1
|
Snow F, O'Connell C, Yang P, Kita M, Pirogova E, Williams RJ, Kapsa RMI, Quigley A. Engineering interfacial tissues: The myotendinous junction. APL Bioeng 2024; 8:021505. [PMID: 38841690 PMCID: PMC11151436 DOI: 10.1063/5.0189221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
The myotendinous junction (MTJ) is the interface connecting skeletal muscle and tendon tissues. This specialized region represents the bridge that facilitates the transmission of contractile forces from muscle to tendon, and ultimately the skeletal system for the creation of movement. MTJs are, therefore, subject to high stress concentrations, rendering them susceptible to severe, life-altering injuries. Despite the scarcity of knowledge obtained from MTJ formation during embryogenesis, several attempts have been made to engineer this complex interfacial tissue. These attempts, however, fail to achieve the level of maturity and mechanical complexity required for in vivo transplantation. This review summarizes the strategies taken to engineer the MTJ, with an emphasis on how transitioning from static to mechanically inducive dynamic cultures may assist in achieving myotendinous maturity.
Collapse
|
2
|
Chen Y, Li Y, Zhu W, Liu Q. Biomimetic gradient scaffolds for the tissue engineering and regeneration of rotator cuff enthesis. Biofabrication 2024; 16:032005. [PMID: 38697099 DOI: 10.1088/1758-5090/ad467d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/02/2024] [Indexed: 05/04/2024]
Abstract
Rotator cuff tear is one of the most common musculoskeletal disorders, which often results in recurrent shoulder pain and limited movement. Enthesis is a structurally complex and functionally critical interface connecting tendon and bone that plays an essential role in maintaining integrity of the shoulder joint. Despite the availability of advanced surgical procedures for rotator cuff repair, there is a high rate of failure following surgery due to suboptimal enthesis healing and regeneration. Novel strategies based on tissue engineering are gaining popularity in improving tendon-bone interface (TBI) regeneration. Through incorporating physical and biochemical cues into scaffold design which mimics the structure and composition of native enthesis is advantageous to guide specific differentiation of seeding cells and facilitate the formation of functional tissues. In this review, we summarize the current state of research in enthesis tissue engineering highlighting the development and application of biomimetic scaffolds that replicate the gradient TBI. We also discuss the latest techniques for fabricating potential translatable scaffolds such as 3D bioprinting and microfluidic device. While preclinical studies have demonstrated encouraging results of biomimetic gradient scaffolds, the translation of these findings into clinical applications necessitates a comprehensive understanding of their safety and long-term efficacy.
Collapse
Affiliation(s)
- Yang Chen
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yexin Li
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Weihong Zhu
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Qian Liu
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| |
Collapse
|
3
|
Hart DA, Ahmed AS, Chen J, Ackermann PW. Optimizing tendon repair and regeneration: how does the in vivo environment shape outcomes following rupture of a tendon such as the Achilles tendon? Front Bioeng Biotechnol 2024; 12:1357871. [PMID: 38433820 PMCID: PMC10905747 DOI: 10.3389/fbioe.2024.1357871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Risk for rupture of the Achilles tendon, and other tendons increases with age. Such injuries of tissues that function in high load environments generally are believed to heal with variable outcome. However, in many cases, the healing does not lead to a good outcome and the patient cannot return to the previous level of participation in active living activities, including sports. In the past few years, using proteomic approaches and other biological techniques, reports have appeared that identify biomarkers that are prognostic of good outcomes from healing, and others that are destined for poor outcomes using validated criteria at 1-year post injury. This review will discuss some of these recent findings and their potential implications for improving outcomes following connective tissue injuries, as well as implications for how clinical research and clinical trials may be conducted in the future where the goal is to assess the impact of specific interventions on the healing process, as well as focusing the emphasis on regeneration and not just repair.
