Effects of long-term immobilization and recovery on human triceps surae and collagen turnover in the Achilles tendon in patients with healing ankle fracture
Effects of long-term immobilization and recovery on human triceps surae and collagen turnover in the Achilles tendon in patients with healing ankle fracture
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DOI：
10.1152/japplphysiol.00201.2008
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发表时间：
2008-08-01
影响因子：
3.3
通讯作者：
Langberg, Henning
中科院分区：
文献类型：
--
作者：
Christensen, Britt;Dyrberg, Eva;Langberg, Henning
本研究的目的是分析单侧踝关节骨折患者中，人类肌腱结缔组织对类似 7 周的固定期和类似长度的再活动期的反应，目前尚不清楚。 7 周后，固定腿的小腿肌肉横截面积 (CSA) 减少了 15%（5,316 至 4,517 mm(2)），力量减少了 54%（239 至 110 N·m）。在 7 周的恢复过程中，CSA 增加了 9%（达到 4,943 mm2），强度增加了 37%（达到 176 Nm）。跟腱 CSA 在固定或再活动期间没有显着变化。局部胶原周转率通过 I 型胶原 NH2 末端前肽 (PINP) 和 I 型胶原 COOH 末端端肽区域 (ICTP) 的腱周浓度来测量，这些标记物分别被认为是 I 型胶原合成和降解的指标。固定腿 7 周后，与对照腿相比，固定腿中两种标记物均有所增加（PINP：257 vs. 56 ng/ml；ICTP：9.8 vs. 2.1 mu g/1），并且在恢复期间固定腿中的水平再次下降（PINP：103 vs. 44 ng/ml；ICTP：4.2 vs. 1.9 mu g/1）。固定 7 周后，小腿肌肉 CSA 和力量显着降低。固定增加了组织附近肌腱的胶原蛋白合成和降解。然而，不能排除附近的脚踝骨折可能会影响这些数据。重新活动增加了肌肉的大小和力量，肌腱的合成和降解减少到基线水平。肌腱结缔组织更新的这些动态变化与肌腱尺寸的宏观变化无关。
The aim of the present study was to analyze how human tendon connective tissue responds to an similar to 7-wk period of immobilization and a remobilization period of a similar length, in patients with unilateral ankle fracture, which is currently unknown. Calf muscle cross-sectional area (CSA) decreased by 15% (5,316 to 4,517 mm(2)) and strength by 54% (239 to 110 N . m) in the immobilized leg after 7 wk. During the 7-wk remobilization, the CSA increased by 9% ( to 4,943 mm2) and strength by 37% ( to 176 Nm). Achilles tendon CSA did not change significantly during either immobilization or remobilization. Local collagen turnover was measured as the peritendinous concentrations of NH2-terminal propeptide of type I collagen ( PINP) and COOH-terminal telopeptide region of type I collagen ( ICTP), markers thought to be indexes of type I collagen synthesis and degradation, respectively. Both markers were increased ( PINP: 257 vs. 56 ng/ml; ICTP: 9.8 vs. 2.1 mu g/1) in the immobilized leg compared with the control leg after the 7 wk of immobilization, and levels decreased again in the immobilized leg during the recovery period ( PINP: 103 vs. 44 ng/ml; ICTP: 4.2 vs. 1.9 mu g/1). A significant reduction in calf muscle CSA and strength was found in relation to 7 wk of immobilization. Immobilization increased both collagen synthesis and degradation in tendon near tissue. However, it cannot be excluded that the facture of the ankle in close proximity could have affected these data. Remobilization increased muscle size and strength and tendon synthesis and degradation decreased to baseline levels. These dynamic changes in tendon connective tissue turnover were not associated with macroscopic changes in tendon size.