Cyclic tensile strain upregulates collagen synthesis in isolated tendon fascicles

Using vocally inspired mechanical conditioning to enhance the synthesis of a cell-derived biomaterial

The collection of cell-derived extracellular matrix (ECM) to form implantable biomaterials has therapeutic potential. However, a significant challenge to the creation of these biomaterials is the ability to produce an adequate quantity of ECM from cells in culture. Mechanical stimulation has long been viewed as a practical means to enhance cellular matrix production. In this study we explored the influence of vocally inspired mechanical stimulation, a unique combination of high frequency vibration and low frequency strain, on the production of ECM. Using a custom fabricated vocal bioreactor, tracheal fibroblast seeded sacrificial foams were treated for 3 weeks using either isolated cyclic strain, combined cyclic strain and vibration (dual mode), or static conditioning. When compared to static controls, ECM production was significantly increased for samples conditioned with either cyclic strain or dual mode stimulation. The quantity of ECM harvested from sacrificial foams increased from 25 ± 1 mg for statically conditioned control foams, to 34 ± 3 and 52 ± 10 mg for cyclic strain and dual mode conditioned samples respectively. Furthermore, mechanical conditioning significantly increased the elastic modulus of ECM biomaterials collected from sacrificial foams. Static control modulus increased from 40 ± 2 to 63 ± 7 kPa and 92 ± 7 kPa following isolated cyclic strain and dual mode conditioning, respectively. These results indicate that cyclic strain conditioning can be used to accelerate the production of ECM by human tracheal cells during growth in culture, and that the addition of high frequency vibration to the conditioning program further enhances ECM production.

GAG depletion increases the stress-relaxation response of tendon fascicles, but does not influence recovery

Cyclic and static loading regimes are commonly used to study tenocyte metabolism in vitro and to improve our understanding of exercise-associated tendon pathologies. The aims of our study were to investigate if cyclic and static stress relaxation affected the mechanical properties of tendon fascicles differently, if this effect was reversible after a recovery period, and if the removal of glycosaminoglycans (GAGs) affected sample recovery. Tendon fascicles were dissected frombovine-foot extensors and subjected to 14% cyclic (1Hz) or static tensile strain for 30min. Additional fascicles were incubated overnight in buffer with 0.5U chondroitinase ABC or in buffer alone prior to the static stress-relaxation regime. To assess the effect of different stress-relaxation regimes, a quasi-static test to failure was carried out, either directly post loading or after a 2h recovery period, and compared with unloaded control fascicles. Both stress-relaxation regimes led to a significant reduction in fascicle failure stress and strain, but this was more pronounced in the cyclically loaded specimens. Removal of GAGs led to more stress relaxation and greater reductions in failure stress after static loading compared to controls. The reduction in mechanical properties was partially reversible in all samples, given a recovery period of 2h. This has implications for mechanical testing protocols, as a time delay between fatiguing specimens and characterization of mechanical properties will affect the results. GAGs appear to protect tendon fascicles from fatigue effects, possibly by enabling sample hydration.

The role of the non-collagenous matrix in tendon function

Tendon consists of highly ordered type I collagen molecules that are grouped together to form subunits of increasing diameter. At each hierarchical level, the type I collagen is interspersed with a predominantly non-collagenous matrix (NCM) (Connect. Tissue Res., 6, 1978, 11). Whilst many studies have investigated the structure, organization and function of the collagenous matrix within tendon, relatively few have studied the non-collagenous components. However, there is a growing body of research suggesting the NCM plays an important role within tendon; adaptations to this matrix may confer the specific properties required by tendons with different functions. Furthermore, age-related alterations to non-collagenous proteins have been identified, which may affect tendon resistance to injury. This review focuses on the NCM within the tensional region of developing and mature tendon, discussing the current knowledge and identifying areas that require further study to fully understand structure-function relationships within tendon. This information will aid in the development of appropriate techniques for tendon injury prevention and treatment.

