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The Effect of Age and Intrinsic Aerobic Exercise Capacity on the Expression of Inflammation and Remodeling Markers in Rat Achilles Tendons. Int J Mol Sci 2021; 23:ijms23010079. [PMID: 35008516 PMCID: PMC8744822 DOI: 10.3390/ijms23010079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/19/2022] Open
Abstract
Old age, adiposity, and metabolic disorders are known as risk factors for chronic tendinopathy, which is a common problem in both athletes and the general population. However, the importance of these influencing factors has not yet been well understood. This study investigated alterations in gene expression and histology of Achilles tendons of young (10 weeks) and old (100 weeks) rats bred for low (low capacity runners, LCR) and high (high capacity runners, HCR) intrinsic aerobic exercise capacity. In this rat model, LCR displayed a phenotype of reduced exercise capacity, higher body weight, and metabolic dysfunctions compared to HCR. We hypothesized that the risk factors for tendinopathy in old LCR could lead to more pronounced impairments in Achilles tendon tissue. In quantitative real-time PCR (qPCR), age-related downregulation of tenocyte markers e.g., tenomodulin, genes related to matrix modeling and remodeling (e.g., collagens, elastin, biglycan, fibronectin, tenascin C) as well as transforming growth factor beta 3 (Tgfb3) have been detected. Inflammation marker cyclooxygenase 2 (Cox2) was downregulated in old rats, while microsomal prostaglandin E synthase 2 (Ptges2) was upregulated in old HCR and old LCR. In all groups, interleukin 6 (Il6), interleukin 1 beta (Il1b), and tumor necrosis factor alpha (Tnfa) showed no significant alteration. In histological evaluation, tendons of old rats had fewer and more elongated tenocyte nuclei than young rats. Even though a higher content of glycosaminoglycans, a sign of degeneration, was found in old HCR and LCR, no further signs of tendinopathy were detectable in tendons of old rats by histological evaluation. Low intrinsic aerobic exercise capacity and the associated phenotype did not show significant effects on gene expression and tendon histology. These findings indicate that aging seems to play a prominent role in molecular and structural alterations of Achilles tendon tissue and suggests that other risk factors associated with intrinsic aerobic exercise capacity are less influential in this rat model.
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Yao W, Zhang Y, Zhang L, Zhou J, Zhang Y, Zheng X, Ding J. MRI features of and factors related to ankle injuries in asymptomatic amateur marathon runners. Skeletal Radiol 2021; 50:87-95. [PMID: 32632469 PMCID: PMC7677287 DOI: 10.1007/s00256-020-03530-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To analyze the MRI manifestations of and factors related to ankle injuries in asymptomatic amateur marathon runners. MATERIALS AND METHODS A total of 113 amateur marathon runners without any ankle joint symptoms were recruited. Each participant was asked to complete a questionnaire at the beginning of the study and underwent MRI of the ankle. The MRI manifestations of ankle injuries were summarized, and binary logistic regression analysis was applied to analyze the factors related to ankle injuries. RESULTS The main MRI features were bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. Others included Achilles tendinopathy, cyst-like lesions, osteochondral lesions, and subcutaneous soft tissue edema. The risk factor for bone marrow edema-like signal intensity in amateur marathon runners was a rearfoot strike pattern (p = 0.028, OR = 1.172); the risk factors for peritendinous effusion were a higher weekly running distance (p = 0.013, OR = 1.685) and increased running years (p = 0.039, OR = 1.113), whereas a rearfoot strike pattern (p = 0.005, OR = 0.831) was a protective factor for peritendinous effusion; the risk factor for Achilles tendinopathy was increased age (p = 0.008, OR = 1.412); the risk factors for anterior talofibular ligament injury were a rearfoot strike pattern (p = 0.017, OR = 1.346) and higher weekly running distance (p = 0.022, OR = 1.171); and the factors for calcaneofibular ligament injury were a higher weekly running distance (p = 0.029, OR = 1.570) and rearfoot strike pattern (p = 0.035, OR = 1.463). CONCLUSION The main MRI features of asymptomatic amateur marathon runners are bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. In addition, increased age, increased running years, higher weekly running distance, and different foot strike patterns are risk factors for ankle injuries.
