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Bioinformatics analysis of ferroptosis in frozen shoulder.

OBJECTIVES: Frozen shoulder is a common shoulder disease that significantly affects the patient's life and work. Ferroptosis is a new type of programmed cell death, which is involved in many diseases. However, there have been no studies reporting the relationship between frozen shoulders and ferroptosis. This study identified potential molecular markers of ferroptosis in frozen shoulders to provide more effective strategies for the treatment of frozen shoulders. METHODS: GSE238053 was downloaded from the Gene Expression Omnibus (GEO) dataset and intersected with ferroptosis genes to obtain differentially expressed genes (DEGs). The signaling pathways and biological functions of DEGs were performed by WebGestalt and Metascape. The interactions related to these DEGs and the key genes between frozen shoulders and ferroptosis was performed by STRING and Cytoscape. A frozen shoulders rat model was used to validate our predicted genes, Western Blot and qRT-PCR was used to assess the expression levels of our genes of interest. RESULTS: A total of 34 DEGs between GSE238053 and Ferroptosis Database were obtained, most of which were involved in the HIF-1 signaling pathway and inflammatory response. A protein-protein interaction network was obtained by Cytoscape and the key genes (IL-6, HMOX1 and TLR4) were screened by MCODE. Our results of Western Blot showed that the protein expression level of TLR4 and HMOX1 were elevated, and the protein level of IL-6 decreased in frozen shoulders rat model. The mRNA level after frozen shoulders showed that IL-6 was upregulated, whereas TLR4 and HMOX1were downregulated. CONCLUSIONS: The results demonstrated that ferroptosis may affect the pathological process of frozen shoulders through these signaling pathways and genes. The identification of IL-6, HMOX1 and TLR4 genes can provide new therapeutic targets for frozen shoulders.

Ferroptosis

HLA-B27 and frozen shoulder.

Histocompatibility antigens were determined in 38 patients with frozen shoulder and 216 normal blood-donors. HLA-B27 was significantly more common in patients with frozen shoulder (42%) than in the controls (10%). The distribution of the other 19 histocompatibility antigens was similar in the patient and control groups. This result may be associated with the suggested immunological pathogenesis of the condition.

Adult

Immunological studies in frozen shoulder.

Serum immunoglobulin levels were determined in 25 patients with frozen shoulder and in 25 age- and sex-matched controls. Serum IgA levels were significantly reduced (P less than 0.001) in the patients with frozen shoulder and remained so after clinical recovery. Lymphocyte transformation to phytohaemagglutinin in 21 patients also showed significant depression (P less than 0.01). These results support the suggested immunological pathogenesis of this condition.

Adult

[Morphology of the incisura scapulae in relation to the frozen shoulder (author's transl)].

A flat incisura scapulae was registered on radiological examination of four cases of frozen shoulder. A modified X-ray technique was used to investigated 250 patients with spondylosis cervicalis in a morphological study of the incisura scapulae. Three types were found: Type I with a deep, sharp incisura, type 2 with a widened, balloon-sharped incisura and type 3 with a flat, barely-distinguishable incisura. The significance of the X-ray appearance is discussed.

Adult

Spectrum of lesions of the anterior capsular mechanism of the shoulder.

The anterior capsular mechanism appears to be the common denominator in a number of shoulder problems ranging from the recurrent dislocation ("too loose") to the frozen shoulder ("too tight"). The shoulder region and the anterior capsular mechanism can be carefully and accurately assessed by arthrography and cineradiography. Bicipital tenosynovitis has been held accountable for shoulder problems at each extreme of the spectrum. Bicipital tenosynovitis may exist in many shoulders; however, in corrective procedures for the unstable shoulder, the biceps becomes a dynamic reinforcement of the anterior capsule. In the frozen shoulder, the biceps tendon frequently is seen as normal at surgery and the anterior capsular mechanism is identified as the site of the essential lesion. Surgery may switch the patient's problem from one side of the spectrum to the other. Shoulder problems should be investigated thoroughly and evaluated in terms of the patient's requirements for shoulder motion as well as in terms of the orthopaedic surgeon's usual criteria for recommending corrective procedures.

