Expression of neuropeptides and cytokines at the extensor carpi radialis brevis muscle origin

J Shoulder Elbow Surg. 2002 Nov-Dec;11(6):570-5. doi: 10.1067/mse.2002.126769.


To reveal whether neuropeptides and cytokines affect the pathogenesis of tennis elbow, expressions of substance P, calcitonin gene-related peptide, interleukin 1 alpha, and transforming growth factor beta1 at the origin of the extensor carpi radialis brevis muscle were investigated in patients with tennis elbow (n = 10). Innervation in the origin was determined with use of the protein gene product 9.5. Substance P-like immunoreactivity and calcitonin gene-related peptide-like immunoreactivity were observed in the nerve fibers around small vessels without apparent infiltration of inflammatory cells. Cells showing positive interleukin 1 alpha or transforming growth factor beta1 immunoreactivity were noted in small vessels and the dense collagen meshwork in 5 of 10 cases. The results suggested that these neuropeptides and cytokines might promote inflammation and stimulate proliferation and matrix synthesis of fibroblasts, contributing to the pathology of tennis elbow.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Needle
  • Cytokines / analysis
  • Cytokines / metabolism*
  • Female
  • Humans
  • Immunohistochemistry
  • Inflammation Mediators / analysis*
  • Male
  • Middle Aged
  • Muscle, Skeletal / metabolism*
  • Neuropeptides / analysis
  • Neuropeptides / metabolism*
  • Pain Measurement
  • Probability
  • Prognosis
  • Range of Motion, Articular / physiology
  • Regression Analysis
  • Sampling Studies
  • Sensitivity and Specificity
  • Substance P / analysis
  • Substance P / metabolism*
  • Tennis Elbow / diagnosis*
  • Tennis Elbow / physiopathology


  • Cytokines
  • Inflammation Mediators
  • Neuropeptides
  • Substance P