Synovial fluid biomarkers: association with chronic rotator cuff tear severity and pain

Shih, Chien-An; Wu, Kuo-Chen; Shao, Chung-Jung; Chern, Tai-Chang; Su, Wei-Ren; Wu, Po‐Ting; Jou, I‐Ming

doi:10.1016/j.jse.2017.09.020

Cited by 16 publications

(25 citation statements)

References 44 publications

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“…). It is well known, that increased pro‐inflammatory cytokine expression profiles negatively affect shoulder pain and tendon integrity . miR‐25 was reported to be an important regulator of inflammatory responses by inhibiting the expression of several cytokines such as tumor necrosis factor α (TNF‐α) and also high mobility group (HMG) protein (e.g., HMGB1) .…”

Section: Discussionmentioning

confidence: 99%

MicroRNA Profiling Reveals Distinct Signatures in Degenerative Rotator Cuff Pathologies

Plachel

Heuberer²,

Gehwolf

et al. 2019

Journal Orthopaedic Research

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MicroRNAs (miRNAs) have emerged as key regulators orchestrating a wide range of inflammatory and fibrotic diseases. However, the role of miRNAs in degenerative shoulder joint disorders is poorly understood. The aim of this explorative case‐control study was to identify pathology‐related, circulating miRNAs in patients with chronic rotator cuff tendinopathy and degenerative rotator cuff tears (RCT). In 2017, 15 patients were prospectively enrolled and assigned to three groups based on the diagnosed pathology: (i) no shoulder pathology, (ii) chronic rotator cuff tendinopathy, and (iii) degenerative RCTs. In total, 14 patients were included. Venous blood samples (“liquid biopsies”) were collected from each patient and serum levels of 187 miRNAs were determined. Subsequently, the change in expression of nine candidate miRNAs was verified in tendon biopsy samples, collected from patients who underwent arthroscopic shoulder surgery between 2015 and 2018. Overall, we identified several miRNAs to be progressively deregulated in sera from patients with either chronic rotator cuff tendinopathy or degenerative RCTs. Importantly, for the several of these miRNAs candidates repression was also evident in tendon biopsies harvested from patients who were treated for a supraspinatus tendon tear. As similar expression profiles were determined for tendon samples, the newly identified systemic miRNA signature has potential as novel diagnostic or prognostic biomarkers for degenerative rotator cuff pathologies. © 2019 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. Inc. J Orthop Res 38:202–211, 2020

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Section: Discussionmentioning

confidence: 99%

MicroRNA Profiling Reveals Distinct Signatures in Degenerative Rotator Cuff Pathologies

Plachel

Heuberer²,

Gehwolf

et al. 2019

Journal Orthopaedic Research

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“…That result may explain why only TNF-α mRNA levels failed to exhibit any significant difference between RCT and hip OA [18]. The significant increasing of IL-6 expression has been confirmed, however, the relationship between IL-6 and RCTs pain is still controversial [2] [4] [18].…”

Section: Discussionmentioning

confidence: 99%

Differential mRNA Expression of <i>COX</i>-2 and Proinflammatory Mediators in Patients with Rotator Cuff Tears and Osteoarthritis of the Hip

Kenmoku¹,

Uchida²,

Nagura³

et al. 2019

OJO

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Purpose: Bursal inflammation is thought to be a major cause of pain in degenerative rotator cuff tears (RCTs). While the expression of proinflammatory mediators, such as COX-2, TNF-α, IL-1β, and IL-6, is crucial for the pathophysiology of osteoarthritis (OA), their role in degenerative RCTs remains unknown. The aim of this study was to determine the expression of COX-2 and proinflammatory mediators in the development of RCT-induced pain by comparing their levels in patients with hip OA or RCTs. Methods: We included samples obtained from 31 shoulders of 31 patients with RCTs and samples from 30 hips of 27 patients with hip OA. The mRNA levels of COX-2, TNF-α, IL-1β, and IL-6 were determined using RT-PCR, and were compared between the subacromial bursa and hip joints. We also analyzed IL-1β-induced COX-2 expression in the subacromial bursa and synovial blast of the hip. Results: COX-2, IL-1β, and IL-6 expression levels were significantly lower in the subacromial bursa of RCTs than in hip OA samples, while no significant difference was observed for TNF-α. No significant difference in the fold increase was observed between subacromial bursa and hip OA samples, even though IL-1β-induced COX-2 expression increased in both samples. Conclusion: Our findings suggest that the main mechanism underlying pain development differs between patients with RCTs and those with hip OA.

