Effects of Hyaluronan on Cell Proliferation and mRNA Expression of Procollagens α1 (I) and α1 (III) in Tendon-Derived Fibroblasts from Patients with Rotator Cuff Disease

Abstract

Background Hyaluronan (HA) improves postoperative recovery after flexor tendon surgery, preventing postoperative adhesion. However, its influence on the rotator cuff tendon after cuff repair has not yet been clarified in detail. Hypothesis Hyaluronan is likely to modulate cell proliferation and mRNA expression of procollagens α1 (I) and α1 (III) in tendon-derived fibroblasts in patients with rotator cuff disease. Study Design Controlled laboratory study. Methods The study subjects were 10 patients with rotator cuff disease, with an average age of 62 years (range, 44-72). Various concentrations of HA (1.0-5.0 mg/mL) were added to monolayer-cultured tendon-derived fibroblasts from these patients. Hyaluronan binding and CD44 expression on the tendon-derived fibroblasts were evaluated by confocal microscopy using fluorescein-conjugated HA and antihuman CD44 antibody (OS/37). Cell proliferation was evaluated by recording changes in cell number. The levels of expression of procollagen α1 (I) and α1 (III) mRNA were measured by real-time reverse transcriptase polymerase chain reaction. Results Immunofluorescence cytochemistry detected constitutive binding of HA and CD44 expression on the tendon-derived cells. Treatment with various concentrations of HA significantly inhibited cell proliferation and decreased the expression level of procollagen α1 (III) mRNA, but not that of procollagen α1 (I) mRNA, in the tendon-derived fibroblasts. Conclusion Hyaluronan modulates cell proliferation and the expression level of procollagen α1 (III) mRNA, but not that of procollagen α1 (I), in fibroblasts from patients with rotator cuff disease. Clinical Relevance Postoperative use of exogenous HA may allow the healing of a repaired rotator cuff tendon with minimal adhesion.