The association between retraction of the torn rotator cuff and increasing expression of hypoxia inducible factor 1α and vascular endothelial growth factor expression: an immunohistological study

BMC Musculoskeletal Disorders

Research Article

Stefan Lakemeier¹  Susanne Fuchs-Winkelmann¹  Markus D Schofer¹  Thilo Patzer¹  Juergen RJ Paletta¹  Johannes JA Reichelt¹ 

[1] Department of Orthopedics and Rheumatology, University Hospital Marburg, Marburg, Germany;

关键词: Vascular Endothelial Growth Factor;    Rotator Cuff;    Vascular Endothelial Growth Factor Expression;    Hypoxia Inducible Factor;    Muscle Atrophy;   

DOI  :  10.1186/1471-2474-11-230

 received in 2010-04-17, accepted in 2010-10-08,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundDiffering levels of tendon retraction are found in full-thickness rotator cuff tears. The pathophysiology of tendon degeneration and retraction is unclear. Neoangiogenesis in tendon parenchyma indicates degeneration. Hypoxia inducible factor 1α (HIF) and vascular endothelial growth factor (VEGF) are important inducers of neoangiogenesis. Rotator cuff tendons rupture leads to fatty muscle infiltration (FI) and muscle atrophy (MA). The aim of this study is to clarify the relationship between HIF and VEGF expression, neoangiogenesis, FI, and MA in tendon retraction found in full-thickness rotator cuff tears.MethodsRotator cuff tendon samples of 33 patients with full-thickness medium-sized rotator cuff tears were harvested during reconstructive surgery. The samples were dehydrated and paraffin embedded. For immunohistological determination of VEGF and HIF expression, sample slices were strained with VEGF and HIF antibody dilution. Vessel density and vessel size were determined after Masson-Goldner staining of sample slices. The extent of tendon retraction was determined intraoperatively according to Patte's classification. Patients were assigned to 4 categories based upon Patte tendon retraction grade, including one control group. FI and MA were measured on standardized preoperative shoulder MRI.ResultsHIF and VEGF expression, FI, and MA were significantly higher in torn cuff samples compared with healthy tissue (p < 0.05). HIF and VEGF expression, and vessel density significantly increased with extent of tendon retraction (p < 0.05). A correlation between HIF/VEGF expression and FI and MA could be found (p < 0.05). There was no significant correlation between HIF/VEGF expression and neovascularity (p > 0.05)ConclusionTendon retraction in full-thickness medium-sized rotator cuff tears is characterized by neovascularity, increased VEGF/HIF expression, FI, and MA. VEGF expression and neovascularity may be effective monitoring tools to assess tendon degeneration.

【 授权许可】

CC BY   
© Lakemeier et al; licensee BioMed Central Ltd. 2010