The Synergistic Effect of Anabolic Steroid and Loading on Intercellular Calcium Signaling Via Gap Junctions in Human Supraspinatus Tendon Cells

Objective: We hypothesized that anabolic steroid administration would act synergistically with substrate strain in two-dimensional cultures of human supraspinatus tendon cells, to upregulate the expression of connexin-43 and to increase the Ca2+ wave propagation through gap junctions. Methods: Supraspinatus tendon cells were isolated intra-operatively from human specimens during shoulder arthroscopy. Cells were plated in two-dimensional spot cultures and arranged into four experimental groups: 1) non-load, non-steroid (NLNS, n=12 wells); 2) non-load, steroid (NLS, n=12 wells); 3) load, non-steroid (LNS, n=12 wells); and 4) load, steroid (LS, n=12 wells) in order to produce bioartificial tendons (BATs). The load groups were stretched in culture plates and the steroid groups were given nandrolone decanoate. When BATs were macro- and microscopically mature, at five days, they were evaluated with immunocytochemistry for connexin-43 staining, fluorescence microscopy for calcium imaging and mechanical stimulation with a micropipette tip manipulation for calcium propagation. Dose response test was performed in order to establish any relation between nandrolone decanoate dose and calcium signaling response. ATP was applied to the spot culture cells from all groups and all patients to determine if the cells were sensitive to extracellular ATP. Results: Load-steroid group demonstrated the greatest density of cnx43 in comparison to all other groups. There were no significant differences between the groups considering the percentage of cells responding after mechanical stimulation (cell recruitment). The cells of load-steroid group showed a significantly greater mean peak [Ca2+]ic compared to the values of the other groups (p<0.05). The propagation time was significantly decreased in the LS group compared with the other groups (p<0.05). There were no significant differences between the groups considering the number of cells that were responding spontaneously prior to stimulation or the number of responding cells that were oscillating after the stimulation. Conclusion: Nandrolone decanoate and loading seem to have a synergistic effect on the upregulation of the gap junction protein cxn43 enhancing calcium signaling via gap junctions. Consecutively, anabolic steroid administration and load may enhance the formation of a better-organized cytoskeleton and particularly the actin stress monofilaments.