Vascular endothelial growth factor (
VEGF), which is known to be an angiogenetic factor, plays an important role in the
inflammation of synovial tissue. To investigate the relationships between
VEGF and clinical symptoms in rotator cuff disease,
VEGF expression was examined using RT-PCR and immunohistochemical analysis in 50 patients with this disease (26 with full-thickness cuff tear, 12 with partial-thickness tear, and 12 with subacromial
bursitis).
VEGF mRNA expression was detected in 40 out of 50 patients by RT-PCR.
VEGF mRNA expression was found more frequently in the patients with motion
pain (39 out of 41) than in those without motion
pain (1 out of 9) with statistical significance (Fisher's test, P < 0.001). Thirty-one out of 33 patients with synovial proliferation showed
VEGF mRNA expression, whereas the expression of this transcript was found in 9 out of 17 patients without synovial proliferation. This association with synovial proliferation was also significant (Fisher's test, P = 0.0013). Thirty out of 41 patients with motion
pain had synovial proliferation but 3 out of 9 patients without motion
pain had synovial proliferation. In all these 30 patients with both motion
pain and synovial proliferation,
VEGF mRNA expression was detected. This association between motion
pain and synovial proliferation was also significant (Fisher's test, P < 0.05). The mean vessel count and area in subacromial bursa expressing
VEGF was significantly higher than in those without
VEGF (Mann Whitney's U test, P < 0.01). These results suggested that
VEGF expression is associated with vascularity, synovial proliferation and shoulder motion
pain in the rotator cuff disease.