Effects of corticosteroid on the expressions of neuropeptide and cytokine mRNA and on tenocyte viability in lateral epicondylitis

Journal of Inflammation

Soon Chul Lee³  Jong Sup Shim⁴  Young Do Kwon⁵  Dong Eun Shin³  Ji Ye Song²  Hee Jung An¹  Soo Hong Han³ 

[1] Department of Pathology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, 463-712, Korea;Institute for Clinical Research, CHA Bundang Medical Center, CHA University, Gyeonggi-do, 463-712, Korea;Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Gyeonggi-do, 463-712, Korea;Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, 135-710, Korea;Department of Biomedical Science, Graduate School, CHA University, Gyeonggi-do, 463-712, Korea

关键词: Tenocyte viability;    mRNA;    Neuropeptide;    Corticosteroid;    Lateral epicondylitis;   

Others  :  821563
DOI  :  10.1186/1476-9255-9-40

 received in 2012-04-23, accepted in 2012-10-26,  发布年份 2012

【 摘 要 】

Background

The purpose of this study was to determine the reaction mechanism of corticosteroid by analyzing the expression patterns of neuropeptides (substance P (SP), calcitonin gene related peptide (CGRP)) and of cytokines (interleukin (IL)-1α, tumor growth factor (TGF)-β) after corticosteroid treatment in lateral epicondylitis. In addition, we also investigated whether corticosteroid influenced tenocyte viability.

Methods

The corticosteroid triamcinolone acetonide (TAA) was applied to cultured tenocytes of lateral epicondylitis, and the changes in the mRNA expressions of neuropeptides and cytokines and tenocyte viabilities were analyzed at seven time points. Quantitative real-time polymerase chain reaction and an MTT assay were used.

Results

The expression of SP mRNA was maximally inhibited by TAA at 24 hours but recovered at 72 hours, and the expressions of CGRP mRNA and IL-1α mRNA were inhibited at 24 and 3 hours, respectively. The expression of TGF-β mRNA was not significant. Tenocyte viability was significantly reduced by TAA at 24 hours.

Conclusions

We postulate that the reaction mechanism predominantly responsible for symptomatic relief after a corticosteroid injection involves the inhibitions of neuropeptides and cytokines, such as, CGRP and IL-1α. However the tenocyte viability was compromised by a corticosteroid.

