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Journal of Shoulder and Elbow Surgery

Increased expression of type 1 cannabinoid (CB1) receptor among patients with rotator cuff lesions and shoulder stiffness

  • Shu-Jui Kuo
    Affiliations
    Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan

    Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan
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  • Feng-Sheng Wang
    Affiliations
    Core Lab for Phenomics and Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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  • Author Footnotes
    1 Contributed equally to the scientific content of this submission.
    Jih-Yang Ko
    Footnotes
    1 Contributed equally to the scientific content of this submission.
    Affiliations
    Core Lab for Phenomics and Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Center for Shockwave Medicine and Tissue Engineering, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Department of Orthopedic Surgery, Xiamen Chang Gung Hospital, Fujian, China
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  • Author Footnotes
    1 Contributed equally to the scientific content of this submission.
    Chih-Hsin Tang
    Correspondence
    Reprint requests: Chih-Hsin Tang, PhD, No. 91, Hsueh-Shih Road, Taichung, Taiwan 40402. (C.-H. Tang).
    Footnotes
    1 Contributed equally to the scientific content of this submission.
    Affiliations
    Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan

    Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan

    Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan

    Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan
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  • Ka-Kit Siu
    Affiliations
    Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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  • Ya-Hung Hsu
    Affiliations
    Core Lab for Phenomics and Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Center for Shockwave Medicine and Tissue Engineering, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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  • Tsai-Chen Tsai
    Affiliations
    Core Lab for Phenomics and Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Center for Shockwave Medicine and Tissue Engineering, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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  • Author Footnotes
    1 Contributed equally to the scientific content of this submission.
Published:November 03, 2017DOI:https://doi.org/10.1016/j.jse.2017.09.010

      Background

      Shoulder stiffness is a disease manifested by pain, limited range of motion, and functional disability. The inflammatory and fibrosis processes play a substantial role in the pathogenesis of shoulder stiffness. The CB1 receptor has been recognized to mediate the processes of pathologic fibrosis. This study investigated the role of the CB1 pathway in pathogenesis of rotator cuff lesions with shoulder stiffness.

      Methods

      All of the patients undergoing repair surgery for rotator cuff lesions were recruited and subcategorized into subjects with and without shoulder stiffness. Reverse transcription-polymerase chain reaction assay was used to evaluate the expression level of CB1 and interleukin 1β (IL-1β) in the subacromial bursae, and enzyme-linked immunosorbent assay was used to measure the concentration of CB1 and IL-1β in the subacromial fluid. Tenocytes treated with CB1 agonists and antagonists were also studied for the relationship of CB1 and the inflammatory cytokine IL-1β.

      Results

      The patients with shoulder stiffness had higher messenger RNA (mRNA) expression (P = .040) and immunohistochemistry staining (P < .001) of CB1 in the subacromial bursa and higher CB1 concentration in the subacromial fluid (P = .008). Tenocytes treated with the CB1 agonist WIN 55,212-2 and antagonist AM251 showed increased expression of IL-1β mRNA (P = .049) and suppressed expression of IL-1β mRNA (P = .001), respectively.

      Discussion

      The CB1 pathway is involved in the pathogenesis of shoulder stiffness. It may be a promising target for the treatment of rotator cuff lesions with shoulder stiffness.

      Level of evidence

      Keywords

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