Matrix metalloproteinase, tissue inhibitor of metalloproteinase and transforming growth factor-beta 1 in frozen shoulder, and their changes as response to intensive stretching and supervised neglect exercise
Matrix metalloproteinase, tissue inhibitor of metalloproteinase and transforming growth factor-beta 1 in frozen shoulder, and their changes as response to intensive stretching and supervised neglect exercise
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DOI：
10.1007/s00776-013-0387-0
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发表时间：
2013-07-01
影响因子：
1.7
通讯作者：
Lubis, Vita Kurniati
中科院分区：
文献类型：
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作者：
Lubis, Andri Maruli Tua;Lubis, Vita Kurniati
肩周炎的特点是关节囊增厚和痉挛。这种疾病的机制尚不清楚，然而，一些蛋白质已经与冻结的肩膀有关。采用双抗体夹心酶联免疫吸附试验(ELISA法)测定冻结肩和正常肩及运动前后冻肩患者血清中基质金属蛋白酶(MMPs)、基质金属蛋白酶组织抑制因子(TIMP)、转化生长因子-β(TGF-β)等相关蛋白水平，并对冻肩患者进行主动拉伸和温和解冻。对冻结肩患者的肩关节功能评定采用简明恒定评分。将肩周炎患者随机分为强化伸展组和有监督忽略组。在运动后的基线、6周和12周对冻结肩患者的简明恒定评分和血清样本进行评估，而只测量对照的基线血清样本。结果表明，冻肩组患者血清中的基质金属蛋白酶-1和基质金属蛋白酶-2水平显著低于对照组，而基质金属蛋白酶-1和基质金属蛋白酶-2水平显著低于对照组，基质金属蛋白酶-1、基质金属蛋白酶-2和转化生长因子-β1水平显著高于对照组。强化拉伸运动后MMPs的升高和TIMPs的降低明显大于监督忽视运动后。强化伸展组的简明恒定评分改善明显高于监督忽略组，血清中的基质金属蛋白酶-1、基质金属蛋白酶-2、组织金属蛋白酶-1、基质金属蛋白酶-2和转化生长因子-β1的水平可能与肩周炎的发生有关。主动伸展对冻结肩的改善作用优于监督忽视，恒定评分的改善证明了主动伸展对肩周炎的改善。
Frozen shoulder is characterized with thickening and contracture of joint capsular. The mechanism of this disorder is not yet clear, however, some proteins have been related to frozen shoulder. This study was to compare the serum levels of proteins related to frozen shoulder, such as matrix metalloproteinase (MMP), tissue inhibitor of metalloproteinase (TIMP) and transforming growth factor-beta (TGF-beta) between frozen shoulder and normal subjects; and before and after physical exercise active stretching and gentle thawing in frozen shoulder patients.Serum levels of MMP-1, MMP-2, TIMP-1, TIMP-2, and TGF-beta 1 was measured from frozen shoulder and normal subjects by using ELISA. Functional assessment of shoulder joint in frozen shoulder patients was based on abbreviated Constant score. Frozen shoulder patients were randomly divided into intensive stretching and supervised neglect groups. Abbreviated Constant score and serum samples of frozen shoulder patients were evaluated at baseline, week-6, and week-12 after exercise, while only baseline serum samples of control were measured. MMP/TIMP ratio was calculated from the total sum of MMP-1 and MMP-2 levels divided by the total sum of TIMP-1 and TIMP-2 levels.Baseline MMP-1 and MMP-2 levels were significantly lower, while TIMP-1, TIMP-2, and TGF-beta 1 levels were significantly higher in frozen shoulder group than in control. Increased MMPs and decreased TIMPs were significantly greater after intensive stretching than after supervised neglect exercise. Abbreviated Constant score improvement was significantly higher in intensive stretching group than in supervised neglect group.Serum levels of MMP-1, MMP-2, TIMP-1, TIMP-2, and TGF-beta 1 may be associated to frozen shoulder. Active stretching can improve frozen shoulder better than supervised neglect, as demonstrated by the improvement of Constant score.