Advanced glycation end products in idiopathic frozen shoulders

Hwang, K. R., Murrell, G. A.C., Millar, N. L. , Bonar, F., Lam, P. and Walton, J. R. (2016) Advanced glycation end products in idiopathic frozen shoulders. Journal of Shoulder and Elbow Surgery, 25(6), pp. 981-988. (doi: 10.1016/j.jse.2015.10.015) (PMID:26776943)

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Background The pathophysiologic mechanisms behind proliferation of fibroblasts and deposition of dense collagen matrix in idiopathic frozen shoulder remain unclear. Accumulation of advanced glycation end products (AGEs) with cross-linking and stabilization of collagen has been hypothesized to contribute to this pathophysiologic process. This study investigated whether the immunoreactivity of AGEs is higher in patients with idiopathic frozen shoulder than in the control groups. Methods Shoulder capsule samples were collected from 8 patients with idiopathic frozen shoulder, 6 with unstable shoulders (control 1), and 8 with rotator cuff tears (control 2). The samples were hematoxylin and eosin stained and analyzed by immunohistochemistry using antibodies against AGEs. Immunoreactivities were rated in a blinded fashion from none (0) to strong (3). Immunohistochemical distribution within the capsule was noted. Results Frozen shoulder patients had greater frequency and severity of self-reported pain (P = .02) than rotator cuff tear patients and more restricted range of motion in all planes (P < .05) than patients of the instability and rotator cuff tear groups. Hematoxylin and eosin–stained capsular tissue from frozen shoulder showed fibroblastic proliferation, increased numbers of adipocytes, and increased subsynovial vascularity. Immunoreactivity of AGEs was stronger in frozen shoulder capsules (2.8) than in instability (0.3; P = .0001) and rotator cuff tear (1.1; P = .016) capsules. Conclusion This study highlights a potential role for AGEs in the pathogenesis of frozen shoulder. The overexpression of AGEs may explain the fibroblastic proliferation and deposition of collagen matrix in idiopathic frozen shoulder.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Millar, Professor Neal
Authors: Hwang, K. R., Murrell, G. A.C., Millar, N. L., Bonar, F., Lam, P., and Walton, J. R.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Journal Name:Journal of Shoulder and Elbow Surgery
ISSN (Online):1532-6500
Published Online:05 January 2016

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