RESUMO
Over the past few years, a number of cases of tendon injuries associated with statin therapy have been reported. In this study, we assessed whether statins can affect the extracellular matrix (ECM) of the deep digital flexor tendon (DDFT) and patellar tendon (PT). Wistar rats were assigned to groups treated with atorvastatin (A20, A80), treated with simvastatin (S20, S80), and control. Zymography, Western blotting for collagen I, non-collagenous proteins (NCP), glycosaminoglycans (GAGs), and hydroxyproline quantifications were performed. DDFT findings: NCP were increased in A20 and A80; higher concentration of hydroxyproline was found in S80; levels of GAGs was increased in all statin-treated groups; collagen I was increased in S80 and pro-MMP-2 activity was reduced in A80, S20, and S80. PT findings: NCP were reduced in A20, A80, and S80; GAGs was reduced in A80 and S20; collagen I was increased in A20 and pro-MMP-2 activity was reduced in the S20. Both the statins provoked marked changes in both tendons. All these changes may make the tendons more prone to microdamage and ruptures. Therefore, a better understanding of the behavior of the tendon ECM components under statin therapy may provide important insights into the mechanisms behind statin-induced tendon injuries.
Assuntos
Atorvastatina/efeitos adversos , Matriz Extracelular/efeitos dos fármacos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Hiperlipidemias/tratamento farmacológico , Sinvastatina/efeitos adversos , Traumatismos dos Tendões/induzido quimicamente , Tendões/efeitos dos fármacos , Animais , Atorvastatina/uso terapêutico , Colágeno Tipo I/metabolismo , Precursores Enzimáticos/metabolismo , Gelatinases/metabolismo , Glicosaminoglicanos/metabolismo , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hidroxiprolina/metabolismo , Masculino , Ratos , Ratos Wistar , Sinvastatina/uso terapêuticoRESUMO
O objetivo deste trabalho foi estudar o efeito do plasma rico em plaquetas (PRP) no tratamento da tendinite induzida no tendão do músculo flexor digital superficial (TFDS) de eqüinos mediante avaliação ultra-sonográfica. Para isso foram utilizados seis eqüinos hígidos machos castrados, com idade de 8-15 anos (x=12 anos). A tendinite do TFDS foi provocada em ambos os membros torácicos, mediante a administração intratendínea de 2,5mg de colagenase (2,5mg.µL-1), sendo esse procedimento considerado o início da fase experimental. Doze dias após a indução da tendinite, os animais foram submetidos a dois tratamentos: sendo que na lesão efetuada no TFDS direito (grupo tratado, GT), foram administrados 2,5mL de PRP ativado com cloreto de cálcio a 0,0125mol.L-1, contendo concentrações variando de 320.000 a 500.000 plaquetas.µL-1; na tendinite do TFDS esquerdo (grupo controle, GC), foram injetados 2,5mL de solução salina a 0,9 por cento. Após cinco dias, os animais foram submetidos à atividade física controlada e progressiva durante 30 dias. Os exames ultra-sonográficos foram realizados antes e após indução da tendinite (48 horas após e no 7º, 12º, 14º, 21º, 28º, 35º, 42º dias do experimento), sendo avaliado a área transversal do tendão (ATT), área transversal da lesão (ATL), o percentual da ATL, a intensidade e ecogenicidade da lesão, assim como o paralelismo das fibras colágenas. Os resultados revelaram redução (P<0,05) da ATL e do grau de ecogenicidade da lesão em função do tempo, mas com diferença (P<0,05) entre grupos apenas para ATL, com valores menores no GT. O tratamento com PRP proporciona maior redução da área da lesão, mensurada por ultra-sonografia.
The objective of the study was to evaluate the effect of platelet-rich plasma (PRP) in the treatment of induced tendinitis in the superficial digital flexor tendon (SDFT) of horses through ultrasonographic evaluation. Thus, six 8 to15-year-old healthy gelding horses (x=12 years) were used. Tendinitis of the SDFT was provoked in both forelimbs via intratendineous administration of 2.5mg of collagenase (2.5mg.mL-1), what was considered as beginning of the experimental phase. Twelve days after induced tendinitis, the horses were submitted to two treatments: (1) in the lesion caused in the right SDFT (treated group, TG), 2.5mL of PRP activated with calcium chloride at 0.0125mol.L-1, at concentrations from 320,000 to 500,000 platelets.µL-1, were administered; (2) in the tendinitis of the left SDFT (control group, CG), 2.5mL of 0.9 percent saline solution was administered. After 5 days, the animals were submitted to controlled and progressive physical activity during 30 days. Ultrasonographic examinations were carried out before and after tendinitis induction (48 hours after and on experimental days 7, 12, 14, 21 28, 35 and 42), with tendon cross-sectional area (CSA), lesion cross-sectional area (L-CSA), L-CSA percentage, severity and echogenicity of the lesion, as well as collagen fiber alignment being evaluated. The result revealed reduction (P<0.05) in the L-CSA and in the degree of lesion echogenicity in function of time, but with difference (P<0.05) between groups only for L-CSA, with smaller values in TG. The treatment with PRP promotes greater reduction in the area of the lesion measured by ultrasound.
Assuntos
Animais , Contagem de Plaquetas/métodos , Equidae , Tendinopatia/induzido quimicamente , Traumatismos dos Tendões/induzido quimicamente , UltrassonografiaRESUMO
A report of two cases of fluoroquinolones-associated Achilles tendon rupture in two previously-healthy males is presented. Neither of them had any other predisposing condition for this complication. Both were used to strenous physical activity. No other cause could be found in relation to their traumatic experience. Emphasis is placed on the necessity of identifying this potential and probably unusual complication of these widely-used antimicrobials