Background
The repair of rotator cuff tears is often complicated by fatty degeneration, which is the combination of lipid accumulation, fibrosis, inflammation and muscle weakness. p38 MAPK is a signaling molecule that plays a central role in these processes. The purpose of this study was to evaluate a small molecule inhibitor of p38 MAPK, SB203580, in reducing fatty degeneration in a preclinical model of rotator cuff injury and repair.
Methods
Adult rats underwent a bilateral supraspinatus tenotomy that was repaired 30 days later. Rats were treated with SB203580 or vehicle every 2 days with injections beginning 3 days prior to surgery, and continued until 7 days after surgery. Two weeks after surgical repair muscles were analyzed using histology, lipid profiling, gene expression and permeabilized muscle fiber contractility.
Results
Inhibition of p38 MAPK resulted in a nearly 49% reduction in fat accumulation and a 29% reduction in collagen content, along with changes in corresponding genes regulating adipogenesis and matrix accumulation. There was also a marked 40–80% decrease in the expression of several proinflammatory genes, including IL1β, IL6 and COX2, and a 360% increase in the antiinflammatory gene IL10. No differences were observed for muscle fiber force production.
Conclusion
Inhibition of p38 MAPK was found to have a significant decrease in intramuscular lipid accumulation and fibrosis that is usually seen in the degenerative cascade of rotator cuff tears, without having negative effects on the contractile properties of the rotator cuff muscle tissue.