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Physical activity level in Achilles tendinosis is associated with blood levels of pain-related factors: a pilot study
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
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2011 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 21, no 6, E430-E438 p.Article in journal (Refereed) Published
Abstract [en]

Physical activity affects the pain symptoms for Achilles tendinosis patients. Brain-derived neurotrophic factor (BDNF), tumor necrosis factor-alpha (TNF-alpha) and their receptors have been detected in human Achilles tendon. This pilot study aimed to compare serum BDNF and soluble tumor necrosis factor receptor I (sTNFRI) levels in Achilles tendinosis patients and healthy controls and to examine the influence of physical activity, and BMI and gender, on these levels. Physical activity was measured with a validated questionnaire, total physical activity being the parameter analyzed. Physical activity was strongly correlated with BDNF among tendinosis women [Spearman's rho (rho) = 0.90, P < 0.01] but not among control women (rho = -0.08, P = 0.83), or among tendinosis and control men. Physical activity was significantly correlated with sTNFRI in the entire tendinosis group and among tendinosis men (rho = 0.65, P = 0.01), but not in the entire control group or among control men (rho = 0.04, P = 0.91). Thus, the physical activity pattern is related to the TNF and BDNF systems for tendinosis patients but not controls, the relationship being gender dependent. This is new information concerning the relationship between physical activity and Achilles tendinosis, which may be related to pain for the patients. This aspect should be further evaluated using larger patient materials.

Place, publisher, year, edition, pages
2011. Vol. 21, no 6, E430-E438 p.
Keyword [en]
tendinopathy, exercise, cytokines, neurotrophins
National Category
Sport and Fitness Sciences
Identifiers
URN: urn:nbn:se:umu:diva-51484DOI: 10.1111/j.1600-0838.2011.01358.xISI: 000297985400051OAI: oai:DiVA.org:umu-51484DiVA: diva2:482093
Available from: 2012-01-23 Created: 2012-01-23 Last updated: 2017-12-08Bibliographically approved
In thesis
1. TNF-α and neurotrophins in Achilles tendinosis
Open this publication in new window or tab >>TNF-α and neurotrophins in Achilles tendinosis
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Tenocytes are the principal cells of the human Achilles tendon. In tendinosis, changes in the metabolism and morphology of these cells occur. Neurotrophins are growth factors essential for the development of the nervous system. Tumour necrosis factor alpha (TNF-α) has been found to kill sarcomas but has destructive effects in several major diseases. The two systems have interaction effects and are associated with apoptosis, proliferation, and pain signalling in various diseases. Whether these systems are present in the Achilles tendon and in Achilles tendinosis is unknown. The hypothesis is that the tenocytes produce substances belonging to these systems. In Studies I–III, we show that the potent effects of these substances are also likely to occur in the Achilles tendon. We found tenocyte immunoreactions for the neurotrophins brain-derived neurotrophic factor (BDNF), the nerve growth factor (NGF), the neurotrophin receptor p75, and for TNF-α and both of its receptors, TNFR1 and TNFR2. This occurred in both subjects with painful mid-portion Achilles tendinosis, and in controls. Furthermore, we found mRNA expression for BDNF and TNF-α in tenocytes, which proves that these cells produce these substances. TNFR1 mRNA was also detected for the tenocytes, and TNFR1 immunoreactions were upregulated in tendinosis tendons. This might explain why tenocytes in tendinosis undergo apoptosis more often than in normal tendons. Total physical activity (TPA) level and blood concentration of both soluble TNFR1 and BDNF were measured in Study IV. The results showed that the blood concentration of both factors were similar in subjects with tendinosis and in controls. Nevertheless, the TPA level was related to the blood concentration of sTNFR1 in tendinosis, but not in controls. This relationship should be studied further. The findings of this doctoral thesis show that neurotrophin and TNF-α systems are expressed in the Achilles tendon. We believe that the functions include tissue remodelling, proliferation and apoptosis.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2013. 121 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1538
Keyword
Achilles tendon, tendinosis, tendinopathy, neurotrophins, TNF-alpha, physical acitivity, apoptosis, proliferation, pain, remodelling
National Category
Basic Medicine
Research subject
Human Anatomy
Identifiers
urn:nbn:se:umu:diva-63660 (URN)978-91-7459-525-3 (ISBN)
Public defence
2013-01-25, Biologihuset, sal BiA201, Umeå universitet, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-01-04 Created: 2013-01-03 Last updated: 2014-12-18Bibliographically approved

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Bagge, JohanDanielson, PatrikAlfredson, HåkanForsgren, Sture

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