新規理学療法ジャーナル

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Evidence of Neuronal Differentiation of Tendon Stromal Cells in Patients with Biceps Branchi Muscle Pain: A Histological and Immunohistochemical Study of 12 Patients

Constantine Hadjileontis and George Kontakis

The tendon of the long head of biceps branchii muscles is a major source of pain in the shoulder region. Our objective was to detect histologically and characterize factors that may contribute to biceps tendon pain generation, and subsequently provide a possible explanation of pain origin. This would permit the investigation of targeted pharmaceutical treatments for long term post-operative restriction of pain. Bioptic samples were obtained from 11 patients operated for shoulder fractures and were harvested during shoulder reconstruction operations. As a control group we used biceps tendons from 10 forensic cases with no history of shoulder diseases. Histologic investigation included quantitative measurement of tendon degeneration, cellularity, neoangiogenesis, inflammation and metaplasia, as well as immunohistochemical detection of cells with neural differentiation within the tendon tissue proper (S-100 protein and neuropeptide Y). Studied lesions were significantly (Mann-Whitney and Wilcox on test) greater in the group of patients compared to the ones found in the control group (p<0,001), while these lesions were statistically proved (Pearson test) to relate with each other, resulting in the neural differentiation of tendon stromal cells, causing thus pain.