期刊
JOURNAL OF SHOULDER AND ELBOW SURGERY
卷 21, 期 2, 页码 191-199出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jse.2011.10.022
关键词
Tendon; rotator cuff; gene; biology; matrix metalloproteinases; predisposition
资金
- Musculoskeletal Biomedical Research Unit of the National Institute for Health Research
Persistently high failure rates that are reported after rotator cuff repairs have encouraged greater understanding of the pathophysiology that underlies rotator cuff tears. Biologic changes that contribute to the pathogenesis of rotator cuff tears and tendinopathies, as well as adaptation after these changes, have been well described. A subset of patients with a genetic predisposition to early onset of rotator cuff tears and earlier symptom and disease progression have been identified. Many biologic changes occurring at the gene level have been identified. Pathways that are believed to contribute to rotator cuff tendinopathies include extracellular matrix remodeling, angiogenesis, changes in metabolism, apoptosis, and stress-related genes. Metaplasia of rotator cuff cells is contributed to by changes in gene expression. Modification of these gene changes may be possible through mechanical loading, drugs, or cellular manipulation. Gene changes may offer greater insight into why certain tears fail to heal and help to identify therapeutic targets. Level of evidence: Review Article. (C) 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.
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