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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open Sport & Exercise Medicine |
| Online Access: | https://bmjopensem.bmj.com/content/9/1/e001494.full |
| _version_ | 1811167238232735744 |
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| author | Neal L Millar Dimitris Challoumas George A C Murrell Shimon Vinay Zedeck Wasker Wai Weng |
| author_facet | Neal L Millar Dimitris Challoumas George A C Murrell Shimon Vinay Zedeck Wasker Wai Weng |
| author_sort | Neal L Millar |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-10T16:05:56Z |
| format | Article |
| id | doaj.art-684104e57e89405c90434eb11bef5af3 |
| institution | Directory Open Access Journal |
| issn | 2055-7647 |
| language | English |
| last_indexed | 2024-04-10T16:05:56Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Sport & Exercise Medicine |
| spelling | doaj.art-684104e57e89405c90434eb11bef5af32023-02-10T05:00:10ZengBMJ Publishing GroupBMJ Open Sport & Exercise Medicine2055-76472023-02-019110.1136/bmjsem-2022-001494Is neurogenic inflammation involved in tendinopathy? A systematic reviewNeal L Millar0Dimitris Challoumas1George A C Murrell2Shimon Vinay Zedeck Wasker3Wai Weng41Institute of Infection, Immunity and Inflammation College of Medicine, Veterinary and Life Sciences, University of Glasgow, UKInstitute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK2 Department of Orthopaedic Surgery, University of New South Wales—St George Campus, Sydney, New South Wales, AustraliaOrthopaedic Research Institute, St George Hospital Sydney, University of New South Wales, Sydney, New South Wales, AustraliaOrthopaedic Research Institute, St George Hospital Sydney, University of New South Wales, Sydney, New South Wales, AustraliaNeurogenic 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.https://bmjopensem.bmj.com/content/9/1/e001494.full |
| spellingShingle | Neal L Millar Dimitris Challoumas George A C Murrell Shimon Vinay Zedeck Wasker Wai Weng Is neurogenic inflammation involved in tendinopathy? A systematic review BMJ Open Sport & Exercise Medicine |
| 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 |
| url | https://bmjopensem.bmj.com/content/9/1/e001494.full |
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