Immunohistochemical Characterization of Human Synovial Bursa Cells by Light and Transmission Electron Microscopy: Where do These Cells Come From?

Hirschmann, Michael T.; Zschäbitz, A.; Stofft, E

doi:10.4067/s0717-95022007000100001

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…More than 80% of harvested subacromial bursal cells expressed CD44 antigens, whereas <20% expressed CD14 antigens (Figure 3). These results coincide with cell surface markers used to detect human bursal cells 9…”

Section: Resultssupporting

confidence: 84%

Interleukin‐1β stimulates stromal‐derived factor‐1α expression in human subacromial bursa

Blaine

Cote

Proto

et al. 2011

Journal Orthopaedic Research

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Chemokines produced by synoviocytes of the subacromial bursa are up-regulated in subacromial bursitis and rotator cuff disease. We hypothesized that SDF-1α production in bursal synoviocytes may be induced by local cytokines such as interleukin IL-1β and IL-6. Subacromial bursa specimens were obtained from patients undergoing shoulder surgery. Bursal specimens were stained with anti-human antibodies to IL-1, IL-6, and SDF-1α by immunohistochemistry and compared to normal and rheumatoid controls. Bursal cells were also isolated from specimens and cultured. Early passaged cells were then treated with cytokines (IL-1β and IL-6) and SDF-1α expression was measured by ELISA and RT-PCR. SDF-1α, IL-1β, and IL-6 were expressed at high levels in bursitis specimens from human subacromial bursa compared to normal controls. In cultured bursal synoviocytes, there was a dose-dependent increase in SDF-1α production in the supernatants of cells treated with IL-1β. SDF-1α mRNA expression was also increased in bursal cells treated with IL-1β. IL-6 caused a minimal but not statistically significant increase in SDF-1α expression. SDF-1α, IL-1β, and IL-6 are expressed in the inflamed human subacromial bursal tissues in patients with subacromial bursitis. In cultured bursal synoviocytes, SDF-1α gene expression and protein production are stimulated by IL-1β. IL-1β produced by bursal syvoviocytes and inflammatory cells in the human subacromial bursa is an important signal in the inflammatory response that occurs in subacromial bursitis and rotator cuff disease.

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Section: Resultssupporting

confidence: 84%

Interleukin‐1β stimulates stromal‐derived factor‐1α expression in human subacromial bursa

Blaine

Cote

Proto

et al. 2011

Journal Orthopaedic Research

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“…the SAB plays a key role in the rotator cuff healing process, a consideration for bursectomy) (Blaine et al, 2005; Brooks et al, 1992; Chillemi et al, 2016; Feldman, 2018; Lohr & Uhthoff, 1990; Nam et al, 2018; Rathbun & Macnab, 1970; Uhthoff & Sarkar, 1991; Yepes et al, 2007). Both joint and bursal synovium are well vascularised (Dunn et al, 2003; Hirschmann et al, 2007; Key, 1932; Sarkar & Uhthoff, 1983; Wilkinson & Edwards, 1989), but the few available descriptions of the blood supply of the shoulder bursae have solely considered the SAB (Determe et al, 1996; Yepes et al, 2007). Neural structures, including nerve fibres, free nerve endings and various other mechanoreceptors have been identified in the subintima of the SAB, suggesting both nociceptive and proprioceptive functions (Ide et al, 1996; Soifer et al, 1996; Tomita et al, 1997; Vangsness et al, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…Little is known about the histological characteristics of the shoulder bursae, including synovial structure, and neurovascular supply (Kennedy et al, 2017). Descriptions of bursal synovium, in general, are scarce (Dunn et al, 2003; Hirschmann et al, 2007; Woodley et al, 2008), with this tissue depicted as being similar to that of synovial joints and tendon sheaths (Key, 1932) with a typical two‐layer arrangement (intima or synovial lining and the underlying subintima; Firestein et al, 2017; Hirschmann et al, 2007; Mitchell et al, 1988; Sarkar & Uhthoff, 1983). The morphology of the SAB subintima has been documented in three studies, variably described as consisting of (1) loose connective tissue containing vascular channels, (2) dense irregular connective tissue interposed with loose areolar tissue or (3) mature adipose tissue (Mitchell et al, 1988; Sarkar & Uhthoff, 1983; Soifer et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

The morphology of the subacromial and related shoulder bursae. An anatomical and histological study

2021

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Shoulder bursae are essential for normal movement and are also implicated in the pathogenesis of shoulder pain and dysfunction. The subacromial bursa (SAB), within the subacromial space, is considered a primary source of shoulder pain. Several other bursae related to the subcoracoid space, including the coracobrachial (CBB), subcoracoid (SCB) and subtendinous bursa of subscapularis (SSB), are also clinically relevant. The detailed morphology and histological characteristics of these bursae are not well described. Sixteen embalmed cadaveric shoulders from eight individuals (five females, three males; mean age 78.6 ± 7.9 years) were investigated using macro‐dissection and histological techniques to describe the locations, dimensions and attachments of the bursae, their relationship to surrounding structures and neurovascular supply. Bursal sections were stained with haematoxylin and eosin to examine the synovium and with antibodies against von Willebrand factor and neurofilament to identify blood vessels and neural structures respectively. Four separate bursae were related to the subacromial and subcoracoid spaces. The SAB was large, with a confluent subdeltoid portion in all except one specimen, which displayed a distinct subdeltoid bursa. The SAB roof attached to the lateral edge and deep surface of the acromion and coracoacromial ligament, and the subdeltoid fascia; its floor fused with the supraspinatus tendon and greater tubercle. The CBB (15/16 specimens) was deep to the conjoint tendon of coracobrachialis and short head of biceps brachii and the tip of the coracoid process, while the inconstant SCB (5/16 specimens) was deep to the coracoid process. Located deep to the subscapularis tendon, the SSB was a constant entity that commonly displayed a superior extension. Synovial tissue was predominantly areolar (SAB and SSB) or fibrous (CBB and SCB), with a higher proportion of areolar synovium in the bursal roofs compared to their floors. Blood vessels were consistently present in the subintima with a median density of 3% of the tissue surface area, being greatest in the SSB and SAB roofs (4.9% and 3.4% respectively) and least in the SAB floor (1.8%) and CBB roof and floor (both 1.6%). Nerve bundles and free nerve endings were identified in the subintima in approximately one‐third of the samples, while encapsulated nerve endings were present in deeper tissue layers. The extensive expanse and attachments of the SAB support adoption of the term subacromial‐subdeltoid bursa. Morphologically, the strong attachments of the bursal roofs and floors along with their free edges manifest as fixed and mobile portions, which enable movement in relation to surrounding structures. The presence of neurovascular structures demonstrates that these bursae potentially contribute blood supply to surrounding structures and are involved in mechanoreception. The anatomical details presented in this study clarify the morphology of the shoulder bursae, including histological findings that offer further insight into their potenti...