Collapse
Affiliation(s)
- David A. Hart
- Department of Surgery, Faculty of Kinesiology, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Aisha S. Ahmed
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Junyu Chen
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital of Sichuan University, Chengdu, China
| | - Paul W. Ackermann
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
4
|
Peng Y, Diao L, Wang J, Wang G, Jia S, Zheng C. Effect of Platelet-Rich Plasma at Different Initiation Times on Healing of the Bone-Tendon Interface of the Rotator Cuff in a Mouse Model. Orthop J Sports Med 2024; 12:23259671231219812. [PMID: 38405010 PMCID: PMC10893834 DOI: 10.1177/23259671231219812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/31/2023] [Indexed: 02/27/2024] Open
Abstract
Background Platelet-rich plasma (PRP) has demonstrated beneficial effects on healing of the bone-tendon interface (BTI). Purpose To determine the optimal initiation time for PRP application after rotator cuff repair in an animal model. Study Design Controlled laboratory study. Methods A total of 136 C57BL/6 mice were included; 40 mice were used to prepare PRP, while 96 mice underwent acute supraspinatus tendon (SST) repair. The animals were randomly divided into 4 groups: a control group and 3 groups in which PRP was injected into the injury interface immediately after surgery, on the 7th postoperative day (PRP-7d), and on the 14th postoperative day. At 4 and 8 weeks postoperatively, the animals were sacrificed, blood was collected by eyeball removal, and samples of the SST-humerus complex were collected. Histological, imaging, immunological, and biomechanical data were compared among the groups using 1-way analysis of variance with the Bonferroni post hoc test. Results Histological analysis revealed that the fibrocartilage layer at the BTI was larger in the PRP-7d group compared to the other groups at both 4 and 8 weeks postoperatively. Moreover, the PRP-7d group exhibited improved proteoglycan content and distribution compared to the other groups. Enzyme-linked immunosorbent assay results demonstrated that at 4 weeks postoperatively, higher concentrations of transforming growth factor-β1 and platelet-derived growth factor-BB (PDGF-BB) were seen in the PRP-7d group versus the PRP-14d and control gruops (P < .05), and at 8 weeks postoperatively, the concentration of PDGF-BB was higher in the PRP-7d group versus the control group (P < .05). Biomechanical testing at 4 weeks postoperatively revealed that the failure load and ultimate strength of the SST-humerus complex were superior in the PRP-7d group compared to the other groups (P < .05), at 8 weeks, PRP-7d group was superior to the control group (P < .05). Additionally, at 8 weeks postoperatively, the PRP-7d group exhibited a greater trabecular number and trabecular thickness at the BTI compared to the PRP-14d and control gruops (P < .05). Conclusion PRP promoted healing of the BTI after a rotator cuff injury at an early stage. Clinical Relevance A PRP injection on the 7th postoperative day demonstrated superior therapeutic effects compared with injections at other time points.
Collapse
Affiliation(s)
- Yundong Peng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
- College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Luyu Diao
- College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Juan Wang
- College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Guanglan Wang
- College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Shaohui Jia
- Hubei Key Laboratory of Sport Training and Monitoring, College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Cheng Zheng
- Department of Sports Medicine, Affiliated Hospital, Wuhan Sports University, Wuhan, China
| |
Collapse
|
5
|
Kawakami J, Hisanaga S, Yoshimoto Y, Mashimo T, Kaneko T, Yoshimura N, Shimada M, Tateyama M, Matsunaga H, Shibata Y, Tanimura S, Takata K, Arima T, Maeda K, Fukuma Y, Uragami M, Ideo K, Sugimoto K, Yonemitsu R, Matsushita K, Yugami M, Uehara Y, Nakamura T, Tokunaga T, Karasugi T, Sueyoshi T, Shukunami C, Okamoto N, Masuda T, Miyamoto T. Remnant tissue enhances early postoperative biomechanical strength and infiltration of Scleraxis-positive cells within the grafted tendon in a rat anterior cruciate ligament reconstruction model. PLoS One 2023; 18:e0293944. [PMID: 37939095 PMCID: PMC10631660 DOI: 10.1371/journal.pone.0293944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023] Open
Abstract
