The Effect of Corticosteroid on Collagen Expression in Injured Rotator Cuff Tendon

Wei, Anthony S.; Callaci, John J.; Juknelis, Dainius; Marra, Guido; Tonino, Pietro; Freedman, Kevin B.; Wezeman, Frederick H.

doi:10.2106/jbjs.e.00806

Cited by 89 publications

(61 citation statements)

References 46 publications

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“…The newly formed scar, however, is mainly composed of type III collagen, instead of Col1 and Col2. Galatz et al [2] and Wei et al [56] have demonstrated that the expression of Col1 and Col2 is an important indicator of the total repair outcome of RCT, especially at later stages during repair maturation. In the current study, a significant increase in Col1 and Col2 in the ICA group compared with those in the control group was observed at each time point, while no significant difference was found between ICA and control groups regarding the Col3 protein expression, which indicated the scar tissues cannot be decreased due to the treatment of ICA in early stage (2–4 weeks).…”

Section: Discussionmentioning

confidence: 99%

Icariin Promotes Tendon-Bone Healing during Repair of Rotator Cuff Tears: A Biomechanical and Histological Study

Zhang

Wang

et al. 2016

IJMS

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To investigate whether the systematic administration of icariin (ICA) promotes tendon-bone healing after rotator cuff reconstruction in vivo, a total of 64 male Sprague Dawley rats were used in a rotator cuff injury model and underwent rotator cuff reconstruction (bone tunnel suture fixation). Rats from the ICA group (n = 32) were gavage-fed daily with ICA at 0.125 mg/g, while rats in the control group (n = 32) received saline only. Micro-computed tomography, biomechanical tests, serum ELISA (calcium; Ca, alkaline phosphatase; AP, osteocalcin; OCN) and histological examinations (Safranin O and Fast Green staining, type I, II and III collagen (Col1, Col2, and Col3), CD31, and vascular endothelial growth factor (VEGF)) were analyzed two and four weeks after surgery. In the ICA group, the serum levels of AP and OCN were higher than in the control group. More Col1-, Col2-, CD31-, and VEGF-positive cells, together with a greater degree of osteogenesis, were detected in the ICA group compared with the control group. During mechanical testing, the ICA group showed a significantly higher ultimate failure load than the control group at both two and four weeks. Our results indicate that the systematic administration of ICA could promote angiogenesis and tendon-bone healing after rotator cuff reconstruction, with superior mechanical strength compared with the controls. Treatment for rotator cuff injury using systematically-administered ICA could be a promising strategy.

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Section: Discussionmentioning

confidence: 99%

Icariin Promotes Tendon-Bone Healing during Repair of Rotator Cuff Tears: A Biomechanical and Histological Study

Zhang

Wang

et al. 2016

IJMS

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“…Their side effects are also well documented, such as infection, tendon ruptures, and skin and subcutaneous fat atrophy [9]. In addition, experimental studies suggest that corticosteroids not only damage the ultrastructure of collagen molecules [26] but also inhibit the regenerative properties of tendon stem cells [27]. Surprisingly, this evidence has not prevented the prevalence of injectable corticosteroids in routine management of tendon disorders.…”

Section: Discussionmentioning

confidence: 99%

Diclofenac and triamcinolone acetonide impair tenocytic differentiation and promote adipocytic differentiation of mesenchymal stem cells

Fredriksson

Stålman

et al. 2013

J Orthop Surg Res

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BackgroundTendinopathies are often empirically treated with oral/topical nonsteroidal anti-inflammatory medications and corticosteroid injections despite their unclear effects on tendon regeneration. Recent studies indicate that tendon progenitors exhibit stem cell-like properties, i.e., differentiation to osteoblasts, adipocytes, and chondrocytes, in addition to tenocytes. Our present study aims at understanding the effects of triamcinolone acetonide and diclofenac on tenocytic differentiation of mesenchymal stem cells.MethodsThe murine fibroblast C3H10T1/2 cell line was induced to tenocytic differentiation by growth differentiation factor-7. Cell proliferation and differentiation with the exposure of different concentrations of triamcinolone acetonide and diclofenac were measured by WST-1 assay and real-time polymerase chain reaction analysis, respectively.ResultsCell proliferation was decreased in a concentration-dependent manner when exposed to triamcinolone acetonide and diclofenac. In addition to tenocytic differentiation, adipocyte formation was observed, both at gene expression and microscopic level, when the cells were exposed to triamcinolone acetonide or high concentrations of diclofenac.ConclusionsOur results indicate that triamcinolone acetonide and diclofenac might alter mesenchymal stem cell differentiation in a nonfavorable way regarding tendon regeneration; therefore, these medications should be used with more caution clinically.

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“…The magnitude of reduction in collagen type 1 and decorin gene expression appeared to be smaller when corticosteroid treatment was combined with mechanical strain (Chen et al, 2007). Further, a 4.5‐fold increase in the type 3 to 1 collagen expression ratio, a tendon injury marker, in uninjured rat rotator cuff tendons was found 1‐week post‐treatment initiation, which was back to baseline levels by 3 weeks (Wei et al, 2006). Additionally, tendon cell migration, which is fundamental to tendon healing, is delayed by 3 days after corticoid injection in rat Achilles tendons and thereafter the migration is reduced in a dose‐dependent manner (Tsai et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Corticosteroid administration alters the mechanical properties of isolated collagen fascicles in rat‐tail tendon

Haraldsson

Aagaard

Crafoord-Larsen

et al. 2009

Scandinavian Med Sci Sports

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Overload tendon injuries are frequent in recreational and elite sports. The optimal treatment strategy remains unknown, but local administration of corticosteroids is one common treatment option. The direct effects of the corticosteroid administration on the tissue are not fully understood. The present study examined the biomechanical effects of intratendinous corticosteroid injections on healthy rat-tail tendon collagen fascicles. A total of 24 Wistar male rats were divided into (A) a corticosteroid group where the animals were injected in the tail tendon with methylprednisolone acetate, 1.0 mL of 40 mg/mL mixed with 1.0 mL 9% saline (n=12), and (B) a control group that was injected with 9% saline (n=12). Three days after the injections, the animals were sacrificed and single individual collagen fascicles were collected and underwent displacement to failure. Corticosteroid administration significantly reduced tensile fascicle yield strength by 16% and Young's modulus by 14% compared with sham treatment (10.5+/-0.8 vs 12.4+/-0.5 MPa, P< or =0.05, and 537+/-27 vs 641+/-30 MPa, P<0.05, respectively), while the strain properties were unaffected. Peak stress was similar between the two groups. There was no difference in fascicle diameter between the two groups.

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The Effect of Corticosteroid on Collagen Expression in Injured Rotator Cuff Tendon

Cited by 89 publications

References 46 publications

Icariin Promotes Tendon-Bone Healing during Repair of Rotator Cuff Tears: A Biomechanical and Histological Study

Icariin Promotes Tendon-Bone Healing during Repair of Rotator Cuff Tears: A Biomechanical and Histological Study

Diclofenac and triamcinolone acetonide impair tenocytic differentiation and promote adipocytic differentiation of mesenchymal stem cells

Corticosteroid administration alters the mechanical properties of isolated collagen fascicles in rat‐tail tendon

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