Cyclic loading of tendon fascicles using a novel fatigue loading system increases interleukin-6 expression by tenocytes

Repetitive strain or 'overuse' is thought to be a major factor contributing to the development of tendinopathy. The aims of our study were to develop a novel cyclic loading system, and use it to investigate the effect of defined loading conditions on the mechanical properties and gene expression of isolated tendon fascicles. Tendon fascicles were dissected from bovine-foot extensors and subjected to cyclic tensile strain (1 Hz) at 30% or 60% of the strain at failure, for 0 h (control), 15 min, 30 min, 1 h, or 5 h. Post loading, a quasi-static test to failure assessed damage. Gene expression at a selected loading regime (1 h at 30% failure strain) was analyzed 6 h post loading by quantitative real-time polymerase chain reaction. Compared with unloaded controls, loading at 30% failure strain took 5 h to lead to a significant decrease in failure stress, whereas loading to 60% led to a significant reduction after 15 min. Loading for 1 h at 30% failure strain did not create significant structural damage, but increased Collagen-1-alpha-chain-1 and interleukin-6 (IL6) expression, suggesting a role of IL6 in tendon adaptation to exercise. Correlating failure properties with fatigue damage provides a method by which changes in gene expression can be associated with different degrees of fatigue damage.

Numerical assessment on the effective mechanical stimuli for matrix-associated metabolism in chondrocyte-seeded constructs

The self-regeneration capacity of articular cartilage is limited, due to its avascular and aneural nature. Loaded explants and cell cultures demonstrated that chondrocyte metabolism can be regulated via physiologic loading. However, the explicit ranges of mechanical stimuli that correspond to favourable metabolic response associated with extracellular matrix (ECM) synthesis are elusive.Unsystematic protocols lacking this knowledge produce inconsistent results. This study aims to determine the intrinsic ranges of physical stimuli that increase ECM synthesis and simultaneously inhibit nitric oxide (NO) production in chondrocyte–agarose constructs, by numerically reevaluating the experiments performed by Tsuang et al. (2008). Twelve loading patterns were simulated with poro-elastic finite element models in ABAQUS. Pressure on solid matrix, von Mises stress, maximum principle stress and pore pressure were selected as intrinsic mechanical stimuli.Their development rates and magnitudes at the steady state of cyclic loading were calculated with MATLAB at the construct level. Concurrent increase in glycosaminoglycan and collagen was observed at 2300 Pa pressure and 40 Pa/s pressure rate. Between 0–1500 Pa and 0–40 Pa/s, NO production was consistently positive with respect to controls, whereas ECM synthesis was negative in the same range. A linear correlation was found between pressure rate and NO production (R =0.77). Stress states identified in this study are generic and could be used to develop predictive algorithms for matrix production in agarose–chondrocyte constructs of arbitrary shape, size and agarose concentration. They could also be helpful to increase the efficacy of loading protocols for avascular tissue engineering.

Efficacy of hESC-MSCs in knitted silk-collagen scaffold for tendon tissue engineering and their roles

Human embryonic stem cells (hESC) and their differentiated progenies are an attractive cell source for transplantation therapy and tissue engineering. Nevertheless, the utility of these cells for tendon tissue engineering has not yet been adequately explored. This study incorporated hESC-derived mesenchymal stem cells (hESC-MSCs) within a knitted silk-collagen sponge scaffold, and assessed the efficacy of this tissue-engineered construct in promoting tendon regeneration. When subjected to mechanical stimulation in vitro, hESC-MSCs exhibited tenocyte-like morphology and positively expressed tendon-related gene markers (e.g. Collagen type I & III, Epha4 and Scleraxis), as well as other mechano-sensory structures and molecules (cilia, integrins and myosin). In ectopic transplantation, the tissue-engineered tendon under in vivo mechanical stimulus displayed more regularly aligned cells and larger collagen fibers. This in turn resulted in enhanced tendon regeneration in situ, as evidenced by better histological scores and superior mechanical performance characteristics. Furthermore, cell labeling and extracellular matrix expression assays demonstrated that the transplanted hESC-MSCs not only contributed directly to tendon regeneration, but also exerted an environment-modifying effect on the implantation site in situ. Hence, tissue-engineered tendon can be successfully fabricated through seeding of hESC-MSCs within a knitted silk-collagen sponge scaffold followed by mechanical stimulation.