Adolescent

Subacromial bursography.

Subacromial bursography was performed on 250 patients with following results. Bursographically, the subacromial bursa was found to have three intercommunicating portions with various frequency; subacromial, subdeltoid and subcoracoid. In complete rotator cuff ruptures, the contrast medium leaked into the shoulder joint. In 'frozen shoulder' the subacromial bursa is reduced in size according to the degree of contracture. The intrabursal injections of steroid hormone and Lidocaine proved to have definite therapeutic and pain alleviating effects.

Acromioclavicular Joint

Shoulder arthrography as a treatment modality.

Some patients undergoing shoulder arthrography with a stiff and painful joint have a small volume capsule or a frozen shoulder. In certain cases when the rotator cuff is intact, the arthrographic procedure has been therapeutic and joint distention has effected a return to normal function. Four such cases are presented.

Anesthesia, Local

Diagnosis of rotator cuff tear on routine radiographs.

Routine shoulder radiographs were reviewed in 42 patients with proven rotator cuff tears and in 38 patients in whom a rotator cuff tear had been excluded by shoulder arthrography. Five radiographic findings were identified which were commonly associated with a rotator cuff tear. One or more of these findings were seen in 90.4% of those patients with a rotator cuff tear. These findings were not specific and were also seen in 64.3% of those patients with a frozen shoulder.

Female

Management of painful shoulder.

55 patients with 60 shoulders painful at rest, and with limitation of all ranges of movement, were treated with multiple injections of methylprednisolone acetate into the subacromial space and glenohumeral joint cavity. Pain was abolished in 80%, two weeks after starting therapy and 95% were pain-free four weeks after the first injection. Maximum functional recovery (at least 150 degrees abduction, 80 degrees internal rotation, and 45 degrees external rotation), was achieved in 90% of patients eight weeks after starting treatment. It is suggested that the "frozen" shoulder--i.e., pain-free shoulder with severe limitation of all movement--is the end result of a neglected painful shoulder and it is essential that painful shoulders be treated as early as possible if normal function is to be preserved.

Adult

Molecular suicide studies of 125I and 3H disintegration in the DNA of Chinese hamster cells.

The shape of the survival curve for cells inactivated by tritium decay in DNA is modified by the presence of halogenated pyrimidines in the DNA in a manner analogous to their effect on X-ray induced reproductive death. The large shoulder found for tritium suicide is removed completely by coincorporation of 10(-6) M IUdR. The oxygen enhancement ratio for 125I and tritium disintegrations in unsynchronized Chinese hamster cells was determined for cells permitted to accumulate damage from these events at 4 degrees C. The oxygen enhancement ratio for 125I induced damage is 1.4. This is much smaller than the OER found for tritium decay which is similar or more than that found for X-ray exposure under the same conditions. These results suggest that the nature of the lesions produced by 125I decay in DNA are analogous to those produced by high LET radiation while those lesions produced by tritium are similar to lesions produced by roentgen rays. In synchronous V79 cells the effects of 125I induced damage in different regions of the mammalian cell DNA was examined taking advantage of the fact that DNA replication in hamster nuclei follows a time-dependent three dimensional pattern. The experiments indicate that 125I decays accumulated in the G2-period of the cell cycle have different efficiences for the induction of reproductive death depending on the region of the DNA which is labeled. The efficiency for the induction of reproductive death appears to be a maximum in DNA that replicates in V79 cells near the end of the DNA replication cycle. Electron capture events are dramatically efficient in the production of lethal chromosome aberrations. In CHO cells synchronized in the G1-stage of the cell cycle stored in the frozen state the efficiency for the induction of dicentric and ring chromosomes is 0.03. The dose response curve for the induction of these aberrations is linear in contrast to the curvilinear response found for roentgen ray exposure under the same conditions. Data on this kind suggest that there may exist "critical" regions within mammalian cell nuclei where chromatin fibers from two different chromosomes are in close proximity to each other and both are damaged non-repairably by a single electron capture event.

Animals