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Is neurogenic inflammation involved in tendinopathy? A systematic review

Neurogenic pain and inflammation have been hypothesised to play an important role in tendinopathy. This systematic review aimed to present and assess the evidence on neurogenic inflammation in tendinopathy. A systematic search was conducted through multiple databases to identify human case–control s...

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Autores principales: Wasker, Shimon Vinay Zedeck, Challoumas, Dimitris, Weng, Wai, Murrell, George A C, Millar, Neal L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923261/
https://www.ncbi.nlm.nih.gov/pubmed/36793930
http://dx.doi.org/10.1136/bmjsem-2022-001494
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author Wasker, Shimon Vinay Zedeck
Challoumas, Dimitris
Weng, Wai
Murrell, George A C
Millar, Neal L
author_facet Wasker, Shimon Vinay Zedeck
Challoumas, Dimitris
Weng, Wai
Murrell, George A C
Millar, Neal L
author_sort Wasker, Shimon Vinay Zedeck
collection PubMed
description Neurogenic pain and inflammation have been hypothesised to play an important role in tendinopathy. This systematic review aimed to present and assess the evidence on neurogenic inflammation in tendinopathy. A systematic search was conducted through multiple databases to identify human case–control studies assessing neurogenic inflammation through the upregulation of relevant cells, receptors, markers and mediators. A newly devised tool was used for the methodological quality assessment of studies. Results were pooled based on the cell/receptor/marker/mediator assessed. A total of 31 case–control studies were eligible for inclusion. The tendinopathic tissue was obtained from Achilles (n=11), patellar (n=8), extensor carpi radialis brevis (n=4), rotator cuff (n=4), distal biceps (n=3) and gluteal (n=1) tendons. Through pooling the results of included studies based on the marker of neurogenic inflammation assessed, we identified possible upregulation of protein gene product 9.5 (PGP 9.5), N-methyl-D-aspartate Receptors, glutamate, glutamate receptors (mGLUT), neuropeptide Y (NPY) and adrenoreceptors in tendinopathic tissue versus control. Calcitonin gene-related peptide (CGRP) was not found to be upregulated, and the evidence was conflicting for several other markers. These findings show the involvement of the glutaminergic and sympathetic nervous systems and the upregulation of nerve ingrowth markers supporting the concept that neurogenic inflammation plays a role in tendinopathy.
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spelling pubmed-99232612023-02-14 Is neurogenic inflammation involved in tendinopathy? A systematic review Wasker, Shimon Vinay Zedeck Challoumas, Dimitris Weng, Wai Murrell, George A C Millar, Neal L BMJ Open Sport Exerc Med Review Neurogenic pain and inflammation have been hypothesised to play an important role in tendinopathy. This systematic review aimed to present and assess the evidence on neurogenic inflammation in tendinopathy. A systematic search was conducted through multiple databases to identify human case–control studies assessing neurogenic inflammation through the upregulation of relevant cells, receptors, markers and mediators. A newly devised tool was used for the methodological quality assessment of studies. Results were pooled based on the cell/receptor/marker/mediator assessed. A total of 31 case–control studies were eligible for inclusion. The tendinopathic tissue was obtained from Achilles (n=11), patellar (n=8), extensor carpi radialis brevis (n=4), rotator cuff (n=4), distal biceps (n=3) and gluteal (n=1) tendons. Through pooling the results of included studies based on the marker of neurogenic inflammation assessed, we identified possible upregulation of protein gene product 9.5 (PGP 9.5), N-methyl-D-aspartate Receptors, glutamate, glutamate receptors (mGLUT), neuropeptide Y (NPY) and adrenoreceptors in tendinopathic tissue versus control. Calcitonin gene-related peptide (CGRP) was not found to be upregulated, and the evidence was conflicting for several other markers. These findings show the involvement of the glutaminergic and sympathetic nervous systems and the upregulation of nerve ingrowth markers supporting the concept that neurogenic inflammation plays a role in tendinopathy. BMJ Publishing Group 2023-02-09 /pmc/articles/PMC9923261/ /pubmed/36793930 http://dx.doi.org/10.1136/bmjsem-2022-001494 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Review
Wasker, Shimon Vinay Zedeck
Challoumas, Dimitris
Weng, Wai
Murrell, George A C
Millar, Neal L
Is neurogenic inflammation involved in tendinopathy? A systematic review
title Is neurogenic inflammation involved in tendinopathy? A systematic review
title_full Is neurogenic inflammation involved in tendinopathy? A systematic review
title_fullStr Is neurogenic inflammation involved in tendinopathy? A systematic review
title_full_unstemmed Is neurogenic inflammation involved in tendinopathy? A systematic review
title_short Is neurogenic inflammation involved in tendinopathy? A systematic review
title_sort is neurogenic inflammation involved in tendinopathy? a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923261/
https://www.ncbi.nlm.nih.gov/pubmed/36793930
http://dx.doi.org/10.1136/bmjsem-2022-001494
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