On the biomechanical function of scaffolds for engineering load-bearing soft tissues

Replacement or regeneration of load-bearing soft tissues has long been the impetus for the development of bioactive materials. While maturing, current efforts continue to be confounded by our lack of understanding of the intricate multi-scale hierarchical arrangements and interactions typically found in native tissues. The current state of the art in biomaterial processing enables a degree of controllable microstructure that can be used for the development of model systems to deduce fundamental biological implications of matrix morphologies on cell function. Furthermore, the development of computational frameworks which allow for the simulation of experimentally derived observations represents a positive departure from what has mostly been an empirically driven field, enabling a deeper understanding of the highly complex biological mechanisms we wish to ultimately emulate. Ongoing research is actively pursuing new materials and processing methods to control material structure down to the micro-scale to sustain or improve cell viability, guide tissue growth, and provide mechanical integrity, all while exhibiting the capacity to degrade in a controlled manner. The purpose of this review is not to focus solely on material processing but to assess the ability of these techniques to produce mechanically sound tissue surrogates, highlight the unique structural characteristics produced in these materials, and discuss how this translates to distinct macroscopic biomechanical behaviors.

In vivo low-intensity pulsed ultrasound (LIPUS) following tendon injury promotes repair during granulation but suppresses decorin and biglycan expression during remodeling

STUDY DESIGN

Bench research, cross-sectional.

OBJECTIVE

To determine if the effects of low-intensity pulsed ultrasound (LIPUS) on matrix synthesis change at different stages of tendon healing.

BACKGROUND

LIPUS is effective in promoting tendon healing by stimulation of matrix synthesis. The timing of initiation and duration of LIPUS treatment have been shown to affect its effectiveness to promote tendon healing, suggesting a change of tissue responses to LIPUS stimulation. Understanding how the cellular responses to LIPUS stimulation change during tendon healing is thus important.

METHODS

In a rat model of patellar tendon donor site injury, a single sonication of LIPUS or mock sonication was delivered to the injured knee of the rats on the fourth, 14th or 28th day postinjury. Tendon samples were harvested at 4 hours and 24 hours after sonication and the mRNA expression of COL1A1, COL3A1, decorin, biglycan, and TGF-beta 1 was analyzed.

RESULTS

The results showed that a single sonication of LIPUS increased COL1A1 and COL3A1 mRNA in healing patellar tendons when administered on the fourth or 14th day postinjury, but not when administered on the 28th day postinjury. Both decorin and biglycan mRNA were decreased by treatment with LIPUS on the 28th day postinjury. Our results showed that LIPUS enhanced collagen synthesis in vivo only during the granulation phase. Matrix remodeling may be affected by LIPUS with the suppressed expression of decorin and biglycan.

CONCLUSION

Our findings suggest that LIPUS should be applied during the granulation phase but not during the remodeling phase, to promote tendon healing.

Relative contributions of mechanical degradation, enzymatic degradation, and repair of the extracellular matrix on the response of tendons when subjected to under- and over- mechanical stimulations in vitro

Tendon response to mechanical loading results in either homeostasis, improvement, or degeneration of tissue condition. In an effort to better understand the development of tendinopathies, this study investigated the mechanical and structural responses of tendons subjected to under- and over-stimulations (1.2% and 1.8% strain respectively, 1 Hz). The objective was to examine three sub-processes of tendon response: mechanical degradation, enzymatic degradation, and repair of the extracellular matrix. We subjected rat tail tendons to a 10-day stimulation protocol with four periods of 6 h each day: 30 min of stimulation and 5 h 30 min of rest. To investigate the contribution of the three sub-processes, we controlled the contribution of the cells through variations in the nutrient and protease inhibitor content in the in vitro solutions. Using nondestructive cyclic tests, we evaluated the daily changes in the peak stress. To assess structural changes, we carried out microscopic analyses at the end of the study period. We observed that the relative contributions of the sub-processes differed according to the stimulation amplitude. With over-stimulation of tendons immersed in DMEM, we succeeded in reducing enzymatic degradation and increasing peak stress. In under-stimulation, the addition of protease inhibitors was required to obtain the same result.

