The expression of substance P and calcitonin gene-related peptide is associated with the severity of tendon degeneration in lateral epicondylitis

Soo-Hong Han,Hyung Kyung Kim,Yoon Jang,Soonchul Lee,Jongbeom Oh,Hyeon Hae Lee,Donghun Han,Jeongbae Rhie

doi:10.1186/s12891-021-04067-1

Abstract

BackgroundIn this study, we investigated whether substance P (SP) or calcitonin gene-related peptide (CGRP) expression is associated with tendon degeneration in patients with lateral epicondylitis.MethodsTwenty-nine patients who underwent surgical treatment for lateral epicondylitis were enrolled in the final analyses. Extensor carpi radialis brevis tendon origins were harvested for histological analysis.ResultsSP and CGRP immunostaining were negative in healthy tendons but positive in degenerative tendons; moreover, their immunoreactivity increased with degeneration severity. Univariate analysis indicated that variables such as the preoperative visual analog scale (VAS) score or SP or CGRP expression levels were significantly associated with the Movin score. However, multivariate analysis revealed that only higher SP and/or CGRP signals were associated with higher Movin scores. Elevations in SP or CGRP expression were also linked with significantly severe preoperative VAS scores.ConclusionWe demonstrated that tendon degeneration severity is associated with increased SP and CGRP expression in the biopsy samples of lateral epicondylitis.

Highlights

In this study, we investigated whether substance P (SP) or calcitonin gene-related peptide (CGRP) expression is associated with tendon degeneration in patients with lateral epicondylitis
Correlation tests between each parameter indicated that the postoperative visual analog scale (VAS) score and postoperative DASH score showed strong correlations (r = 0.85, p < 0.001); only postoperative DASH scores were used in the following analyses (Supplemental Fig. 1)
Univariate analysis results revealed that SP and CGRP expression were significantly related to the preoperative VAS score (r = 0.61, p = 0.0006 for SP expression and r = 0.39, p = 0.034 for CGRP expression) (Fig. 3)

Summary

Introduction

We investigated whether substance P (SP) or calcitonin gene-related peptide (CGRP) expression is associated with tendon degeneration in patients with lateral epicondylitis. Commonly known as tennis elbow, refers to a pathological condition with varying degrees of pain or point tenderness at the common extensor origin [1,2,3]. This condition has an annual estimated prevalence of 1–3% in the general population and is one of the most frequently diagnosed elbow conditions typically. The findings collectively indicate the importance of SP or CGRP in the pathogenesis of lateral epicondylitis [17,18,19,20]

Methods

Results

Discussion

Conclusion