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Stem cells and tendinopathy

Kenneth M Lin, Dean Wang, Joshua S Dines
Rotator cuff disease affects a large proportion of the overall population and encompasses a wide spectrum of pathologies, including subacromial impingement, rotator cuff tendinopathy or tear, and calcific tendinitis. Various injection therapies have been used for the treatment of rotator cuff disease, including corticosteroid, prolotherapy, platelet-rich plasma, stem cells, and ultrasound-guided barbotage for calcific tendinitis. However, the existing evidence for these therapies remains controversial or sparse...
April 2018: Orthopedic Clinics of North America
Jan Zabrzyński, Łukasz Łapaj, Łukasz Paczesny, Agnieszka Zabrzyńska, Dariusz Grzanka
Tendons are connective tissue structures of paramount importance to human ability of locomotion. The understanding of their physiology and pathology is gaining importance as advances in regenerative medicine are being made today. So far, very few studies were conducted to extend the knowledge about pathology, healing response and management of tendon lesions. In this paper we summarize actual knowledge on structure, process of healing and ageing of the tendons. The structure of tendon is optimized for the best performance of the tissue...
January 18, 2018: Folia Morphologica (Warsz)
Sun Jeong Kim, Da-Hyun Song, Sang Jun Kim
Tendon derived stem cells (TDSCs) have been used as a therapeutic agent and as a healing marker. However, there has been no study about the characteristics of TDSCs extracted from tendinopathic tendon tissues. The aim of this study was to find the different characteristics of TDSCs according to the factors to induce the tendinopathy. Five- and 15-week old Sprague Dawley rats were used for this study and chemically-induced and injury-induced tendinopathy models were made depending on the age of the animal for different types of tendinopathy...
January 17, 2018: Journal of Cellular Physiology
Leigh J Weiss, Dean Wang, Michael Hendel, Philip Buzzerio, Scott A Rodeo
PURPOSE OF REVIEW: Rotator cuff injuries are a common cause of pain and dysfunction for the elite athlete and can result in time loss from participation. This review highlights the current management of these injuries. RECENT FINDINGS: Conservative management of rotator cuff injuries continues to be the "gold standard" in the elite athlete. This includes a comprehensive rehabilitation program, anti-inflammatories, and corticosteroid injections. Newer treatment techniques such as intramuscular dry needling and the use of biologics such as platelet-rich plasma and stem cells demonstrate early promising results; however, these modalities require further investigation to determine their effectiveness...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
Zexing Yan, Heyong Yin, Michael Nerlich, Christian G Pfeifer, Denitsa Docheva
BACKGROUND: Tendons are dense connective tissues and critical components for the integrity and function of the musculoskeletal system. Tendons connect bone to muscle and transmit forces on which locomotion entirely depends. Due to trauma, overuse and age-related degeneration, many people suffer from acute or chronic tendon injuries. Owing to their hypovascularity and hypocellularity, tendinopathies remain a substantial challenge for both clinicians and researchers. Surgical treatment includes suture or transplantation of autograft, allograft or xenograft, and these serve as the most common technique for rescuing tendon injuries...
January 5, 2018: Journal of Experimental Orthopaedics
Letizia Rinella, Francesca Marano, Laura Paletto, Marco Fraccalvieri, Laura Annaratone, Isabella Castellano, Nicoletta Fortunati, Alessandro Bargoni, Laura Berta, Roberto Frairia, Maria Graziella Catalano
PURPOSES: Incomplete tendon healing impairs the outcome of tendon ruptures and tendinopathies. Human Adipose-derived Stem Cells (hASCs) are promising for tissue engineering applications. Extracorporeal Shock Waves (ESW) are a leading choice for the treatment of several tendinopathies. In this study, we investigated the effects of ESW treatment and tenogenic medium on the differentiation of hASCs into tenoblast-like cells. MATERIALS AND METHODS: hASCs were treated with ESW generated by a piezoelectric device and tenogenic medium...
January 9, 2018: Connective Tissue Research
Xiao Xia Cong, Xi Sheng Rao, Jun Xin Lin, Xiao Ceng Liu, Guang An Zhang, Xiu Kui Gao, Min Yi He, Wei Liang Shen, Wei Fan, Dominique Pioletti, Li Ling Zheng, Huan Huan Liu, Zi Yin, Boon Chuan Low, Ronen Schweitzer, Hongwei Ouyang, Xiao Chen, Yi Ting Zhou
Tendon repair is a clinical challenge because of the limited understanding on tenogenesis. The synthesis of type I collagen (Collagen I) and other extracellular matrix are essential for tendon differentiation and homeostasis. Current studies on tenogenesis focused mostly on the tenogenic transcriptional factors while the signaling controlling tenogenesis on translational level remains largely unknown. Here, we showed that mechanistic target of rapamycin (mTOR) signaling was activated by protenogenic growth factor, transforming growth factors beta1, and insulin-like growth factor-I...