Deposition of collagenous matrices by tendon fibroblasts in vitro: a comparison of fibroblast behavior in pellet cultures and a novel three-dimensional long-term scaffoldless culture system

Tendons transmit tensile loads from muscle to bone. They consist primarily of parallel collagen fibers between longitudinally oriented rows of tendon fibroblasts. In this study, we describe a novel scaffoldless dialysis-roller culture system that allows tendon cells to form large, organized, tendon-like structures. We compare cell and collagen orientation and synthesis in these cultures with that of monolayer and high-density pellet cultures. Monolayers are unable to deposit a substantial matrix, losing most of their secreted collagen to the medium. High-density pellet cultures deposit more matrix, lose less to the medium, and become organized at their periphery but show signs of nutritional compromise in the center core. In the novel system, cells formed highly organized structures resembling embryonic tendons, synthesized much more collagen, and incorporated around 70% of the secreted collagen into the tendon-like extracellular matrix. The three-dimensional cultures appear to allow substantial cell-cell interactions and may mimic important aspects of the early development of tendons, including the formation of membrane-bound extracellular spaces to contain and organize the secreted collagen.

Differential regulation of gene expression in isolated tendon fascicles exposed to cyclic tensile strain in vitro

Mechanical stimulus is a regulator of tenocyte metabolism. The present study investigated temporal regulation of the expression of selected genes by tenocytes in isolated fascicles subjected to tensile strain in vitro. Cyclic tensile strain with a 3% amplitude superimposed on a 2% static strain was provided for 10 min, followed by either an unstrained period or continuous cyclic strain until the end of a 24-h incubation period. mRNA expression of selected anabolic and catabolic genes were evaluated with quantitative PCR at 10 min, 1 h, 6 h, and 24 h. The application of 6-h cyclic strain significantly upregulated type III collagen mRNA expression in strained fascicles compared with unstrained controls, but no alterations were observed in mRNA expression of type I collagen and biglycan. Significant downregulation in the expression of the decorin core protein was observed in fascicles subjected to 24-h cyclic strain. MMP3 and MMP13 expression levels were upregulated by the application of 10 min of cyclic strain, followed by a progressive downregulation until the end of the incubation period in both the absence and the presence of the continuing cyclic strain. Accordingly, alterations in the expression of anabolic genes were limited to the upregulation of type III collagen by prolonged exposure to cyclic strain, whereas catabolic genes were upregulated by a small number of strain cycles and downregulated by a prolonged cyclic strain. These findings demonstrate distinctive patterns of mechanoregulation for anabolic and catabolic genes and help our understanding of tenocyte response to mechanical stimulation.

The effect of bioreactor induced vibrational stimulation on extracellular matrix production from human derived fibroblasts

To study the affect of mechanical stimuli on human laryngeal fibroblasts, we developed bioreactors capable of vibrating cell seeded substrates at frequencies and displacements comparable to measured phonation values in human subjects. In addition, we developed a means of harvesting the secreted matrix as a bulk biomaterial by removing the polymer foam using an organic solvent. Using the system human derived laryngeal fibroblasts were subjected to vibrational stimuli (100 Hz) for 1-21 days. Following mechanical conditioning, extracellular matrix and matrix related gene expression, cytokine production, matrix protein accumulation, and construct material properties were assessed with DNA microarray, enzyme linked immunosorbent, indirect immunofluorescent, and uni-axial tensile assays respectively. The results show that vocal fold-like vibrational stimuli is sufficient to influence the expression of several key matrix and matrix related genes, enhance the secretion of the profibrotic cytokine TGFbeta1, increase the accumulation of the extracellular matrix proteins, fibronectin and collagen type 1, as well as enhance construct stiffness compared to non-stimulated controls. Our results demonstrate that high frequency substrate vibration, like cyclic strain, can accelerate matrix deposition from human derived laryngeal fibroblasts. The study supports the notion that preconditioning regimens using human cells may be useful for producing cell derived biomaterials for therapeutic application.

