The Effect of Insulin and Insulin-like Growth Factor 1 (IGF-1) on Cellular Proliferation and Migration of Human Subacromial Bursa Tissue

Abstract

Purpose To evaluate the effect of a one-time dose of insulin or insulin-like growth factor 1 (IGF-1) on cellular proliferation and migration of subacromial bursa tissue (SBT) over time. Methods SBT was harvested from over the rotator cuff tendon in 4 consecutive patients undergoing primary arthroscopic rotator cuff repair. SBT was cultured for 3 weeks in complete media until reaching confluence. The culture dishes were stored in a humidified, low oxygen tension (5% CO 2 ) incubator at 37°C. SBT of each patient underwent treatment with a one-time dose of insulin or IGF-1, whereas nontreated SBT served as a negative control. Cellular proliferation and migration were evaluated after 24, 48, 72, and 96 hours of incubation. SBT-derived cells migrated in the detection field were visualized using fluorescent microscopy. Results Cellular proliferation at 24, 48, 72, and 96 hours was 1.40 ± 0.27, 1.00 ± 0.20, 1.47 ± 0.31, and 1.68 ± 0.28 for IGF-1; 1.44 ± 0.24, 1.15 ± 0.27, 1.60 ± 0.36, and 1.61 ± 0.32 for insulin; and 1.51 ± 0.35, 1.29 ± 0.33, 1.53 ± 0.35, and 1.57 ± 0.38 for nontreated SBT. Untreated SBT demonstrated a significantly greater proliferation when compared with IGF-1 and insulin within the first 48 hours, although this effect was found to subside by 96 hours. Cellular migration at 24, 48, 72, and 96 hours was 575.7 ± 45.0, 641.6 ± 77.7, 728.3 ± 122.9, and 752.3 ± 114.5 for IGF-1; 528.4 ± 31.3, 592.5 ± 69.8, 664.2 ± 115.2, and 695.6 ± 148.2 for insulin; and 524.4 ± 41.9, 564.4 ± 49.8, 653.2 ± 81.5, and 685.7 ± 115.5 for nontreated SBT. Insulin showed no difference in migration at each timepoint compared to nontreated SBT ( P > .05, respectively). Conclusions Insulin and IGF-1 initially inhibit cellular proliferation of human SBT, although this effect was found to subside by 96 hours. Further, neither insulin nor IGF-1 changed the slope of cellular migration over time. However, each treatment group demonstrated a significant increase in cellular proliferation and migration. Clinical Relevance In the setting of biologic augmentation of rotator cuff repair, the compatibility and synergistic effect of insulin on human SBT is highly limited.

Activated Serum Increases In Vitro Cellular Proliferation and Growth Factor Expression of Musculoskeletal Cells

“…Leong et al describes the necessary role that growth factors such as PDGF, VEGF, and IGF-1 have on tendon and ligament healing [ 37 ]. Muench, et al found that, when IGF-1 is added to musculoskeletal cells, there is increased cellular proliferation over time [ 38 ]. Lastly, Liu et al showed that there is a cellular proliferation benefit to growth factor treatments; however, there seems to be some variability in the efficacy of long-term treatments [ 39 ].…”

The effect of augmenting suture material with magnesium and platelet-rich plasma on the in vitro adhesion and proliferation potential of subacromial bursa-derived progenitor cells

“…Cells were then cultured in growth media at 37 ° C with 5% CO 2 until reaching confluence. 22 , 23 , 28 , 29 …”

“…However, maximizing the amount of retained progenitor cells at the targeted zone of repaired tissue still remains essential for ensuring an optimal healing environment. 28 , 29 Interestingly, SBDCs were found to have the in vitro ability to adhere and proliferate on suture material commonly used in rotator cuff repair. 28 More importantly, augmenting the surface of the suture with magnesium resulted in a significant increase in the cellular adhesion of SBDCs when compared to nonaugmented sutures while not impairing their proliferative capacity.…”

Subacromial Bursa: A Neglected Tissue Is Gaining More and More Attention in Clinical and Experimental Research

“…To improve cell migration potential and proliferation, subacromial bursa-derived cells were stimulated with a one-time dosage of insulin or insulin-like growth factor (IGF-1), which might be useful for achieving an improved healing through the provision of a sufficient number of healing-promoting cells at the rotator cuff repair side. However, no significant impact of insulin or IGF-1 on cell proliferation and migration of bursa-derived cells could be detected [ 92 ].…”