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“…An outer lining consisting of fibroblasts mixed with few histiocytes and mast cells and a sub‐lining consisting mostly of areolar connective tissue is found in synovium and PDM (Bosscher et al, 2016; Dean, Hoyland, Denton, Donn, & Freemont, 1993). Absence of a basement membrane distinguishes PDM and synovium from mesothelium (Hirschmann, 2007; Revell et al, 1995). Both synovium and PDM are highly vascular membranes (Haywood & Walsh, 2001; Smith, 2011; Wilkinson & Edwards, 1989), but size and number of irregularly shaped thick‐walled veins and arteries in the PDM are striking and have been reported by others (Clemens & Walter de Gruyter, 1961; Stringer, 2012; Walther, 1885).…”

Section: Discussionmentioning

confidence: 99%

“…The density of CD68 positive cells may increase markedly under pathological conditions (Bresnihan et al, 2009). The macrophages in the lining of synovium (Type A or macrophage‐like synoviocytes; Barland, Novikoff, & Hamerman, 1962) are thought to be transmigrated bone marrow derived monocytes and to have a scavenging function (Hirschmann, 2007; Smith, 2004).…”

Section: Discussionmentioning

confidence: 99%

The peridural membrane of the spine has characteristics of synovium

Bosscher

Grozdanov

Warraich

et al. 2020

The Anatomical Record

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Recent investigations have renewed interest in a thin well‐innervated peridural membrane PDM which envelopes the contents of the spinal canal and neural foramen in human. Anatomical relations of the PDM in the neural foramen suggest that the suprapedicular compartment of the neural foramen functions as a joint cavity with PDM as its boundary. Inflamed and sensitized PDM may be a source of common low back pain. The purpose of this investigation is to evaluate PDM in the caudal compartment of the neural foramen of the lumbar spine for histological and immunohistochemical (IHC) characteristics of synovium. Dorsolateral and suprapedicular samples of PDM in the lumbar spine of an unembalmed human cadaver were obtained. Samples were evaluated using hematoxylin and eosin staining (HE) and IHC. Four slices of each sample were analyzed (FDNeurotech). Monoclonal and polyclonal antibodies to CD44 (hyaluronan receptor), CD55 (fibroblast like synoviocyte), CD68 (macrophage like synoviocyte) and HAS2 (hyaluronan synthetase 2) were used. Results were evaluated using A1 Nikon confocal immunofluorescent microscopy. HE staining showed a continuous membrane that contains extensive vascular and lymphatic plexus and duct‐like structures, dense and loose fibrous tissue, adipose tissue and nerve tissue in all samples. CD44 was expressed extensively throughout tissues of PDM in all samples, predominantly in perivascular areas but also in adipose, fibrous and nerve tissue. Numerous CD55 positive cells in layer like formations between and around vessels and in the wall of duct‐like structures and in the outer layers of PDM were seen in all samples. CD68 positive cells were found in all samples, but were sparse and mainly found in the outer layer of the membrane. HAS2 positive cells in layer like distributions between vessels or deep to the outer layer of the membrane were found extensively in all samples. Distributions of CD55 and HAS@ positive columnar cells in walls of duct‐like structures and blood vessels were observed in several samples. The results of this study indicate that PDM has histological and IHC characteristics of synovium. IHC identification of CD68 positive cells in the outer layers of PDM and CD55 throughout the membrane, in conjunction with conventional microscopic evaluation of the membrane, suggests the presence of an intima and subintima in PDM similar to synovium. Indeed, PDM histology similar to synovium has been reported by the author and presence of CD44, CD55, CD68 and HAS2 in synovium has been shown by other investigators. No prior reports on the presence of these markers in PDM are available in the literature. Extensive distribution of HAS2 and CD44 in PDM suggests that PDM plays a role in lubrication and homeostasis of the neural foramen and epidural cavity. Presence of CD68, a marker for macrophages, CD55, a receptor involved in regulation of complement activation and CD44, a receptor for metalloproteinases and other inflammatory mediators, indicates that PDM plays an important role in the inflammatory respo...

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Immunohistochemical Characterization of Human Synovial Bursa Cells by Light and Transmission Electron Microscopy: Where do These Cells Come From?

Cited by 6 publications

References 32 publications

Interleukin‐1β stimulates stromal‐derived factor‐1α expression in human subacromial bursa

Interleukin‐1β stimulates stromal‐derived factor‐1α expression in human subacromial bursa

The morphology of the subacromial and related shoulder bursae. An anatomical and histological study

The peridural membrane of the spine has characteristics of synovium

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