Changes in gene expression of individual matrix metalloproteinases differ in response to mechanical unloading of tendon fascicles in explant culture

Immobilization of the tendon and ligament has been shown to result in a rapid and significant decrease in material properties. It has been proposed that tissue degradation leading to tendon rupture or pain in humans may also be linked to mechanical unloading following focal tendon injury. Hence, understanding the remodeling mechanism associated with mechanical unloading has relevance for the human conditions of immobilization (e.g., casting), delayed repair of tendon ruptures, and potentially overuse injuries as well. This is the first study to investigate the time course of gene expression changes associated with tissue harvest and mechanical unloading culture in an explant model. Rat tail tendon fascicles were harvested and placed in culture unloaded for up to 48 h and then evaluated using qRT-PCR for changes in two anabolic and four catabolic genes at 12 time points. Our data demonstrates that Type I Collagen, Decorin, Cathepsin K, and MMP2 gene expression are relatively insensitive to unloaded culture conditions. However, changes in both MMP3 and MMP13 gene expression are rapid, dramatic, sustained, and changing during at least the first 48 h of unloaded culture. This data will help to further elucidate the mechanism for the loss of mechanical properties associated with mechanical unloading in tendon.

Engineering of extensor tendon complex by an ex vivo approach

Engineering of extensor tendon complex remains an unexplored area in tendon engineering research. In addition, less is known about the mechanism of mechanical loading in human tendon development and maturation. In the current study, an ex vivo approach was developed to investigate these issues. Human fetal extensor tenocytes were isolated, expanded and seeded on polyglycolic acid (PGA) fibers that formed a scaffold with a shape mimicking human extensor tendon complex. After in vitro culture for 6 weeks, 7 cell-scaffold constructs were further in vitro cultured with dynamic mechanical loading for another 6 weeks in a bioreactor. The other 14 constructs were in vivo implanted subcutaneously to nude mice for another 14 weeks. Seven of them were implanted without loading, whereas the other 7 were sutured to mouse fascia and animal movement provided a natural dynamic loading in vivo. The results demonstrated that human fetal cells could form an extensor tendon complex structure in vitro and become further matured in vivo by mechanical stimulation. In contrast to in vitro loaded and in vivo non-loaded tendons, in vivo loaded tendons exhibited bigger tissue volume, better aligned collagen fibers, more mature collagen fibril structure with D-band periodicity, and stronger mechanical properties. These findings indicate that an extensor tendon complex like structure is possible to generate by an ex vivo approach and in vivo mechanical loading might be an optimal niche for engineering functional extensor tendon.

Tendon tissue engineering using scaffold enhancing strategies

Tendon traumas or diseases are prevalent and debilitating lesions that affect the quality of life among populations worldwide. As a novel solution, tendon tissue engineering aims to address these lesions by integrating engineered, living substitutes with their native counterparts in vivo, thereby restoring the defective functions in situ. For such a purpose, competent scaffolding materials are essential. To date, three major categories of scaffolding materials have been employed: polyesters, polysaccharides, and collagen derivatives. Furthermore, with these materials as a base, a variety of specialized methodologies have been developed or adopted to enhance neo-tendogenesis. These strategies include cellular hybridization, interfacing improvement, and physical stimulation.

