Structural and biochemical evaluation of the elbow capsule after trauma
Structural and biochemical evaluation of the elbow capsule after trauma
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DOI：
10.1016/j.jse.2006.06.018
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发表时间：
2007-07-01
影响因子：
3
通讯作者：
Muehleman, Carol
中科院分区：
文献类型：
--
作者：
Cohen, Mark S.;Schimmel, Daniel R.;Muehleman, Carol
本研究通过显微镜和免疫组织化学评估创伤后肘关节囊的结构和生化改变。我们比较了37例肘关节挛缩手术患者的囊体与7例供体的正常囊体。挛缩囊的厚度显著高于对照组（P < 0.05），胶原纤维束排列明显紊乱。测量了参与结缔组织更新的特定细胞因子的水平。结果表明，细胞因子基质金属蛋白酶（MMP） 1、MMP-2、MMP-3水平显著高于对照组（P < 0.05）。这与胶原组织紊乱，成纤维细胞浸润，在一些标本中，包膜组织中淋巴细胞浸润有关。在挛缩标本中，仅在滑膜附近和血管中可见基质金属蛋白酶2组织抑制剂的局部染色。与挛缩胶囊相比，对照胶囊中III型胶原蛋白的免疫组织化学含量更高。本研究证明了创伤后肘关节挛缩的病理增厚、胶原纤维排列紊乱和细胞因子的参与。
This study evaluates the structural and biochemical alterations of the elbow capsule after trauma through microscopy and immunohistochemistry. We compared capsules from 37 patients undergoing surgery for elbow contracture with normal capsules from 7 donors. Contracture capsules were significantly thicker than control capsules (P < .05) and exhibited extensive disorganization of collagen fiber bundle arrangement. Levels of specific cytokines involved in connective tissue turnover were measured. The results showed that the levels of cytokines matrix metalloproteinase (MMP) 1, MMP-2, and MMP-3 were greater as compared with control capsules (P < .05). This was associated with Collagen disorganization, fibroblast infiltration, and in some specimens, lymphocytic infiltration in the capsular tissue. In contracture specimens, there was a localization of tissue inhibitor of matrix metalloproteinase 2 staining only in the vicinity of the synovial membrane and in blood vessels. Immunohistochemistry for type III Collagen showed a greater presence in the control capsules compared with contracture capsules. This study demonstrates pathologic thickening, disorganization of the collagen fiber arrangement, and involvement of cytokines in the pathology of posttraumatic contracture of the elbow.