When ruptured, ligaments and tendons have limited self-repair capacity and rarely heal spontaneously. In the knee, the Anterior Cruciate Ligament (ACL) often ruptures during sports activities, causing functional impairment and requiring surgery using tendon grafts. Patients with insufficient time to recover before resuming sports risk re-injury. To develop more effective treatment, it is necessary to define mechanisms underlying ligament repair. For this, animal models can be useful, but mice are too small to create an ACL reconstruction model. Thus, we developed a transgenic rat model using control elements of Scleraxis (Scx), a transcription factor essential for ligament and tendon development, to drive GFP expression in order to localize Scx-expressing cells. As anticipated, Tg rats exhibited Scx-GFP in ACL during developmental but not adult stages. Interestingly, when we transplanted the flexor digitorum longus (FDP) tendon derived from adult Scx-GFP+ rats into WT adults, Scx-GFP was not expressed in transplanted tendons. However, tendons transplanted from adult WT rats into Scx-GFP rats showed upregulated Scx expression in tendon, suggesting that Scx-GFP+ cells are mobilized from tissues outside the tendon. Importantly, at 4 weeks post-surgery, Scx-GFP-expressing cells were more frequent within the grafted tendon when an ACL remnant was preserved (P group) relative to when it was not (R group) (P vs R groups (both n = 5), p<0.05), and by 6 weeks, biomechanical strength of the transplanted tendon was significantly increased if the remnant was preserved (P vsR groups (both n = 14), p<0.05). Scx-GFP+ cells increased in remnant tissue after surgery, suggesting remnant tissue is a source of Scx+ cells in grafted tendons. We conclude that the novel Scx-GFP Tg rat is useful to monitor emergence of Scx-positive cells, which likely contribute to increased graft strength after ACL reconstruction.
Collapse
Affiliation(s)
- Junki Kawakami
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Satoshi Hisanaga
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Yuki Yoshimoto
- Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Department of Molecular Biology and Biochemistry, Basic Life Sciences, Graduate School of Biomedical and Health Sciences, Minami-ku, Hiroshima, Japan
| | - Tomoji Mashimo
- Division of Animal Genetics, Laboratory Animal Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Takehito Kaneko
- Graduate School of Science and Engineering, Iwate University, Morioka, Iwate, Japan
| | - Naoto Yoshimura
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Masaki Shimada
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Makoto Tateyama
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Hideto Matsunaga
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Yuto Shibata
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Shuntaro Tanimura
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Kosei Takata
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Takahiro Arima
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Kazuya Maeda
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Yuko Fukuma
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Masaru Uragami
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Katsumasa Ideo
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Kazuki Sugimoto
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Ryuji Yonemitsu
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Kozo Matsushita
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Masaki Yugami
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Yusuke Uehara
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Takayuki Nakamura
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Takuya Tokunaga
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Tatsuki Karasugi
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Takanao Sueyoshi
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Chisa Shukunami
- Department of Molecular Biology and Biochemistry, Basic Life Sciences, Graduate School of Biomedical and Health Sciences, Minami-ku, Hiroshima, Japan
| | - Nobukazu Okamoto
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Tetsuro Masuda
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Takeshi Miyamoto
- Faculty of Life Sciences, Department of Orthopaedic Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|
6
|
Zuo Y, Luo J, Zhang X. A review on the use of porcine in tendon research. Ann Anat 2023; 250:152166. [PMID: 37806500 DOI: 10.1016/j.aanat.2023.152166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/02/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE OF REVIEW Large animals have been increasingly employed in tendon research; the objective of this review was to summarize the employment of porcine in tendon research. RECENT FINDINGS Literature before 2022-03-31 was searched using the following strategy: (pig[MeSH Terms]) AND (tendon[MeSH Terms]); (pig[MeSH Terms]) AND (tendon[title]); (tendon[MeSH Terms]) AND (porcine[title]); (tendon[title]) AND (porcine[title]); (tendon[MeSH Terms]) AND (pig[title]); (tendon[title]) AND (pig[title]); (tendon[MeSH Terms]) AND (swine[title]); (tendon[title]) AND (swine[title]). 296 studies were included in this review. There were wide application areas of porcine tendon, including tissue engineering tendons, training of surgical skills. Porcine tendon was used both in in vitro studies, such as anatomy, biomechanics, cytology, and material science as well as in in vivo studies. The research techniques of porcine tendon are relatively common. SUMMARY In conclusion, pigs have been widely used as a good animal model of tendon research. However, the limitations of porcine tendon research (the lack of anatomical research and in vivo studies) should be given more attention in future studies.
