著者

浜田 純一郎 大野 弥 玉井 和哉

出版者

日本肩関節学会

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.26, no.2, pp.309-314, 2002-01-01

参考文献数

8

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The purpose of this study was to identify whether the glenohumeral joint (GHj) or subacromial bursa (SAB) is the main inflamed site, and which pathway should be operated on for the degradation of the articular cartilage after a cuff tear. We obtained synovial fluid, SAB, the stump of a torn supraspinatus tendon (cuff), synovium, and articular cartilage (cartilage) from 8 patients with a complete-thickness tear. As a control, the cuff and cartilage were removed from 2 patients with tumors around the shoulders. We measured the concentration of interleukin-1 β (IL-1 β), IL-6, matrix metalloproteinase-1 (MMP-1), MMP-3. Immunohistochemical localization with antibodies to proliferative cell nuclear antigen (PCNA), IL-1 β, IL-6 and MMP-3 was performed using the ABC immunoperoxidase method. Concentrations of IL-1 β were 4.8±4.3 pg/ml, IL-6 485±4.3 pg/ml, MMP-1 417±330 ng/ml, MMP-3 6105±4258 ng/ml. A few nuclei were stained by PCNA but no cell by IL-1 β, IL-6, or MMP-3 in the control tissues. IL-1 β immunoreactivity was highest in the following order synovium, cuff, SAB, and cartilage ; for IL-6 the order was synovium, cuff, and SAB ; for MMP-3 in the order was synovium and cuff. Even though we found the same pathological findings (hyperplasia and abundant blood vessels) between the SAB and the synovium, expression of both IL-1 β and MMP-3 were much higher in the synovium than in the SAB. We conclude from these results that GHj is the main inflamed site after a cuff tear, and the extrinsic pathway is more greatly operated than the intrinsic pathway to cartilage degradation.