Effect of altered mechanical load conditions on the structure and function of cultured tendon fascicles

We have developed an in vitro model system to investigate the relationships between mechanical unloading and tendon matrix remodeling. Remodeling was characterized by changes in the functional and structural characteristics of rat tail tendon fascicles (RTTF) subjected to no load conditions for 1 week in vitro. We hypothesized that the absence of load will: (I) maintain cross-sectional area (CSA), with decreased elastic modulus and increased stress-relaxation; (II) cause an increase in denatured collagen and a decrease in water and total glycosaminoglycan (GAG) content. Fascicles cultured under a nominal static stress were used as control for culture conditions effects. Unloading resulted in a decrease of approximately 23% in the elastic modulus of cultured fascicles, consistent with previous stress-deprivation studies. Contrary to our hypothesis, a nominal static stress caused an increase in elastic modulus ( approximately 30%) and a significant decrease in stress-relaxation when compared to fresh fascicles at 1% strain. Mechanical changes were associated with changes in the GAG content of the fascicles, but not their CSA, water, or collagen content. Furthermore, we did not find evidence of measurable denatured collagen in the cultured fascicles. Together these results suggest a role for GAG but not collagen or water in the elastic and viscoelastic changes measured in tendon fascicles cultured for 1 week under altered load conditions.

Tissue engineering approaches to rotator cuff tendon deficiency

Tissue engineering is an emerging scientific approach that may offer alternative pathways for managing tissue degeneration. The use of cellular and acellular matrix in combination with cells and/or growth factors is one approach currently being explored in the management of rotator cuff disease. Interestingly, the integration of gene therapy with this technique introduces a new dimension to treatment options. The scope of this article is to present an overview of the current tissue engineering in vivo methods being clinically investigated in rotator cuff disease.

Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude

Tendons are able to remodel their mechanical and morphological properties in response to mechanical loading. However, there is little information about the effects of controlled modulation in cyclic strain magnitude applied to the tendon on the adaptation of tendon's properties in vivo. The present study investigated whether the magnitude of the mechanical load induced as cyclic strain applied to the Achilles tendon may have a threshold in order to trigger adaptation effects on tendon mechanical and morphological properties. Twenty-one adults (experimental group, N=11; control group, N=10) participated in the study. The participants of the experimental group exercised one leg at low-magnitude tendon strain (2.85+/-0.99%) and the other leg at high-magnitude tendon strain (4.55+/-1.38%) of similar frequency and volume. After 14 weeks of exercise intervention we found a decrease in strain at a given tendon force, an increase in tendon-aponeurosis stiffness and tendon elastic modulus and a region-specific hypertrophy of the Achilles tendon only in the leg exercised at high strain magnitude. These findings provide evidence of the existence of a threshold or set-point at the applied strain magnitude at which the transduction of the mechanical stimulus may influence the tensional homeostasis of the tendons. The results further show that the mechanical load exerted on the Achilles tendon during the low-strain-magnitude exercise is not a sufficient stimulus for triggering further adaptation effects on the Achilles tendon than the stimulus provided by the mechanical load applied during daily activities.

Time dependence of cyclic tensile strain on collagen production in tendon fascicles

Mechanical loading is a regulator of tissue metabolism in tendon, which may lead to alterations in structural and mechanical properties via mechanotransduction processes. The present study investigated specified responses of tenocyte metabolism in isolated tendon fascicles subjected to four loading regimes. Cyclic tensile strain of 3% amplitude superimposed on a 2% static strain was applied to the fascicles for 10min, 1, 6 or 24h of a 24-h incubation period. Collagen synthesis, assessed by [(3)H]-proline incorporation, was upregulated by the 24h straining regime, but was inhibited by the 10-min regime. Cyclic strain enhanced the retention of newly synthesised collagen within the matrix. More than 90% of the newly synthesised collagen was retained in all cases, but the long-term application of cyclic strain had less pronounced effects on the retention. These results indicate that collagen synthesis by tenocytes is controlled by a complex mechanosensitive process with a temporal component.