Collapse
Affiliation(s)
- Yanhai Zuo
- Department of Orthopedics, SiJing hospital of SongJiang District, Shanghai, China.
| | - Jingtao Luo
- Department of Orthopedics, SiJing hospital of SongJiang District, Shanghai, China
| | - Xinjun Zhang
- Department of Orthopedics, SiJing hospital of SongJiang District, Shanghai, China.
| |
Collapse
|
7
|
Li Y, Li W, Liu X, Liu X, Zhu B, Guo S, Wang C, Wang D, Li S, Zhang Z. Effects of Low-Intensity Pulsed Ultrasound in Tendon Injuries. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1923-1939. [PMID: 37079603 DOI: 10.1002/jum.16230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
Tendon injuries are the most common soft tissue injuries, caused by tissue overuse and age-related degeneration. However, the tendon repair process is slow and inefficient due to the lack of cellular structure and blood vessels in the tendon. Low-intensity pulsed ultrasound (LIPUS) has received increasing attention as a non-invasive, simple, and safe way to promote tendon healing. This review summarizes the effects and underlying mechanisms of LIPUS on tendon injury by comprehensively examining the published literature, including in vitro, in vivo, and clinical studies. This review reviewed 24 studies, with 87.5% showing improvement. The application of LIPUS in tendon diseases is a promising field worthy of further study.
Collapse
Affiliation(s)
- Yujie Li
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Wei Li
- Orthopaedics Department, Hejiang County People's Hospital, Luzhou, Sichuan, China
| | - Xinyue Liu
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Xueli Liu
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Bin Zhu
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Sheng Guo
- Spinal Surgery Department, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Chenglong Wang
- Spinal Surgery Department, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Dingxuan Wang
- Institute of Physical Education, Southwest Medical University, Luzhou, Sichuan, China
| | - Sen Li
- Spinal Surgery Department, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Zhongfa Zhang
- Orthopaedics Department, Hejiang County People's Hospital, Luzhou, Sichuan, China
| |
Collapse
|
8
|
Watanabe G, Yamamoto M, Taniguchi S, Sugiyama Y, Hirouchi H, Ishizuka S, Kitamura K, Mizoguchi T, Takayama T, Hayashi K, Abe S. Chronological Changes in the Expression and Localization of Sox9 between Achilles Tendon Injury and Functional Recovery in Mice. Int J Mol Sci 2023; 24:11305. [PMID: 37511063 PMCID: PMC10379325 DOI: 10.3390/ijms241411305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Tendons help transmit forces from the skeletal muscles and bones. However, tendons have inferior regenerative ability compared to muscles. Despite studies on the regeneration of muscles and bone tissue, only a few have focused on tendinous tissue regeneration, especially tendon regeneration. Sex-determining region Y-box transcription factor 9 (Sox9) is an SRY-related transcription factor with a DNA-binding domain and is an important control factor for cartilage formation. Sox9 is critical to the early-to-middle stages of tendon development. However, how Sox9 participates in the healing process after tendon injury is unclear. We hypothesized that Sox9 is expressed in damaged tendons and is crucially involved in restoring tendon functions. We constructed a mouse model of an Achilles tendon injury by performing a 0.3 mm wide partial excision in the Achilles tendon of mice, and chronologically evaluated the function restoration and localization of the Sox9 expressed in the damaged sites. The results reveal that Sox9 was expressed simultaneously with the formation of the pre-structure of the epitenon, an essential part of the tendinous tissue, indicating that its expression is linked to the functional restoration of tendons. Lineage tracing for Sox9 expressed during tendon restoration revealed the tendon restoration involvement of cells that switched into Sox9-expressing cells after tendon injury. The stem cells involved in tendon regeneration may begin to express Sox9 after injury.