January 4, 2018: Stem Cells
Isabel Andia, Jose Ignacio Martin, Nicola Maffulli
PRPs can be used in the management of tendinopathy if we improve our understanding of pathophysiology and achieve to integrate molecular knowledge about PRP participation in healing mechanisms. Areas covered: We provide new insights into the pathophysiology of tendinopathy, PRP therapies, and the potential links between both. We discuss the place of PRP in promoting tendon repair within what is currently understood of the role of PRP molecules in promoting tendon regeneration. We also highlight the many opportunities for further exploration and identification of strategically designed treatments providing meaningful clinical benefit...
January 4, 2018: Expert Opinion on Biological Therapy
Magdalena Schneider, Peter Angele, Tero A H Järvinen, Denitsa Docheva
Due to the increasing age of our society and a rise in engagement of young people in extreme and/or competitive sports, both tendinopathies and tendon ruptures present a clinical and financial challenge. Tendon has limited natural healing capacity and often responds poorly to treatments, hence it requires prolonged rehabilitation in most cases. Till today, none of the therapeutic options has provided successful long-term solutions, meaning that repaired tendons do not recover their complete strength and functionality...
December 23, 2017: Advanced Drug Delivery Reviews
Yi Wang, Xu Zhang, Huihui Huang, Yin Xia, YiFei Yao, Arthur Fuk-Tat Mak, Patrick Shu-Hang Yung, Kai-Ming Chan, Li Wang, Chenglin Zhang, Yu Huang, Kingston King-Lun Mak
Both extrinsic and intrinsic tissues contribute to tendon repair, but the origin and molecular functions of extrinsic tissues in tendon repair are not fully understood. Here we show that tendon sheath cells harbor stem/progenitor cell properties and contribute to tendon repair by activating Hedgehog signaling. We found that Osteocalcin (Bglap) can be used as an adult tendon-sheath-specific marker in mice. Lineage tracing experiments show that Bglap-expressing cells in adult sheath tissues possess clonogenic and multipotent properties comparable to those of stem/progenitor cells isolated from tendon fibers...
December 15, 2017: ELife
Louise I Pease, Peter D Clegg, Carole J Proctor, Daryl J Shanley, Simon J Cockell, Mandy J Peffers
The development of tendinopathy is influenced by a variety of factors including age, gender, sex hormones and diabetes status. Cross platform comparative analysis of transcriptomic data elucidated the connections between these entities in the context of ageing. Tissue-engineered tendons differentiated from bone marrow derived mesenchymal stem cells from young (20-24 years) and old (54-70 years) donors were assayed using ribonucleic acid sequencing (RNA-seq). Extension of the experiment to microarray and RNA-seq data from tendon identified gender specific gene expression changes highlighting disparity with existing literature and published pathways...
October 31, 2017: Scientific Reports
Mohamed A Imam, James Holton, Saman Horriat, Ahmed S Negida, Florian Grubhofer, Rohit Gupta, Ali Narvani, Martyn Snow
Tendon pathologies are a group of musculoskeletal conditions frequently seen in clinical practice. They can be broadly classified into traumatic, degenerative and overuse-related tendinopathies. Rotator cuff tears, Achilles tendinopathy and tennis elbow are common examples of these conditions. Conventional treatments have shown inconsistent outcomes and might fail to provide satisfactory clinical improvement. With the growing trend towards the use of mesenchymal stem cells (MSCs) in other branches of medicine, there is an increasing interest in treating tendon pathologies using the bone marrow MSC...
2017: SICOT-J
A Romero, L Barrachina, B Ranera, A R Remacha, B Moreno, I de Blas, A Sanz, F J Vázquez, A Vitoria, C Junquera, P Zaragoza, C Rodellar
Several therapies have been investigated for equine tendinopathies, but satisfactory long term results have not been achieved consistently and a better understanding of the healing mechanism elicited by regenerative therapies is needed. The aim of this study was to assess the separate effects of autologous bone marrow (BM) and adipose tissue (AT) derived mesenchymal stem cells (MSCs), and platelet rich plasma (PRP), for treating lesions induced in the superficial digital flexor tendon (SDFT) of horses. Lesions were created surgically in both SDFTs of the forelimbs of 12 horses and were treated with BM-MSCs (six tendons), AT-MSCs (six tendons) or PRP (six tendons)...