【 授权许可】

   
2012 Han et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

【 参考文献 】

• [1]Galliani I, Burattini S, Mariani AR, Riccio M, Cassiani G, et al.: Morpho-functional changes in human tendon tissue. Eur J Histochem 2002, 46:3-12.
• [2]Khan KM, Cook JL, Kannus P, Maffulli N, Bonar SF: Time to abandon the "tendinitis" myth. BMJ 2002, 324:626-627.
• [3]Nirschl RP, Ashman ES: Elbow tendinopathy: tennis elbow. Clin Sports Med 2003, 22:813-836.
• [4]Maffulli N, Testa V, Capasso G, Ewen SW, Sullo A, et al.: Similar histopathological picture in males with Achilles and patellar tendinopathy. Med Sci Sports Exerc 2004, 36:1470-1475.
• [5]Bisset L, Beller E, Jull G, Brooks P, Darnell R, et al.: Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006, 333:939.
• [6]Rees JD, Maffulli N, Cook J: Management of tendinopathy. Am J Sports Med 2009, 37:1855-1867.
• [7]Zeisig E, Ljung BO, Alfredson H, Danielson P: Immunohistochemical evidence of local production of catecholamines in cells of the muscle origins at the lateral and medial humeral epicondyles: of importance for the development of tennis and golfer's elbow? Br J Sports Med 2009, 43:269-275.
• [8]Uchio Y, Ochi M, Ryoke K, Sakai Y, Ito Y, et al.: Expression of neuropeptides and cytokines at the extensor carpi radialis brevis muscle origin. J Shoulder Elbow Surg 2002, 11:570-575.
• [9]Lieber RL, Loren GJ, Friden J: In vivo measurement of human wrist extensor muscle sarcomere length changes. J Neurophysiol 1994, 71:874-881.
• [10]Regan W, Wold LE, Coonrad R, Morrey BF: Microscopic histopathology of chronic refractory lateral epicondylitis. Am J Sports Med 1992, 20:746-749.
• [11]Ljung BO, Forsgren S, Friden J: Sympathetic and sensory innervations are heterogeneously distributed in relation to the blood vessels at the extensor carpi radialis brevis muscle origin of man. Cells Tissues Organs 1999, 165:45-54.
• [12]Ljung BO, Alfredson H, Forsgren S: Neurokinin 1-receptors and sensory neuropeptides in tendon insertions at the medial and lateral epicondyles of the humerus. Studies on tennis elbow and medial epicondylalgia. J Orthop Res 2004, 22:321-327.
• [13]Ozturan KE, Yucel I, Cakici H, Guven M, Sungur I: Autologous blood and corticosteroid injection and extracoporeal shock wave therapy in the treatment of lateral epicondylitis. Orthopedics 2010, 33:84-91.
• [14]Tempfer H, Gehwolf R, Lehner C, Wagner A, Mtsariashvili M, et al.: Effects of crystalline glucocorticoid triamcinolone acetonide on cultered human supraspinatus tendon cells. Acta Orthop 2009, 80:357-362.
• [15]Wong MW, Lui WT, Fu SC, Lee KM: The effect of glucocorticoids on tendon cell viability in human tendon explants. Acta Orthop 2009, 80:363-367.
• [16]Lambert MI, St Clair Gibson A, Noakes TD: Rupture of the triceps tendon associated with steroid injections. Am J Sports Med 1995, 23:778.
• [17]Balasubramaniam P, Prathap K: The effect of injection of hydrocortisone into rabbit calcaneal tendons. J Bone Joint Surg Br 1972, 54:729-734.
• [18]Wiesenfeld-Hallin Z, Xu XJ: The differential roles of substance P and neurokinin A in spinal cord hyperexcitability and neurogenic inflammation. Regul Pept 1993, 46:165-173.
• [19]Andersson G, Danielson P, Alfredson H, Forsgren S: Presence of substance P and the neurokinin-1 receptor in tenocytes of the human Achilles tendon. Regul Pept 2008, 150:81-87.
• [20]Lui PP, Chan LS, Fu SC, Chan KM: Expression of sensory neuropeptides in tendon is associated with failed healing and activity-related tendon pain in collagenase-induced tendon injury. Am J Sports Med 2010, 38:757-764.
• [21]Angeli A, Masera RG, Sartori ML, Fortunati N, Racca S, et al.: Modulation by cytokines of glucocorticoid action. Ann N Y Acad Sci 1999, 876:210-220.
• [22]Brattsand R, Linden M: Cytokine modulation by glucocorticoids: mechanisms and actions in cellular studies. Aliment Pharmacol Ther 1996, 10(2):81-90. discussion 91-82
• [23]Klein MB, Yalamanchi N, Pham H, Longaker MT, Chang J: Flexor tendon healing in vitro: effects of TGF-beta on tendon cell collagen production. J Hand Surg Am 2002, 27:615-620.
• [24]Chakir J, Shannon J, Molet S, Fukakusa M, Elias J, et al.: Airway remodeling-associated mediators in moderate to severe asthma: effect of steroids on TGF-beta, IL-11, IL-17, and type I and type III collagen expression. J Allergy Clin Immunol 2003, 111:1293-1298.
• [25]Osborne H: Stop injecting corticosteroid into patients with tennis elbow, they are much more likely to get better by themselves! J Sci Med Sport 2010, 13:380-381.
• [26]Ihara H, Nakanishi S: Selective inhibition of expression of the substance P receptor mRNA in pancreatic acinar AR42J cells by glucocorticoids. J Biol Chem 1990, 265:22441-22445.
• [27]Torricelli P, Fini M, Giavaresi G, Carpi A, Nicolini A, et al.: Effects of systemic glucocorticoid administration on tenocytes. Biomed Pharmacother 2006, 60:380-385.
• [28]Dickerson C, Undem B, Bullock B, Winchurch RA: Neuropeptide regulation of proinflammatory cytokine responses. J Leukoc Biol 1998, 63:602-605.