Cytokines' Role in the Pathogenesis and Their Targeting for the Prevention of Frozen Shoulder: A Narrative Review

Abstract

Frozen shoulder (FS) is a common name for shoulder movement limitation with different degrees of shoulder rigidity and pain. It is characterized by varying developmental courses, different levels of shoulder movement limitation, and background ambiguity due to the multiplicity of its causative factors. Systemic inflammatory cytokines monitoring and restraining is easy to apply, fast to conduct, and needs lower costs compared to invasive methods for frozen shoulder stage evaluation and early controlling of its progress to the stage that necessitates surgical intervention. The aim of this review was to assess the recent findings concerning the role of cytokines in FS pathogenesis and the possibility of preventing or controlling their progress through targeting these cytokines by the new drugs candidates, such as hyaluronan (HA), botulinum toxin type A (BoNT A), Tetrandrine, tumor necrosis factor-stimulated gene-6 (TSG-6), and cannabidiol. Searching the PubMed site, we encountered out of 1608 records, from which 16 original studies were included for the quantitative construction of this systematic review screening of the recent studies to investigate the different FS pathogenic pathways. Most of the scenarios are centered around the inflammatory and fibrotic process triggered by synovial and capsular fibroblast stimulation. This mechanism depends mainly on alarmins cytokines, including thymic stromal lymphopoietin (TSLP), interleukin-33 (IL-33), and interleukin-25 (IL-25), with the stimulation of interleukin-1 α (IL-1α), interleukin-1 β (IL-1β), tumor necrosis alpha (TNF-α), cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) in a joint capsule. Different pathways of transforming growth factor- β (TGF-β) stimulation, resulting in overexpression of the fibrotic factors as tenascin C (TNC), fibronectin 1, collagen I (COL 1) and collagen III (COL III), and matrix metalloproteinases (MMPs) in the capsular or synovial/capsular fibroblasts. The overall investigation of these studies led us to conclude that the new drug candidates proved their efficiency in controlling the common pathogenesis of the inflammatory and fibrotic pathways of frozen shoulder and therefore represent a prospect for easy and early controlling and efficiently treating this serious disease.

Adhesive Capsulitis Following Improper Tetanus-Diphtheria (Td) Booster Administration

“…The pathophysiology of adhesive capsulitis secondary to improper IM vaccination administration is not fully understood. Previous studies have found an increased expression of inflammatory mediators (interleukins, tumor necrosis factor-alpha {TNF-α}, tumor necrosis factor-beta {TNF-β}, and vascular endothelial growth factor {VEG-F}) in the joint capsule of patients with adhesive capsulitis [9]. It is postulated that improper injection of tetanus and diphtheria toxoids into the glenohumeral joint capsule leads to a significant inflammatory response within the joint, triggering adhesive capsulitis.…”

A Comparative Study of Manual Therapy Interventions for Improving Shoulder Pain and Range of Motion in Frozen Shoulder : An Experimental Study

“…It is characterised by varying developmental courses, different levels of shoulder movement limitation, and background ambiguity due to the multiplicity of its causative factors. 13 This study was conducted to evaluate the efficacy of different manual therapy interventions in improving pain and ROM. This study consists of six groups of manual therapy interventions, namely: 1.…”

Council of Experts: chronic shoulder pain as a multidisciplinary problem

“…Частота синдрома сдавления ротаторов плеча (ССРП), или субакромиального импинджментсиндрома, колеблется от 4,6 до 46,0% в зависимости от изучаемой популяции [3]. Адгезивный капсулит ПС поражает от 2 до 5% жителей Земли и наблюдается у 30% пациентов с сахарным диабетом (СД) 2-го типа 50 лет и старше [6]. Кальцифицирующий тендинит является причиной ХБОП в 7-17% случаев [7].…”