ORIGINAL RESEARCH article

Front. Immunol.

Sec. Inflammation

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1559422

This article is part of the Research TopicImmunological Aspects of Fibrosis Pathogenesis: Novel Mechanisms and Therapeutic StrategiesView all 22 articles

Identification and Validation of Biomarkers, Construction of Diagnostic Models, and Investigation of Immunological Infiltration Characteristics for Idiopathic Frozen Shoulder

Provisionally accepted
Han-tao  JiangHan-tao JiangLi-ping  ShenLi-ping ShenMeng-qi  PangMeng-qi PangMin-jiao  WuMin-jiao WuJiang  LiJiang LiWei-jie  GongWei-jie GongGang  JinGang Jin*Rang-teng  ZhuRang-teng Zhu*
  • Zhejiang Taizhou Hospital, Taizhou, China

The final, formatted version of the article will be published soon.

Background: Idiopathic frozen shoulder (FS) can lead to difficulties in daily activities and significantly impact the quality of life. Early diagnosis and treatment can help alleviate symptoms and restore shoulder function. Therefore, we aimed to explore the diagnostic biomarkers and potential mechanisms of FS from a transcriptomics perspective. Methods: Total RNA was extracted from tissue samples of 15 FS and 11 controls. At the outset, we conducted differential expression analysis, weighted gene co-expression network analysis (WGCNA), and utilized the cytoHubba plugin, complemented by two machine learning algorithms, receiver operating characteristic (ROC) analysis, and expression level evaluation to identify biomarkers for FS. Subsequently, a nomogram was constructed based on the biomarkers. Additionally, we conducted enrichment and immune infiltration analyses to explore the mechanisms associated with these biomarkers. Finally, we confirmed the expression patterns of the biomarkers at the clinical level through reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Results: SNAI1, TWIST1, COL1A1, TUBB2B, and DCN were identified as biomarkers for FS. The nomogram constructed based on them had a good predictive value for the occurrence of FS. Except for DCN, the other four genes were upregulated in FS samples, and the expression of SNAI1, TWIST1, and TUBB2B was also observed to be significantly upregulated in RT-qPCR. Moreover, these genes played important roles in pathways such as "ECM receptor interaction" and "lysosome". We also found that the infiltration abundances of 11 types of immune cells were significantly upregulated in the FS samples, and they were positively correlated with each other. Our biomarkers showed strong correlations with these immune cells; DCN generally displayed a negative correlation, while the other four genes were generally positively correlated. Conclusion: This study established a link between FS biomarkers that have strong diagnostic potential and specific immune responses, highlighting possible targets for diagnosing and treating FS.

Keywords: Frozen shoulder, Immune infiltration, Transcriptomics, bioinformatics, nomogram

Received: 12 Jan 2025; Accepted: 27 Jun 2025.

Copyright: © 2025 Jiang, Shen, Pang, Wu, Li, Gong, Jin and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Gang Jin, Zhejiang Taizhou Hospital, Taizhou, China
Rang-teng Zhu, Zhejiang Taizhou Hospital, Taizhou, China

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