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“…Furthermore, Abrams et al reported similar results in which patients with full-thickness rotator cuff tears had greater levels of synovial inflammation compared to patients without tears [6]. Shih et al found a significant correlation between elevated IL-1ß (interleukin), levels in the synovial fluid of patients with rotator cuff tears and pain, and lower functional outcome scores [7]. To date, however, no study has attempted to provide a quantitative analysis to correlate the volume of synovial fluid aspirated at the time of rotator cuff repair to the size of rotator cuff tear.…”

Section: Introductionmentioning

confidence: 88%

Synovial Fluid Volume at the Time of Arthroscopic Rotator Cuff Repair Correlates With Tear Size

Stone¹,

Jamgochian²,

Thakar³

et al. 2020

Cureus

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Background Inflammatory biomarkers are increased in the synovium and tendon of rotator cuff tears. Several studies demonstrate an associated increase in these markers and size of the tear, with implications of chondral destruction leading to rotator cuff tear arthropathy and glenohumeral arthritis. Methods This is a prospective study of 105 patients undergoing arthroscopic rotator cuff repair in which intra-articular synovial fluid was aspirated just prior to arthroscopy. Adult patients with a partial or full-thickness rotator cuff tear undergoing arthroscopic repair were included, and those with inflammatory arthritis, active infection, open cuff repair, intraoperative findings of osteoarthritis, or those undergoing revision cuff repair were excluded. Results The average patient age was 58 years (range 33-74 years), with 59 (56.2%) males. The mean aspirate volume of partial tears was 0.76 ± 0.43 mL, small tears 1.46 ± 1.88 mL, medium tears 3.04 ± 2.21 mL, and large tears 6.60 ± 3.23 mL. Full-thickness versus partial tears had significantly more synovial fluid (3.64 vs. 0.76 mL, respectively, p < 0.0001). An aspiration volume of 1.5 mL or greater resulted in 91.3% specificity and 96.8% positive predictive value for a full-thickness tear. Smoking (p = 0.017), tear size (p < 0.0001), and tears of the infraspinatus (p = 0.048) were significantly correlated with synovial fluid volume. Age, body mass index, chronicity of tear, sex, subscapularis involvement, supraspinatus involvement, and teres minor involvement had no association to synovial fluid volume. Conclusion Preoperative aspiration of the glenohumeral joint to identify the volume of synovial fluid can aid to identify full-thickness rotator cuff tears, and increased fluid volume should alert the clinician of a large tear.

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Synovial fluid biomarkers: association with chronic rotator cuff tear severity and pain

Cited by 16 publications

References 44 publications

MicroRNA Profiling Reveals Distinct Signatures in Degenerative Rotator Cuff Pathologies

MicroRNA Profiling Reveals Distinct Signatures in Degenerative Rotator Cuff Pathologies

Differential mRNA Expression of <i>COX</i>-2 and Proinflammatory Mediators in Patients with Rotator Cuff Tears and Osteoarthritis of the Hip

Synovial Fluid Volume at the Time of Arthroscopic Rotator Cuff Repair Correlates With Tear Size

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Synovial fluid biomarkers: association with chronic rotator cuff tear severity and pain

Cited by 16 publications

References 44 publications

MicroRNA Profiling Reveals Distinct Signatures in Degenerative Rotator Cuff Pathologies

MicroRNA Profiling Reveals Distinct Signatures in Degenerative Rotator Cuff Pathologies

Differential mRNA Expression of &lt;i&gt;COX&lt;/i&gt;-2 and Proinflammatory Mediators in Patients with Rotator Cuff Tears and Osteoarthritis of the Hip

Synovial Fluid Volume at the Time of Arthroscopic Rotator Cuff Repair Correlates With Tear Size

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Differential mRNA Expression of <i>COX</i>-2 and Proinflammatory Mediators in Patients with Rotator Cuff Tears and Osteoarthritis of the Hip