Collapse
Affiliation(s)
- Genji Watanabe
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Masahito Yamamoto
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Shuichirou Taniguchi
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Yuki Sugiyama
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Hidetomo Hirouchi
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Satoshi Ishizuka
- Department of Pharmacology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Kei Kitamura
- Department of Histology and Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Toshihide Mizoguchi
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Takashi Takayama
- Department of Dentistry, The Jikei University School of Medicine, 3-19-18 Nishi-shinnbashi, Minato, Tokyo 105-8471, Japan
| | - Katsuhiko Hayashi
- Department of Dentistry, The Jikei University School of Medicine, 3-19-18 Nishi-shinnbashi, Minato, Tokyo 105-8471, Japan
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| |
Collapse
|
9
|
Zulkifli A, Ahmad RE, Krishnan S, Kong P, Nam HY, Kamarul T. The potential mechanism of hypoxia-induced tenogenic differentiation of mesenchymal stem cell for tendon regeneration. Tissue Cell 2023; 82:102075. [PMID: 37004269 DOI: 10.1016/j.tice.2023.102075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/27/2023] [Accepted: 03/16/2023] [Indexed: 04/03/2023]
Abstract
Tendon injuries account up to 50% of all musculoskeletal problems and remains a challenge to treat owing to the poor intrinsic reparative ability of tendon tissues. The natural course of tendon healing is very slow and often leads to fibrosis and disorganized tissues with inferior biomechanical properties. Mesenchymal stem cells (MSC) therapy is a promising alternative strategy to augment tendon repair due to its proliferative and multilineage differentiation potential. Hypoxic conditioning of MSC have been shown to enhance their tenogenic differentiation capacity. However, the mechanistic pathway by which this is achieved is yet to be fully defined. A key factor involved in this pathway is hypoxia-inducible factor-1-alpha (HIF-1α). This review aims to discuss the principal mechanism underlying the enhancement of MSC tenogenic differentiation by hypoxic conditioning, particularly the central role of HIF-1α in mediating activation of tenogenic pathways in the MSC. We focus on the interaction between HIF-1α with fibroblast growth factor-2 (FGF-2) and transforming growth factor-beta 1 (TGF-β1) in regulating MSC tenogenic differentiation pathways in hypoxic conditions. Strategies to promote stabilization of HIF-1α either through direct manipulation of oxygen tension or the use of hypoxia mimicking agents are therefore beneficial in increasing the efficacy of MSC therapy for tendon repair.
Collapse
|
10
|
Ren Z, Duan Z, Zhang Z, Fu R, Zhu C, Fan D. Instantaneous self-healing and strongly adhesive self-adaptive hyaluronic acid-based hydrogel for controlled drug release to promote tendon wound healing. Int J Biol Macromol 2023; 242:125001. [PMID: 37224906 DOI: 10.1016/j.ijbiomac.2023.125001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/26/2023]
Abstract
The treatment of tendon injuries is an important healthcare challenge. Irregular wounds, hypocellularity, and prolonged inflammation impede the rate of healing for tendon injuries. To address these problems, a high-tenacity shape-adaptive, mussel-like hydrogel (PH/GMs@bFGF&PDA) was designed and constructed with polyvinyl alcohol (PVA) and hyaluronic acid grafted with phenylboronic acid (BA-HA) by encapsulating polydopamine and gelatin microspheres containing basic fibroblast growth factor (GMs@bFGF). The shape-adaptive PH/GMs@bFGF&PDA hydrogel can quickly adapt to irregular tendon wounds, and the strong adhesion (101.46 ± 10.88 kPa) can keep the hydrogel adhered to the wound at all times. In addition, the high tenacity and self-healing properties allow the hydrogel to move with the tendon without fracture. Additionally, even if fractured, it can quickly self-heal and continue to adhere to the tendon wound, while slowly releasing basic fibroblast growth factor during the inflammatory phase of the tendon repair process, promoting cell proliferation, migration and shortening the inflammatory phase. In acute tendon injury and chronic tendon injury models, PH/GMs@bFGF&PDA significantly alleviated inflammation and promoted collagen I secretion, enhancing wound healing through the synergistic effects of its shape-adaptive and high-adhesion properties.
