 surrounding surfaces. At 16 weeks post-detachment, muscle mass and the fiber properties in the deep muscle layers returned to normal levels. However, the fiber shifts observed in the superficial layers persisted throughout the experiment. These results suggest that load returned to the muscle via adhesions to surrounding surfaces, which may be sufficient to reverse changes in muscle mass.

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Section: Discussionmentioning

confidence: 99%

Rat supraspinatus muscle atrophy after tendon detachment

Barton

Gimbel

Williams

et al. 2005

Journal Orthopaedic Research

107

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“…Biology and histology of rotator cuff tears Necrotic tendon tissue, fibrin and fibronectin appear to be signs of tendon degeneration, while fibrosis and thinning of fascicles have also been found in controls without rotator cuff tears (7). The biochemical changes in rotator cuff tears are yet not perfectly known.…”

Section: J Ointsmentioning

confidence: 99%

Degenerative disease in rotator cuff tears: what are the biochemical and histological changes?

Giorgi¹

2014

jts

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The histopathological changes associated with rotator cuff tears include thinning and disorganization of collagen fibers, the presence of granulation tissue, increased levels of glycosaminoglycans, fibrocartilaginous metaplasia, calcification, fatty infiltration, and necrosis of the tendon margin with cell apoptosis. The biochemical changes include an increase in the expression of matrix metalloproteinases (MMPs) and a decrease in tissue inhibitor of metalloproteinases (TIMP) messenger ribonucleic acid expression. Histological evidence of tendinopathy has been found in patients with rotator cuff tear. Biochemical changes include significant increases in MMP1, MMP2, MMP3, and in TIMP1 and TIMP2 levels, not only at the lateral supraspinatus edge, but also in the macroscopically intact portion of the supraspinatus tendon and in the intact subscapularis. The tissue in the ruptured area of the supraspinatus tendon undergoes marked rearrangement at molecular levels. This involves the activity of MMP1, 2, and 3 and supports a critical role of MMPs in tendon physiology. Intact parts of the torn supraspinatus tendon can present the histopathological changes associated with rotator cuff tears. These findings suggest that biochemical changes can already occur in a macroscopically intact tendon and seem to point to a global degenerative process in the shoulder.Key Words: biology, histology, degenerative changes, rotator cuff tear.Rotator cuff tears are a frequent cause of shoulder pain and disability. The pathogenesis and the biochemical changes associated with rotator cuff tears are unclear, but they may arise from a combination of extrinsic impingement and intrinsic alterations within the tendon tissue itself (1). The etiology of rotator cuff disease is likely multifactorial, including age-related degeneration and microtrauma. Smoking, hypercholesterolemia and genetics have all been shown to influence the development of rotator cuff tearing (2). Tendons have a water content of 70%, while type I collagen accounts for 85% of their dry weight. Cells are scarce and those present are mostly (90-95%) fibroblasts. The histopathological changes associated with rotator cuff tears include thinning and disorganization of collagen fibers, the presence of granulation tissue, infiltration of glycosaminoglycans, fibrocartilaginous metaplasia, calcification, fatty degeneration, and necrosis of the tendon margin with cell apoptosis (3-5). These changes are also present in macroscopically intact tendons in the early stage of the degenerative process (3, 6). The degenerative changes at the tendon margin can also explain the high rate of recurrence after surgery, even in cases with less than grade 2 fatty infiltration (4). Chronic rotator cuff tears in elderly patients have limited healing potential and a high risk of recurrence, even if surgically treated. In these cases, the weak healing process seems to be produced more from the bursal side than from the tendinous one. Conversely, the healing potential of small and acute rotator c...

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“…Fibronectin and tenascin-C are key factors in the tendon repairing process by promoting fibroblast migration, and adhesion of fibroblasts to fibrin [41,106]. In addition to the genomic study [73] showing variants of the tenascin-C gene are associated with Achilles tendon injury, a persistent increase in expression of fibronectin and tenascin-C has been reported in tendinopathy (Table 2) and may contribute to the pathogenic matrix remodeling in tendinopathy [90,105].…”

Section: Extracellular Matrix (Ecm)mentioning

confidence: 99%

The Basic Science of Tendinopathy

Murrell

2008

Clinical Orthopaedics &Amp; Related Research

314

254

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Tendinopathy is a common clinical problem with athletes and in many occupational settings. Tendinopathy can occur in any tendon, often near its insertion or enthesis where there is an area of stress concentration, and is directly related to the volume of repetitive load to which the tendon is exposed. Recent studies indicate tendinopathy is more likely to occur in situations that increase the ''dose'' of load to the tendon enthesis -including increased activity, weight, advancing age, and genetic factors. The cells in tendinopathic tendon are rounder, more numerous, and show evidence of oxidative damage and more apoptosis. These cells also produce a matrix that is thicker and weaker with more water, more immature and cartilage-like matrix proteins, and less organization. There is now evidence of a population of regenerating stem cells within tendon. These studies suggest prevention of tendinopathy should be directed at reducing the volume of repetitive loads to below that which induces oxidative-induced apoptosis and cartilage-like genes. The management strategies might involve agents or cells that induce tendon stem cell proliferation, repair and restoration of matrix integrity.

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Fibronectin, MMP‐1 and histologic changes in rotator cuff disease

Cited by 59 publications

References 32 publications

Rat supraspinatus muscle atrophy after tendon detachment

Rat supraspinatus muscle atrophy after tendon detachment

Degenerative disease in rotator cuff tears: what are the biochemical and histological changes?

The Basic Science of Tendinopathy

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