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The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study

BACKGROUND: Rotator cuff (RC) tears represent a common cause of shoulder pain and dysfunction in adults. The disease affects primarily women and occurs mainly in the postmenopausal period. This study aimed to investigate immunohistochemically the presence of estrogen receptor-alpha (ER-⍺), estrogen...

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Autores principales: Longo, Umile Giuseppe, Mazzola, Alessandro, Carotti, Simone, Francesconi, Maria, Catapano, Simone, Magrì, Francesco, Perrone, Giuseppe, Morini, Sergio, De Salvatore, Sergio, Denaro, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529750/
https://www.ncbi.nlm.nih.gov/pubmed/34670550
http://dx.doi.org/10.1186/s12891-021-04778-5
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author Longo, Umile Giuseppe
Mazzola, Alessandro
Carotti, Simone
Francesconi, Maria
Catapano, Simone
Magrì, Francesco
Perrone, Giuseppe
Morini, Sergio
De Salvatore, Sergio
Denaro, Vincenzo
author_facet Longo, Umile Giuseppe
Mazzola, Alessandro
Carotti, Simone
Francesconi, Maria
Catapano, Simone
Magrì, Francesco
Perrone, Giuseppe
Morini, Sergio
De Salvatore, Sergio
Denaro, Vincenzo
author_sort Longo, Umile Giuseppe
collection PubMed
description BACKGROUND: Rotator cuff (RC) tears represent a common cause of shoulder pain and dysfunction in adults. The disease affects primarily women and occurs mainly in the postmenopausal period. This study aimed to investigate immunohistochemically the presence of estrogen receptor-alpha (ER-⍺), estrogen receptor-beta (ER-β) and progesterone receptor (PR) in the supraspinatus tendon of patients with RC tendinopathy, searching for gender differences of expression. A secondary aim was to evaluate potential links between their expression and the typical histopathological findings of the ailment. METHODS: Biopsies of the supraspinatus tendon were collected intraoperatively from 15 postmenopausal women and 9 men undergoing RC surgery. Specimens were stained with Haematoxylin/Eosin, Masson-Goldner Trichrome, Alcian Blu and immunohistochemical stainings for ER-⍺, ER-β and PR were performed. Tendon alterations were evaluated with the Bonar histopathological scale. Statistical tests used in this study were the Spearman correlation coefficient and the Mann-Whitney U test. RESULTS: In the supraspinatus tendon, cells expressed ER-⍺ (p = 0.043), ER-β (p = 0.048) and PR (p = 0.004) with statistically significant differences related to age and sex of patients. Immunoreactivity was seen in the nuclei of tenocytes and vascular cells. Postmenopausal women’s samples showed a markedly higher expression of these receptors compared to their male counterpart. There was a positive correlation between the expression of ER-⍺ and ER-β (r = 0.59; p = 0.02) and between ER-β and PR (r = 0.72; p = 0.002) in women’s samples. Furthermore, in postmenopausal women the PR expression decreased with age (r = − 0.56; p = 0.027). Only in women, the ER-β expression positively correlated with the total Bonar histopathological score (p = 0.019) and the ER-β vascular expression positively correlated with ground substance alterations (p = 0.029). CONCLUSIONS: These results reveal that ERs and PR are present in the supraspinatus tendon of patients with RC tears, suggesting a role of sex hormones in the pathogenesis of the disease.
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spelling pubmed-85297502021-10-25 The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study Longo, Umile Giuseppe Mazzola, Alessandro Carotti, Simone Francesconi, Maria Catapano, Simone Magrì, Francesco Perrone, Giuseppe Morini, Sergio De Salvatore, Sergio Denaro, Vincenzo BMC Musculoskelet Disord Research BACKGROUND: Rotator cuff (RC) tears represent a common cause of shoulder pain and dysfunction in adults. The disease affects primarily women and occurs mainly in the postmenopausal period. This study aimed to investigate immunohistochemically the presence of estrogen receptor-alpha (ER-⍺), estrogen receptor-beta (ER-β) and progesterone receptor (PR) in the supraspinatus tendon of patients with RC tendinopathy, searching for gender differences of expression. A secondary aim was to evaluate potential links between their expression and the typical histopathological findings of the ailment. METHODS: Biopsies of the supraspinatus tendon were collected intraoperatively from 15 postmenopausal women and 9 men undergoing RC surgery. Specimens were stained with Haematoxylin/Eosin, Masson-Goldner Trichrome, Alcian Blu and immunohistochemical stainings for ER-⍺, ER-β and PR were performed. Tendon alterations were evaluated with the Bonar histopathological scale. Statistical tests used in this study were the Spearman correlation coefficient and the Mann-Whitney U test. RESULTS: In the supraspinatus tendon, cells expressed ER-⍺ (p = 0.043), ER-β (p = 0.048) and PR (p = 0.004) with statistically significant differences related to age and sex of patients. Immunoreactivity was seen in the nuclei of tenocytes and vascular cells. Postmenopausal women’s samples showed a markedly higher expression of these receptors compared to their male counterpart. There was a positive correlation between the expression of ER-⍺ and ER-β (r = 0.59; p = 0.02) and between ER-β and PR (r = 0.72; p = 0.002) in women’s samples. Furthermore, in postmenopausal women the PR expression decreased with age (r = − 0.56; p = 0.027). Only in women, the ER-β expression positively correlated with the total Bonar histopathological score (p = 0.019) and the ER-β vascular expression positively correlated with ground substance alterations (p = 0.029). CONCLUSIONS: These results reveal that ERs and PR are present in the supraspinatus tendon of patients with RC tears, suggesting a role of sex hormones in the pathogenesis of the disease. BioMed Central 2021-10-20 /pmc/articles/PMC8529750/ /pubmed/34670550 http://dx.doi.org/10.1186/s12891-021-04778-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Longo, Umile Giuseppe
Mazzola, Alessandro
Carotti, Simone
Francesconi, Maria
Catapano, Simone
Magrì, Francesco
Perrone, Giuseppe
Morini, Sergio
De Salvatore, Sergio
Denaro, Vincenzo
The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study
title The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study
title_full The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study
title_fullStr The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study
title_full_unstemmed The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study
title_short The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study
title_sort role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529750/
https://www.ncbi.nlm.nih.gov/pubmed/34670550
http://dx.doi.org/10.1186/s12891-021-04778-5
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