The Usefulness of Serological Inflammatory Markers in Patients with Rotator Cuff Disease—A Systematic Review

Abstract

Background and Objectives: Rotator cuff disease (RCD) is a prominent musculoskeletal pain condition that spans a variety of pathologies. The etiology and precise diagnostic criteria of this condition remain unclear. The current practice of investigating the biochemical status of RCD is by conducting biopsy studies but their invasiveness is a major limitation. Recent biochemical studies on RCD demonstrate the potential application of serological tests for evaluating the disease which may benefit future clinical applications and research. This systematic review is to summarize the results of available studies on serological biochemical investigations in patients with RCD. Methods: An electronic search on databases PubMed and Virtual Health Library was conducted from inception to 1 September 2021. The inclusion criteria were case-control, cross-sectional, and cohort studies with serological biochemical investigations on humans with RCD. Methodological quality was assessed using the Study Quality Assessment Tool for Observational Cohort and Cross-sectional studies from the National Heart, Lung, and Blood Institute. Results: A total of 6008 records were found in the databases; of these, 163 full-text studies were checked for inclusion and exclusion criteria. Nine eligible studies involving 984 subjects with RCD emerged from this systematic review. The quality of the studies found ranged from poor to moderate. In summarizing all the studies, several fatty acids, nonprotein nitrogen, interleukin-1 β, interleukin-8, and vascular endothelial growth factor were found to be significantly higher in blood samples of patients with RCD than with control group patients ,while Omega-3 Intex, vitamin B12, vitamin D, phosphorus, interleukin-10, and angiogenin were observed to be significantly lower. Conclusions: This is the first systematic review to summarize current serological studies in patients with RCD. Results of the studies reflect several systemic physiological changes in patients with RCD, which may prove helpful to better understand the complex pathology of RCD. In addition, the results also indicate the possibility of using serological tests in order to evaluate RCD; however, further longitudinal studies are required.

Hypoxia-Inducible Factor and Oxidative Stress in Tendon Degeneration: A Molecular Perspective

“…This leads to excess cellular apoptosis due to BNIP3 regulation, resulting in poor healing of the tendon [17]. In another study, the levels of HIF-1 and VEGF were found to be elevated in samples of rotator cuff tendon disease, and there was also a marked increase in the levels of MMPs, which promotes matrix degradation [54]. Mosca et al compared the levels of HIF-1α pre-and post-tendinopathy treatment and found that the levels of HIF-1α were increased in diseased tendons when compared to post-treatment and healthy tendons (Table 1) [55].…”

The role of vitamin D on rotator cuff tear with osteoporosis

“…tendon integrity (13). Chi et al found that Vitamin B12, vitamin D and angiopoietin are significantly reduced in tendon disorders, which may contribute to a better understanding of the complex pathology of tendon disorders (54). High vitamin D level also promote bone health (55).…”

The major pain source of rotator cuff‐related shoulder pain: A narrative review on current evidence

“…In summary, these studies have shown that pathological changes of RCRSP could be derived from intra-articular (synovial fluid) (Guan et al, 2020;Shih et al, 2018), extra-articular (RC and bursa) (Chillemi et al, 2016) and systemic inflammation (Savitskaya et al, 2011) (Figure 1). Two recent review articles summarised the functions and proposed new hypotheses of the involvement of VGEF, IL-1 β, IL-6, MMPs and other biomarkers in RCRSP (Lo, Leung, & Ngai, 2022;Lo, van Griensven, et al, 2022). IL-1β is an inflammatory mediator involved in tendinopathies (Mobasheri & Shakibaei, 2013;Tang et al, 2018), IL-6 regulates tendon healing and immune function (Andersen et al, 2011) and VEGF is a pro-inflammatory signal protein working for the formation of vascular tissue during tendon healing (Liu et al, 2021).…”

“…Two recent review articles summarised the functions and proposed new hypotheses of the involvement of VGEF, IL‐1 β, IL‐6, MMPs and other biomarkers in RCRSP (Lo, Leung, & Ngai, 2022; Lo, van Griensven, et al., 2022). IL‐1β is an inflammatory mediator involved in tendinopathies (Mobasheri & Shakibaei, 2013; Tang et al., 2018), IL‐6 regulates tendon healing and immune function (Andersen et al., 2011) and VEGF is a pro‐inflammatory signal protein working for the formation of vascular tissue during tendon healing (Liu et al., 2021).…”