June 2017: Veterinary Journal
Yang Liu, Jia Xu, Liangliang Xu, Tianyi Wu, Yuxin Sun, Yuk-Wai Lee, Bin Wang, Hsiao-Chang Chan, Xiaohua Jiang, Jinfang Zhang, Gang Li
Tendons are a mechanosensitive tissue, which enables them to transmit to bone forces that are derived from muscle. Patients with tendon injuries, such as tendinopathy or tendon rupture, were often observed with matrix degeneration, and the healing of tendon injuries remains a challenge as a result of the limited understanding of tendon biology. Our study demonstrates that the stretch-mediated activation channel, cystic fibrosis transmembrane conductance regulator (CFTR), was up-regulated in tendon-derived stem cells (TDSCs) during tenogenic differentiation under mechanical stretching...
September 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Yu-Cheng Lin, Ying-Juan Li, Yun-Feng Rui, Guang-Chun Dai, Liu Shi, Hong-Liang Xu, Ming Ni, Song Zhao, Hui Chen, Chen Wang, Gang Li, Gao-Jun Teng
Patients with diabetes are at great risk to suffer many musculoskeletal disorders, such as tendinopathy, tendon rupture and impaired tendon healing. However, the pathogenesis of these tendon disorders still remains unclear. In this study, we aimed to investigate the effects of high glucose on cell proliferation, cell apoptosis and tendon-related markers expression of tendon-derived stem cells (TDSCs) in vitro. These findings might provide new insights into the pathogenesis of diabetic tendon disorders. The cell proliferative ability and apoptosis rate of TDSCs in different groups were evaluated by MTT assay and Annexin V-FITC/PI staining assay...
March 14, 2017: Oncotarget
Annu Navani, Gang Li, Joshua Chrystal
BACKGROUND: Platelet rich plasma (PRP) has been used for decades to facilitate surgical tissue repair; therefore, the current trend of percutaneously injecting PRP to theoretically enhance tissue regeneration and repair is a logical progression. Applications include treatment of osteoarthritis, tendinopathy, chondropathy, acute and chronic soft tissue injuries, muscle or ligament tear, as well as enhancement of healing after bone or tissue reconstruction. However, there is limited evidence to support the use of PRP in the abovementioned conditions...
March 2017: Pain Physician
Sang Yoon Lee, Bomi Kwon, Kyoungbun Lee, Young Hoon Son, Sun G Chung
BACKGROUND: Although survival of transplanted stem cells in vivo and differentiation of stem cells into tenocytes in vitro have been reported, there have been no in vivo studies demonstrating that mesenchymal stem cells (MSCs) could secrete their own proteins as differentiated tenogenic cells. Purpose/Hypothesis: Using a xenogeneic MSC transplantation model, we aimed to investigate whether MSCs could differentiate into the tenogenic lineage and secrete their own proteins. The hypothesis was that human MSCs would differentiate into the human tenogenic lineage and the cells would be able to secrete human-specific proteins in a rat tendon injury model...
May 2017: American Journal of Sports Medicine
A Kendal, S Snelling, S Dakin, E Stace, P-A Mouthuy, A Carr
Chronic tendinopathy in an active and ageing population represents an increasing burden to healthcare systems. Rotator cuff tendinopathy alone accounts for approximately 70 % of all shoulder pain. Tendinopathic tissue has a disorganised extracellular matrix, altered vasculature, and infiltration of fibroblasts and inflammatory cells. This altered biology may contribute to the limited success of surgical repair strategies. Electrospun resorbable scaffolds can potentially enhance endogenous repair mechanisms by influencing the tissue microenvironment...
February 20, 2017: European Cells & Materials
P P Y Lui
Chronic tendinopathy is a frequent and disabling musculo-skeletal problem affecting the athletic and general populations. The affected tendon is presented with local tenderness, swelling, and pain which restrict the activity of the individual. Tendon degeneration reduces the mechanical strength and predisposes it to rupture. The pathogenic mechanisms of chronic tendinopathy are not fully understood and several major non-mutually exclusive hypotheses including activation of the hypoxia-apoptosis-pro-inflammatory cytokines cascade, neurovascular ingrowth, increased production of neuromediators, and erroneous stem cell differentiation have been proposed...
August 2017: Scandinavian Journal of Medicine & Science in Sports
Sun Jeong Kim, Da Hyun Song, Jong Wook Park, Silvia Park, Sang Jun Kim
Bone marrow aspirate concentrates (BMACs) and platelet-rich plasma (PRP) are good sources to control the differentiation of tendon-derived stem cells (TDSCs), but there has been no study about the effect of the BMAC-PRP complex on TDSCs and tendinopathy. The aim of this study was to investigate the effect of BMAC-PRP on the TDSCs and to find the therapeutic effect of BMAC-PRP on the rotator cuff tendon tear. The chondrogenic and osteogenic potential of TDSCs decreased, but the adipogenic potential of TDSCs revealed no significant difference when they were cocultured with BMAC-PRP...
May 9, 2017: Cell Transplantation
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