大鼠过度使用性肌腱病损伤的多模态特征分析

刘杨晓雪; 赵天舒; 周明; 张攻孜; 张佳丽; 耿雨涵; 王文欣; 辛敏; 黄丽萍

doi:10.12435/j.issn.2095-5227.2023.149

大鼠过度使用性肌腱病损伤的多模态特征分析

Multimodal characteristics analysis of overuse induced tendinopathy injury in rats

摘要

摘要:
背景过度使用性肌腱病是部队非战斗减员的重要原因，然而过度使用后肌腱损伤的特征目前尚不明确。
目的从行为学、影像学、组织病理学及细胞因子水平的角度分析过度使用导致的大鼠肌腱损伤特征。
方法 16只SD大鼠随机分为正常组和损伤组，每组8只。损伤组利用跑台构建大鼠过度使用性跟腱病模型，跑步方案为10°倾斜角上坡、17米/分、运动频率1小时/天，5天/周，持续8周；正常组大鼠笼中饲养，自由活动。跑台训练8周后采用CatWalk步态分析系统评估大鼠运动功能，高频超声活体观察跟腱周围炎症水肿浸润情况，病理染色观察肌腱组织学改变，ELISA测定血清白细胞介素1β(interleukin-1β，IL-1β）和转化生长因子-β1(Transforming growth factor beta，TGF-β1)浓度。
结果与正常组相比，损伤组大鼠支撑相缩短(P<0.001)，步长缩短(P=0.03)，足印面积减小(P<0.001)，摆动速度增加(P<0.001)。超声图像显示，损伤组跟腱周围存在炎症及水肿浸润的低回声。病理染色显示，损伤组肌腱细胞形态改变，局部可见胶原纤维破坏，血管异常聚集和蛋白聚糖沉积。与正常组相比，损伤组Bonar评分增加(P<0.001)，血清IL-1β表达水平显著高于正常组(P=0.03)，TGF-β1表达水平存在高于正常组的差异趋势(P=0.09)。
结论过度使用导致肌腱组织病理结构改变，表现为肌腱周围炎症水肿浸润和步态异常，炎症细胞因子及纤维化相关细胞因子的上调可能发挥了重要作用。

Abstract:
Background Overuse tendinopathy is an important cause of noncombat attrition in the armed forces, however, the characterization of tendon injuries after overuse is unclear.
Objective To analyze the characteristics of tendon injuries caused by overuse from various perspectives, including etiology, ultrasonic imaging, histopathology, and cytokine levels.
Methods Sixteen Sprague-Dawley rats were randomly divided into normal group (n=8) and injury group (n=8). The overuse tendinopathy model was established through treadmill training, with a running protocol involving a 10° uphill inclination, 17 m/min speed, 1 hour of exercise per day, and a frequency of 5 days per week for 8 weeks. Normal rats were kept in cages and allowed unrestricted movement. After 8 weeks of treadmill training, the motor function of the rats was evaluated using the CatWalk gait analysis system. Inflammation and edema infiltration were observed using high-frequency ultrasound. Pathological staining was performed to observe histological changes in the tendon tissue. The expression levels of interleukin-1β (IL-1β) and transforming growth factor beta-1 (TGF-β1) were detected by ELISA.
Results Compared with the normal group, rats in the injury group had shorter stance (P<0.001), shorter paw print length (P=0.03), lower paw print area (P<0.001), and higher swing speed (P<0.001). Ultrasound images showed low echoes of inflammation and edema infiltration around the tendon in the injury group. Pathological staining showed that the tendon tissue in the injury group presented morphological alterations, including local collagen fiber destruction, abnormal blood vessel aggregation, and proteoglycan deposition. The Bonar score of rats in the injury group was higher than that of the normal group (P<0.001). The level of serum cytokine IL-1β in the injury group was significantly higher than that in the normal group (P=0.03), and there was a trend for TGF-β1 expression to be higher (P=0.09).
Conclusion Overuse leads to histopathological and structural changes in tendon tissue, which are manifested by peritendinous inflammatory edematous infiltrates and gait abnormalities. The up-regulation of proinflammatory cytokines and fibrosis-related cytokines may play an important role in the pathological changes of tendons.

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