Changes in Circulating Biomarkers of Muscle Atrophy, Inflammation, and Cartilage Turnover in Patients Undergoing Anterior Cruciate Ligament Reconstruction and Rehabilitation
Changes in Circulating Biomarkers of Muscle Atrophy, Inflammation, and Cartilage Turnover in Patients Undergoing Anterior Cruciate Ligament Reconstruction and Rehabilitation
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DOI：
10.1177/0363546513490651
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发表时间：
2013-08-01
影响因子：
4.8
通讯作者：
Bedi, Asheesh
中科院分区：
文献类型：
--
作者：
Mendias, Christopher L.;Lynch, Evan B.;Bedi, Asheesh
背景：前交叉韧带(ACL)重建后，股四头肌严重萎缩，限制了完全恢复，并使运动员在重返赛场后面临复发损伤的风险。肌肉萎缩的原因尚不完全清楚。假设：前交叉韧带重建后循环中萎缩、促炎和软骨周转的细胞因子和生物标志物水平会增加。研究设计：描述性实验室研究。方法：患者(N=18；平均年龄28~2.4岁)在非接触性运动损伤后接受前交叉韧带手术重建。在手术前和术后6次访问时，循环生物标记物水平与国际膝关节文件委员会的简表-12和客观膝关节力量测量一起被测量。结果：肌抑素、转化生长因子-β和C-反应蛋白水平在术后早期显著升高，并恢复到基线水平。软骨低聚基质蛋白水平在手术后立即下降，然后恢复到基线水平。CCL2、CCL3、CCL4、CCL5、EGF、成纤维细胞生长因子-2、IGF-1、IL-10、IL-1、IL-1、IL-1ra、IL-6、肌红蛋白和肿瘤坏死因子在研究过程中无差异。结论：在前交叉韧带重建后，可以观察到有效的诱导萎缩的细胞因子的增加以及相应的膝关节力量和功能评分的变化。临床相关性：尽管还需要进一步的研究，但对肌肉抑制素的治疗可能有助于防止前交叉韧带重建后发生的肌肉萎缩，并加速患者恢复运动。
Background: After anterior cruciate ligament (ACL) reconstruction, there is significant atrophy of the quadriceps muscles that can limit full recovery and place athletes at risk for recurrent injuries with return to play. The cause of this muscle atrophy is not fully understood.Hypothesis: Circulating levels of proatrophy, proinflammatory, and cartilage turnover cytokines and biomarkers would increase after ACL reconstruction.Study Design: Descriptive laboratory study.Methods: Patients (N = 18; mean age, 28 2.4 years) underwent surgical reconstruction of the ACL after a noncontact athletic injury. Circulating levels of biomarkers were measured along with Short Form-12, International Knee Documentation Committee, and objective knee strength measures preoperatively and at 6 postoperative visits. Differences were tested using repeated-measures 1-way analysis of variance.Results: Myostatin, TGF-, and C-reactive protein levels were significantly increased in the early postoperative period and returned to baseline. Cartilage oligomeric matrix protein levels decreased immediately after surgery and then returned to baseline. CCL2, CCL3, CCL4, CCL5, EGF, FGF-2, IGF-1, IL-10, IL-1, IL-1, IL-1ra, IL-6, myoglobin, and TNF- were not different over the course of the study.Conclusion: An increase in potent atrophy-inducing cytokines and corresponding changes in knee strength and functional scores were observed after ACL reconstruction.Clinical Relevance: Although further studies are necessary, the therapeutic inhibition of myostatin may help prevent the muscle atrophy that occurs after ACL reconstruction and provide an accelerated return of patients to sport.