Tendon and ligament engineering: from cell biology to in vivo application

Tendons and ligaments are related connective tissues that join muscle to bone and bone to bone, respectively. Tendon and ligament injuries are widely distributed clinical problems in society and while healing of such disorders can occur, the original biological properties of the tissue do not return to normal. In this review, recent work on tendon and ligament development and the use of growth factors for successful cellular therapy of tendon and ligament disorders are discussed. In addition, anti-inflammatory concepts for the treatment of tendon and ligament injuries and recent developments in stem cell engineering for tendon and ligament tissues are examined. Lastly, gene transfer strategies for therapeutic applications to heal tendon and ligament disorders are reviewed.

Pathological changes of human ligament after complete mechanical unloading

OBJECTIVE

To investigate the pathologic changes with a time sequence among patients with injured ligaments after complete mechanical unloading, based on a human anterior cruciate ligament (ACL) model.

DESIGN

Pathologic examinations were done on remnants of completely ruptured ACLs at various times up to 14 wks after injury on 31 patients and on normal ACLs from five cadaver donors. Testing variables included fibroblast density, crimp amplitude, and crimp nuclear shape.

RESULTS

Sequential changes were observed: Fibroblast density significantly increased within 5-6 wks of unloading. By 7-8 wks, crimp amplitude significantly decreased, accompanied by formation of irregular fiber patterns and fragments. This was followed by crimp wavelength and nuclear shape change within 9-14 wks.

CONCLUSIONS

These pathologic findings suggest that the ACL undergoes significantly deleterious changes from 5 to 6 wks after mechanical unloading. This study may emphasize the important concept of early implementation of mechanical force in rehabilitation programs for patients with injured ligaments.

Biomechanical response of collagen fascicles to restressing after stress deprivation during culture

In vitro tissue culture experiments were performed to study the biomechanical response of collagen fascicles to restressing after exposure to non-loaded condition. Collagen fascicles of approximately 300 microm in diameter were aseptically dissected from rabbit patellar tendons. They were cultured under no-load condition for 1 week, and then under a static stress of approximately 1.2 MPa for the subsequent 1 or 2 weeks. After culture, their mechanical properties were determined with a micro-tensile tester, and were compared to those of fascicles cultured under no-load condition and non-cultured, control fascicles. Tangent modulus and tensile strength of the non-loaded fascicles were significantly lower than those of the control fascicles at 1 week and gradually decreased thereafter. However, the modulus and strength were increased by restressing. After 2-week restressing, both parameters were significantly greater than those of the time-matched, non-loaded fascicles, although these values were still significantly lower than those of the control fascicles. That is, the application of stress after exposure to non-loaded condition suppressed the deterioration of the biomechanical properties of fascicles, although it did not improve. These results indicate that a short period of stressing is not sufficient for cultured collagen fascicles to completely recover their mechanical properties, if they are once exposed to no-stress condition even for a short period of time. These are similar to previous results observed in tendons and ligaments inside the body.

Early voluntary exercise does not promote healing in a rat model of Achilles tendon injury

Mechanical stress is an important modulator of connective tissue repair. However, the effects on tendon healing are very poorly defined, preventing optimal use of mechanical stress. We hypothesized that early voluntary exercise initially retards tendon repair but results in a faster recovery rate at longer term. Male Wistar rats were injured by a collagenase injection in the Achilles tendon, and exercise was voluntarily performed on a running wheel. We observed the persistent presence of neutrophils in injured tendons of rats that began exercise immediately after the trauma [injured + early exercise (Inj+EEx)]. Early exercise also increased the concentration of ED1(+) macrophages in injured tendons after 3 and 7 days compared with ambulatory injured rats (Inj). Similar results were obtained with the subset of ED2(+) macrophages in the tendon core 3 days after the collagenase injection. Furthermore, collagen content returned to normal values more rapidly in the Inj+EEx tendons than in the Inj group, but this was not associated with an increase in cell proliferation. Surprisingly, Inj+EEx tendons roughly displayed lower stiffness and force at rupture point relative to Inj tendons at day 28. Injured tendons of rats that began exercise only from day 7 had better mechanical properties than those of early-exercised rats 28 days postinjury. We speculate that the persistence of the inflammatory response and undue mechanical loading in the Inj+EEx tendons led to fibrosis and a loss of tendon function.