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Novel information on the non-neuronal cholinergic system in orthopedics provides new possible treatment strategies for inflammatory and degenerative diseases

Sture Forsgren, Håkan Alfredson, Dennis Bjur, Solbritt Rantapää-Dahlqvist, Örjan Norrgård, Tore Dalén, Patrik Danielson
  • Sture Forsgren
    Dept. of Integrative Medical Biology, Anatomy, Umeå University, Umeå, Sweden,
  • Håkan Alfredson
    Dept. of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden,
  • Dennis Bjur
    Dept. of Integrative Medical Biology, Anatomy, Umeå University, Umeå, Sweden,
  • Solbritt Rantapää-Dahlqvist
    Dept. of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden,
  • Örjan Norrgård
    Dept. of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden,
  • Tore Dalén
    Dept. of Surgical and Perioperative Sciences, Orthopaedics, Umeå University, Umeå, Sweden,

Abstract

Anti-cholinergic agents are used in the treatment of several pathological conditions. Therapy regimens aimed at up-regulating cholinergic functions, such as treatment with acetylcholinesterase inhibitors, are also currently prescribed. It is now known that not only is there a neuronal cholinergic system but also a non-neuronal cholinergic system in various parts of the body. Therefore, interference with the effects of acetylcholine (ACh) brought about by the local production and release of ACh should also be considered. Locally produced ACh may have proliferative, angiogenic, wound-healing, and immunomodulatory functions. Interestingly, cholinergic stimulation may lead to anti-inflammatory effects. Within this review, new findings for the locomotor system of a more widespread non-neuronal cholinergic system than previously expected will be discussed in relation to possible new treatment strategies. The conditions discussed are painful and degenerative tendon disease (tendinopathy/tendinosis), rheumatoid arthritis, and osteoarthritis.

Keywords

Acetylcholine; Tendinosis; Tendinopathy; Rheumatoid Arthritis; Osteoarthritis

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Submitted: 2009-05-27 17:48:13
Published: 2009-07-02 08:18:33
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Copyright (c) 2009 Sture Forsgren, Håkan Alfredson, Dennis Bjur, Solbritt Rantapää-Dahlqvist, Örjan Norrgård, Tore Dalén, Patrik Danielson

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