Tendon and ligament regeneration and repair: clinical relevance and developmental paradigm.
TLDR
A greater understanding of the molecular mechanisms involved in T/L development and natural healing, coupled with the capability of producing complex biomaterials to deliver multiple biofactors with high spatiotemporal resolution and specificity, should lead to regenerative procedures that more closely recapitulate T/l morphogenesis.Abstract:
Tendon and ligament (T/L) are dense connective tissues connecting bone to muscle and bone to bone, respectively. Similar to other musculoskeletal tissues, T/L arise from the somitic mesoderm, but they are derived from a recently discovered somitic compartment, the syndetome. The adjacent sclerotome and myotome provide inductive signals to the interposing syndetome, thereby upregulating the expression of the transcription factor Scleraxis, which in turn leads to further tenogenic and ligamentogenic differentiation. These advances in the understanding of T/L development have been sought to provide a knowledge base for improving the healing of T/L injuries, a common clinical challenge due to the intrinsically poor natural healing response. Specifically, the three most common tendon injuries involve tearing of the rotator cuff of the shoulder, the flexor tendon of the hand, and the Achilles tendon. At present, injuries to these tissues are treated by surgical repair and/or conservative approaches, including biophysical modalities such as physical rehabilitation and cryotherapy. Unfortunately, the healing tissue forms fibrovascular scar and possesses inferior mechanical and biochemical properties as compared to native T/L. Therefore, tissue engineers have sought to improve upon the natural healing response by augmenting the injured tissue with cells, scaffolds, bioactive agents, and mechanical stimulation. These strategies show promise, both in vitro and in vivo, for improving T/L healing. However, several challenges remain in restoring full T/L function following injury, including uncertainties over the optimal combination of these biological agents as well how to best deliver tissue engineered elements to the injury site. A greater understanding of the molecular mechanisms involved in T/L development and natural healing, coupled with the capability of producing complex biomaterials to deliver multiple growth factors with high spatiotemporal resolution and specificity, will allow tissue engineers to more closely recapitulate T/L morphogenesis, thereby offering future patients the prospect of T/L regeneration, as opposed to simple tissue repair.read more
Citations
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Journal ArticleDOI
Descriptive transcriptome analysis of tendon derived fibroblasts following in-vitro exposure to advanced glycation end products
TL;DR: It is suggested that AGEs disrupt the tendon fibroblast transcriptome on a large scale and that these pathways may contribute to the development and progression of diabetic tendinopathy.
Journal ArticleDOI
Hyaluronic acid/platelet rich plasma-infused core-shell nanofiber membrane to prevent postoperative tendon adhesion and promote tendon healing.
TL;DR: An anti-adhesive barrier membrane incorporating hyaluronic acid (HA) can reduce fibroblasts attachment and impart lubrication effect for smooth tendon gliding during management of post-surgical tendon adhesion as mentioned in this paper .
Journal ArticleDOI
Ginsenoside Rg1 enhances the healing of injured tendon in achilles tendinitis through the activation of IGF1R signaling mediated by oestrogen receptor
TL;DR: Ginsenoside Rg1 promotes injured tendon healing in AT rat model through IGF1R and MAPK signaling pathway activation.
Book ChapterDOI
Injury and Repair of Tendon, Ligament, and Meniscus
TL;DR: The challenges and promises of combining stem/progenitor cells, scaffolds, and bioactive factors, for ligament, tendon, and meniscus tissue engineering and regenerative medicine approaches are highlighted in this review.
Journal ArticleDOI
Resistance training decreases matrix metalloproteinase-2 activity in quadriceps tendon in a rat model of osteoarthritis.
Fernando Augusto Vasilceac,Rita de Cássia Marqueti,Ivo Vieira de Sousa Neto,Dahan da Cunha Nascimento,Mariana Carvalho de Souza,João Luiz Quaglioti Durigan,Stela Márcia Mattiello +6 more
TL;DR: RT induced down-regulated MMP-2 activity in the quadriceps tendon and patellar tendon, suggesting RT is a potential therapeutic approach to minimize the deleterious effects of extracellular matrix degeneration.
References
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