TY - JOUR
T1 - Increased substance P expression in the trochanteric bursa of patients with greater trochanteric pain syndrome
AU - FEARON, Angie
AU - Twin, Jane
AU - Dahlstrom, Jane
AU - Cook, Jill
AU - Cormick, Wes
AU - Smith, Paul
AU - Scott, Alexander
N1 - Funding Information:
Approval for this study was provided by the ACT Health, the Australian National University and Calvary Health Care human research ethics committees (HREC). Following an explanation of the tissue collection procedure, and the risks and benefits of the research, the participants provided signed informed consent. As an exception to this procedure, in phase 1, the GTPS participants’ tissue had already been collected at the time of surgery and the HREC provided a waiver for the gaining of signed consent. Prior to analysis at the University of British Columbia, the secondary approval of the local clinical research ethics board was obtained.
Funding Information:
Acknowledgments This study was funded through the Australian National University as well as through a WorksafeBC Research at Work grant. AF was a recipient of an ANU PhD scholarship. AS is a recipient of a career investigator award from the Michael Smith Foundation for Health Research. JC was supported by the Australian Centre for Research into Sports Injury and its Prevention, which is one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee. We gratefully acknowledge the expert assistance of Dr T Abraham with second harmonic generation and multiphoton excitation fluorescence microscopy, Jennie Scarvell for assistance with supervising the study, and Al Burns and Damian Smith for tissue collection.
Publisher Copyright:
© 2014, Springer-Verlag Berlin Heidelberg.
PY - 2014/9/24
Y1 - 2014/9/24
N2 - Greater trochanteric pain syndrome (GTPS) is a pathology that can involve the trochanteric bursa or the tendons which attach to the greater trochanter. To clarify the potential importance of bursa versus tendon pathology and of substance P (SP) in contributing to pain in this condition tendon and bursa tissue biopsies were obtained from 34 patients with GTPS and 29 control subjects. Specimens were evaluated via light microscopy for histopathological and morphological differences, as well as using immunohistochemistry for macrophages (CD68), inflammatory cells (CD45) and SP. Bursa [stroma score, mean (SD): 4.18 (1.65) vs. 2.53 (1.61), p = 0.051] and tendon [Bonar score, mean (SD): GTPS mean (SD) 12.65 (2.0), control (10.43 (4.84), p = 0.04] from subjects with GTPS demonstrated more extensive signs of pathology than specimens from control subjects. There was a significantly greater presence of SP in the bursa (frequency: 9/12 vs. 6/16, p = 0.047), but not in the tendon (8/12 vs. 8/15, p = 0.484) of subjects with GTPS compared to controls. An increased presence of SP in the trochanteric bursa may be related to the pain associated with GTPS.
AB - Greater trochanteric pain syndrome (GTPS) is a pathology that can involve the trochanteric bursa or the tendons which attach to the greater trochanter. To clarify the potential importance of bursa versus tendon pathology and of substance P (SP) in contributing to pain in this condition tendon and bursa tissue biopsies were obtained from 34 patients with GTPS and 29 control subjects. Specimens were evaluated via light microscopy for histopathological and morphological differences, as well as using immunohistochemistry for macrophages (CD68), inflammatory cells (CD45) and SP. Bursa [stroma score, mean (SD): 4.18 (1.65) vs. 2.53 (1.61), p = 0.051] and tendon [Bonar score, mean (SD): GTPS mean (SD) 12.65 (2.0), control (10.43 (4.84), p = 0.04] from subjects with GTPS demonstrated more extensive signs of pathology than specimens from control subjects. There was a significantly greater presence of SP in the bursa (frequency: 9/12 vs. 6/16, p = 0.047), but not in the tendon (8/12 vs. 8/15, p = 0.484) of subjects with GTPS compared to controls. An increased presence of SP in the trochanteric bursa may be related to the pain associated with GTPS.
KW - Bursitis
KW - Histopathology
KW - Lateral hip pain
KW - Osteoarthritis
KW - Tendinopathy
KW - Prospective Studies
KW - Humans
KW - Bursa, Synovial/metabolism
KW - Substance P/metabolism
KW - Tendons/metabolism
KW - Biopsy
KW - Female
KW - Retrospective Studies
KW - Femur/metabolism
KW - Pain/metabolism
UR - http://www.scopus.com/inward/record.url?scp=84918803719&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/increased-substance-p-expression-trochanteric-bursa-patients-greater-trochanteric-pain-syndrome-1
U2 - 10.1007/s00296-014-2957-7
DO - 10.1007/s00296-014-2957-7
M3 - Article
VL - 34
SP - 1441
EP - 1448
JO - Rheumatology International
JF - Rheumatology International
SN - 0172-8172
IS - 10
ER -