Collapse
Affiliation(s)
- Zhen Ren
- Shaanxi Key Laboratory of Degradable Biomedical Materials, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Biotech. & Biomed. Research Institute, Northwest University, Xi'an 710069, Shaanxi, China
| | - Zhiguang Duan
- Shaanxi Key Laboratory of Degradable Biomedical Materials, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Biotech. & Biomed. Research Institute, Northwest University, Xi'an 710069, Shaanxi, China
| | - Zhuo Zhang
- Plastic and Cosmetic Maxillofacial Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710069, Shaanxi, China
| | - Rongzhan Fu
- Shaanxi Key Laboratory of Degradable Biomedical Materials, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Biotech. & Biomed. Research Institute, Northwest University, Xi'an 710069, Shaanxi, China
| | - Chenhui Zhu
- Shaanxi Key Laboratory of Degradable Biomedical Materials, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Biotech. & Biomed. Research Institute, Northwest University, Xi'an 710069, Shaanxi, China.
| | - Daidi Fan
- Shaanxi Key Laboratory of Degradable Biomedical Materials, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an 710069, Shaanxi, China; Biotech. & Biomed. Research Institute, Northwest University, Xi'an 710069, Shaanxi, China.
| |
Collapse
|
11
|
Biological and Mechanical Factors and Epigenetic Regulation Involved in Tendon Healing. Stem Cells Int 2023; 2023:4387630. [PMID: 36655033 PMCID: PMC9842431 DOI: 10.1155/2023/4387630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/18/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
Tendons are an important part of the musculoskeletal system. Connecting muscles to bones, tendons convert force into movement. Tendon injury can be acute or chronic. Noticeably, tendon healing requires a long time span and includes inflammation, proliferation, and remodeling processes. The mismatch between endogenous and exogenous healing may lead to adhesion causing further negative effects. Management of tendon injuries and complications such as subsequent adhesion formation are still challenges for clinicians. Due to numerous factors, tendon healing is a complex process. This review introduces the role of various biological and mechanical factors and epigenetic regulation processes involved in tendon healing.
Collapse
|
12
|
Peserico A, Barboni B, Russo V, Bernabò N, El Khatib M, Prencipe G, Cerveró-Varona A, Haidar-Montes AA, Faydaver M, Citeroni MR, Berardinelli P, Mauro A. Mammal comparative tendon biology: advances in regulatory mechanisms through a computational modeling. Front Vet Sci 2023; 10:1175346. [PMID: 37180059 PMCID: PMC10174257 DOI: 10.3389/fvets.2023.1175346] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
There is high clinical demand for the resolution of tendinopathies, which affect mainly adult individuals and animals. Tendon damage resolution during the adult lifetime is not as effective as in earlier stages where complete restoration of tendon structure and property occurs. However, the molecular mechanisms underlying tendon regeneration remain unknown, limiting the development of targeted therapies. The research aim was to draw a comparative map of molecules that control tenogenesis and to exploit systems biology to model their signaling cascades and physiological paths. Using current literature data on molecular interactions in early tendon development, species-specific data collections were created. Then, computational analysis was used to construct Tendon NETworks in which information flow and molecular links were traced, prioritized, and enriched. Species-specific Tendon NETworks generated a data-driven computational framework based on three operative levels and a stage-dependent set of molecules and interactions (embryo-fetal or prepubertal) responsible, respectively, for signaling differentiation and morphogenesis, shaping tendon transcriptional program and downstream modeling of its fibrillogenesis toward a mature tissue. The computational network enrichment unveiled a more complex hierarchical organization of molecule interactions assigning a central role to neuro and endocrine axes which are novel and only partially explored systems for tenogenesis. Overall, this study emphasizes the value of system biology in linking the currently available disjointed molecular data, by establishing the direction and priority of signaling flows. Simultaneously, computational enrichment was critical in revealing new nodes and pathways to watch out for in promoting biomedical advances in tendon healing and developing targeted therapeutic strategies to improve current clinical interventions.
Collapse
|
13
|
Citro V, Clerici M, Boccaccini AR, Della Porta G, Maffulli N, Forsyth NR. Tendon tissue engineering: An overview of biologics to promote tendon healing and repair. J Tissue Eng 2023; 14:20417314231196275. [PMID: 37719308 PMCID: PMC10501083 DOI: 10.1177/20417314231196275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/06/2023] [Indexed: 09/19/2023] Open
Abstract
Tendons are dense connective tissues with a hierarchical polarized structure that respond to and adapt to the transmission of muscle contraction forces to the skeleton, enabling motion and maintaining posture. Tendon injuries, also known as tendinopathies, are becoming more common as populations age and participation in sports/leisure activities increases. The tendon has a poor ability to self-heal and regenerate given its intrinsic, constrained vascular supply and exposure to frequent, severe loading. There is a lack of understanding of the underlying pathophysiology, and it is not surprising that disorder-targeted medicines have only been partially effective at best. Recent tissue engineering approaches have emerged as a potential tool to drive tendon regeneration and healing. In this review, we investigated the physiochemical factors involved in tendon ontogeny and discussed their potential application in vitro to reproduce functional and self-renewing tendon tissue. We sought to understand whether stem cells are capable of forming tendons, how they can be directed towards the tenogenic lineage, and how their growth is regulated and monitored during the entire differentiation path. Finally, we showed recent developments in tendon tissue engineering, specifically the use of mesenchymal stem cells (MSCs), which can differentiate into tendon cells, as well as the potential role of extracellular vesicles (EVs) in tendon regeneration and their potential for use in accelerating the healing response after injury.
