凍結肩由来肩甲上腕関節滑膜線維芽細胞へのヒアルロン酸の影響

抄録

There is a growing body of evidence supporting the use of hyaluronan (HA) in patients with adehesive capsulitis of the shoulder, although the mechanisms of the effect have not been clarified as yet. This in vitro study examined the effects of HA in glenohumeral synovial/capsular fibroblast (GSCF) from patients with adhesive capsulitis of the shoulder. The study subjects were 7 patients with primary or secondary adhesive capusulitis of the shoulder, with an average age of 55 years old. Synovial/capsular specimens were obtained from the rotator interval in each patient during arthroscopy. The tissue was prepared for cell culture. Various concentrations of HA (1.0 ∼ 4.0 mg/ml) were added to the monolayer-cultured GSCF from these patients. CD44 expression on the GSCF was evaluated by confocal microscopy using fluorescein-conjugated anti-human CD44 antibody. Cell proliferation was evaluated by recording changes in the cell number. The mRNA expression level of adhesion-related collagen (procollagen α 1 (III)) and cytokines (TGF-β, PDGF A & B) were measured by real-time reverse transcriptase polymerase chain reaction. Immunoflurescence cytochemistry detected constitutive binding of CD44 expression on the GSCF. Treatment with various concentrations of HA significantly and dose-dependently inhibited cell proliferation and decreased the mRNA expression level of the adhesion-related procollagen and cytokines. These results suggest that exogenous HA may prevent the progression of the adhesion formation in patients with adhesive capusulitis of the shoulder.