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Affiliation(s)
- Wanzhen Yao
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Yanjing Zhang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Li Zhang
- Department of Radiology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang China
| | - Jing Zhou
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Yi Zhang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Xiaozhong Zheng
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Jianping Ding
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126, Wenzhou Road, Gongshu District, Hangzhou, 310000 Zhejiang China
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Rodas G, Soler R, Balius R, Alomar X, Peirau X, Alberca M, Sánchez A, Sancho JG, Rodellar C, Romero A, Masci L, Orozco L, Maffulli N. Autologous bone marrow expanded mesenchymal stem cells in patellar tendinopathy: protocol for a phase I/II, single-centre, randomized with active control PRP, double-blinded clinical trial. J Orthop Surg Res 2019; 14:441. [PMID: 31842921 PMCID: PMC6916077 DOI: 10.1186/s13018-019-1477-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/14/2019] [Indexed: 02/08/2023] Open
Abstract
Introduction Patellar tendon overuse injuries are common in athletes. Imaging may show a change in tissue structure with tendon thickening and disruption of the intratendinous substance. We wish to test the hypothesis that both autologous bone marrow expanded mesenchymal stem cells and autologous leukocyte-poor platelet-rich plasma (LP-PRP) implanted into the area of the disrupted tendinopathic patellar tendon will restore function, but tendon regeneration tissue will only be observed in the subjects treated with autologous bone marrow expanded mesenchymal stem cells. Methods and analysis This is a single-centre, pilot phase I/II, double-blinded clinical trial with randomisation with active control. Twenty patients with a diagnosis of patellar tendinopathy with imaging changes (tendon thickening and disruption of the intratendinous substance at the proximal portion of the patellar tendon) will be randomised in a 1:1 ratio to receive a local injection of either bone-marrow autologous mesenchymal stem cells (MSC), isolated and cultured under GMP at The Institute of Biology and Molecular Genetics (IBGM) (Spain) or P-PRP. The study will have two aims: first, to ascertain whether a clinically relevant improvement after 3, 6 and 12 months according to the visual analogue scale (VAS), Victorian Institute of Sport Assessment for patellar tendons (VISA-P) and dynamometry scales (DYN) will be achieved; and second, to ascertain whether the proposed intervention will restore tendon structure as determined by ultrasonography (US), Doppler ultrasonography (DUS), and innovative MRI and ultrasound techniques: Magnetic Resonance T2 FAT SAT (UTE, Ultrashort Echo TE) sequence and Ultrasound Tissue Characterization (UTC). Patients who are randomised to the P-PRP treatment group but do not achieve a satisfactory primary endpoint after 6 months will be offered treatment with MSC. Trial registration NCT03454737.
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Affiliation(s)
- Gil Rodas
- Medical Department, Football Club Barcelona, C/Aristides Maillol, s/n 08028, Barcelona, Spain.,Medicine and Exercise Sport Unit, Hospital Clínic and Sand Joan de Deu, Barcelona University, C/Villarroel 170, 08036, Barcelona, Spain
| | - Robert Soler
- ITRT Institut Terapia Regenerativa Tissular Centro Médico Teknon, C/Vilana 12. 08022, Barcelona, Spain
| | - Ramón Balius
- Consell Català del'Esport, Unitat d'Esporti Salut Av Països Catalans, 40-48, 08950, Esplugues, Spain
| | - Xavier Alomar
- Diagnóstico por la Imagen, Clínica Creu Blanca, Passeig de la Reina Elisenda de Montcada, 17, 08034, Barcelona, Spain
| | - Xavier Peirau
- ITRT Institut Terapia Regenerativa Tissular Centro Médico Teknon, C/Vilana 12. 08022, Barcelona, Spain.,Institut Nacional d'Educació Física de Catalunya (INEFC), Partida Caparrella s/n, 25192, Lleida, Lleida, Spain
| | - Mercedes Alberca
- Instituto de Biología y Genética Molecular (IBGM), Universidad Valladolid y CSIC Edificio IBGM, C/ Sanz y Forés, s/n, 47003, Valladolid, Spain.,Red TerCel de Terapia Celular, Instituto de Salud Carlos III, Hospital Clínico Universitario Virgen de la Arrixaca. Servicio de Hematología. Edf. General, Ctra. Madrid-Cartagena s/n, 30120, Murcia, Spain
| | - Ana Sánchez
- Instituto de Biología y Genética Molecular (IBGM), Universidad Valladolid y CSIC Edificio IBGM, C/ Sanz y Forés, s/n, 47003, Valladolid, Spain.,Red TerCel de Terapia Celular, Instituto de Salud Carlos III, Hospital Clínico Universitario Virgen de la Arrixaca. Servicio de Hematología. Edf. General, Ctra. Madrid-Cartagena s/n, 30120, Murcia, Spain
| | - Javier García Sancho
- Instituto de Biología y Genética Molecular (IBGM), Universidad Valladolid y CSIC Edificio IBGM, C/ Sanz y Forés, s/n, 47003, Valladolid, Spain.,Red TerCel de Terapia Celular, Instituto de Salud Carlos III, Hospital Clínico Universitario Virgen de la Arrixaca. Servicio de Hematología. Edf. General, Ctra. Madrid-Cartagena s/n, 30120, Murcia, Spain
| | - Clementina Rodellar
- LAGENBIO, Facultad de Veterinaria, Lab. Genética Bioquímica. Facultad de Veterinaria, Universidad de Zaragoza, C/Miguel Servet 177, 50013, Zaragoza, Spain
| | - Antonio Romero
- LAGENBIO, Facultad de Veterinaria, Lab. Genética Bioquímica. Facultad de Veterinaria, Universidad de Zaragoza, C/Miguel Servet 177, 50013, Zaragoza, Spain
| | | | - Lluís Orozco
- ITRT Institut Terapia Regenerativa Tissular Centro Médico Teknon, C/Vilana 12. 08022, Barcelona, Spain
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine, Surgery and Dentistry, Salerno, Italy. .,Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK. .,School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, UK.
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