Collapse
Affiliation(s)
- Vera Citro
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Department of Materials Science and Engineering, Institute of Biomaterials University of Erlangen-Nuremberg, Cauerstrasse 6, Erlangen, Germany
| | - Marta Clerici
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Department of Medicine, Surgery and Dentistry, University of Salerno, via S. Allende, Baronissi, Salerno, Italy
| | - Aldo R. Boccaccini
- Department of Materials Science and Engineering, Institute of Biomaterials University of Erlangen-Nuremberg, Cauerstrasse 6, Erlangen, Germany
| | - Giovanna Della Porta
- Department of Medicine, Surgery and Dentistry, University of Salerno, via S. Allende, Baronissi, Salerno, Italy
- Interdepartmental Centre BIONAM, University of Salerno, via Giovanni Paolo I, Fisciano, Salerno, Italy
| | - Nicola Maffulli
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Department of Medicine, Surgery and Dentistry, University of Salerno, via S. Allende, Baronissi, Salerno, Italy
- Department of Trauma and Orthopaedic Surgery, University Hospital ‘San Giovanni di Dio e Ruggi D’Aragona’, Salerno, Italy
| | - Nicholas R. Forsyth
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Vice Principals’ Office, University of Aberdeen, Kings College, Aberdeen, UK
| |
Collapse
|
14
|
Donderwinkel I, Tuan RS, Cameron NR, Frith JE. Tendon tissue engineering: Current progress towards an optimized tenogenic differentiation protocol for human stem cells. Acta Biomater 2022; 145:25-42. [PMID: 35470075 DOI: 10.1016/j.actbio.2022.04.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/10/2022] [Accepted: 04/18/2022] [Indexed: 12/19/2022]
Abstract
Tendons are integral to our daily lives by allowing movement and locomotion but are frequently injured, leading to patient discomfort and impaired mobility. Current clinical procedures are unable to fully restore the native structure of the tendon, resulting in loss of full functionality, and the weakened tissue following repair often re-ruptures. Tendon tissue engineering, involving the combination of cells with biomaterial scaffolds to form new tendon tissue, holds promise to improve patient outcomes. A key requirement for efficacy in promoting tendon tissue formation is the optimal differentiation of the starting cell populations, most commonly adult tissue-derived mesenchymal stem/stromal cells (MSCs), into tenocytes, the predominant cellular component of tendon tissue. Currently, a lack of consensus on the protocols for effective tenogenic differentiation is hampering progress in tendon tissue engineering. In this review, we discuss the current state of knowledge regarding human stem cell differentiation towards tenocytes and tendon tissue formation. Tendon development and healing mechanisms are described, followed by a comprehensive overview of the current protocols for tenogenic differentiation, including the effects of biochemical and biophysical cues, and their combination, on tenogenesis. Lastly, a synthesis of the key features of these protocols is used to design future approaches. The holistic evaluation of current knowledge should facilitate and expedite the development of efficacious stem cell tenogenic differentiation protocols with future impact in tendon tissue engineering. STATEMENT OF SIGNIFICANCE: The lack of a widely-adopted tenogenic differentiation protocol has been a major hurdle in the tendon tissue engineering field. Building on current knowledge on tendon development and tendon healing, this review surveys peer-reviewed protocols to present a holistic evaluation and propose a pathway to facilitate and expedite the development of a consensus protocol for stem cell tenogenic differentiation and tendon tissue engineering.
Collapse
|