1
|
Ma RX, Li RF, Deng XQ, Qiao RQ, Li JK, Song KX, Ji SL, Hu YC. Repair of tendons treated with peracetic acid-ethanol and gamma irradiation by EDC combined with NHS: a morphological, biochemical and biomechanical study in vitro. Cell Tissue Bank 2024; 25:427-442. [PMID: 36797536 DOI: 10.1007/s10561-023-10080-6] [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: 11/23/2022] [Accepted: 02/04/2023] [Indexed: 02/18/2023]
Abstract
The purpose of this study was to investigate whether 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) combined with n-hydroxysuccinimide (NHS) can repair tendon damage caused by peracetic acid-ethanol and gamma irradiation sterilization. The semitendinosus tendons of 15 New Zealand white rabbits were selected as experimental materials, and the tendons were sterilized in a solution containing 1% (v/w) peracetic acid and 24% (v/w) ethanol. After 15 kGy gamma irradiation sterilization, the tendons were randomly divided into three groups (n = 10). The tendons were repaired with EDCs of 0, 2.5 and 5 mM combined with 5 mM NHS for 6 h, the tendons were temporarily stored at - 80 ± °C. The arrangement and spatial structure of collagen fibers were observed by light microscopy and scanning electron microscopy, the collagen type and collagen crimp period were observed under a polarizing microscope, and the collagen fibril diameter and its distribution were measured by transmission electron microscopy, from which the collagen fibril index and mass average diameter were calculated. The resistance of collagen to enzymolysis was detected by the free hydroxyproline test, and tensile fracture and cyclic loading tests of each group of tendons were carried out, from which the elastic modulus, maximum stress, maximum strain, strain energy density and cyclic creep strain were calculated. The obtained results showed that the gap between loose collagen fibers in the 0 mM control group was wider, the parallel arrangement of tendons in the 2.5 and 5 mM groups was more uniform and regular and the fiber space decreased, the crimp period in the 5 mM group was lower than that in the 0 mM group (P < 0.05), and the concentration of hydroxyproline in the 5 mM group (711.64 ± 77.95 μg/g) was better than that in the control group (1150.57 ± 158.75 μg/g). The elastic modulus of the 5 mM group (424.73 ± 150.96 MPa) was better than that of the 0 mM group (179.09 ± 37.14 MPa). Our results show that EDC combined with NHS can repair damaged tendons after peracetic acid-ethanol and gamma radiation treatment, and 5 mM EDC has better morphological performance, anti-enzymolysis ability and biomechanical properties than 2.5 mM EDC.
Collapse
Affiliation(s)
- Rong-Xing Ma
- Department of Bone and Soft Tissue Oncology, Tianjin Hospital, 406 Jiefang Southern Road, Tianjin, 300211, China
- Graduate School, Tianjin Medical University, Tianjin, China
| | - Rui-Feng Li
- Graduate School, Tianjin Medical University, Tianjin, China
| | | | - Rui-Qi Qiao
- Graduate School, Tianjin Medical University, Tianjin, China
| | - Ji-Kai Li
- Graduate School, Tianjin Medical University, Tianjin, China
| | - Kun-Xiu Song
- Department of Hand and Microsurgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| | - Shao-Lin Ji
- Shandong Provincial Third Hospital, Shandong University, Jinan, Shandong Province, China
| | - Yong-Cheng Hu
- Department of Bone and Soft Tissue Oncology, Tianjin Hospital, 406 Jiefang Southern Road, Tianjin, 300211, China.
| |
Collapse
|
2
|
Ditton DM, Marchus CR, Bozeman AL, Martes AC, Brumley MR, Schiele NR. Visualization of rat tendon in three dimensions using micro-Computed Tomography. MethodsX 2024; 12:102565. [PMID: 38292310 PMCID: PMC10825692 DOI: 10.1016/j.mex.2024.102565] [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] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
Micro-computed tomography (CT) is an X-ray-based imaging modality that produces three-dimensional (3D), high-resolution images of whole-mount tissues, but is typically limited to dense tissues, such as bone. The X-rays readily pass-through tendons, rendering them transparent. Contrast-enhancing chemical stains have been explored, but their use to improve contrast in different tendon types and across developmental stages for micro-CT imaging has not been systematically evaluated. Therefore, we investigated how phosphotungstic acid (PTA) staining and tissue hydration impacts tendon contrast for micro-CT imaging. We showed that PTA staining increased X-ray absorption of tendon to enhance tissue contrast and obtain 3D micro-CT images of immature (postnatal day 21) and sexually mature (postnatal day 50) rat tendons within the tail and hindlimb. Further, we demonstrated that tissue hydration state following PTA staining significantly impacts soft tissue contrast. Using this method, we also found that tail tendon fascicles appear to cross between fascicle bundles. Ultimately, contrast-enhanced 3D micro-CT imaging will lead to better understanding of tendon structure, and relationships between the bone and soft tissues.•Simple tissue fixation and staining technique enhances soft tissue contrast for tendon visualization using micro-CT.•3D tendon visualization in situ advances understanding of musculoskeletal tissue structure and organization.
Collapse
Affiliation(s)
- Destinee M. Ditton
- Chemical & Biological Engineering, University of Idaho, 875 Perimeter Dr. MS 0904, Moscow, ID 83844, USA
| | - Colin R. Marchus
- Chemical & Biological Engineering, University of Idaho, 875 Perimeter Dr. MS 0904, Moscow, ID 83844, USA
| | - Aimee L. Bozeman
- Psychology, Idaho State University, 921 S 8th Avenue Stop 8087, Pocatello, ID 83209, USA
| | - Alleyna C. Martes
- Psychology, Idaho State University, 921 S 8th Avenue Stop 8087, Pocatello, ID 83209, USA
| | - Michele R. Brumley
- Psychology, Idaho State University, 921 S 8th Avenue Stop 8087, Pocatello, ID 83209, USA
| | - Nathan R. Schiele
- Chemical & Biological Engineering, University of Idaho, 875 Perimeter Dr. MS 0904, Moscow, ID 83844, USA
| |
Collapse
|
3
|
Konar S, Leung S, Tay ML, Coleman B, Dalbeth N, Cornish J, Naot D, Musson DS. Novel In Vitro Platform for Studying the Cell Response to Healthy and Diseased Tendon Matrices. ACS Biomater Sci Eng 2024; 10:3293-3305. [PMID: 38666422 DOI: 10.1021/acsbiomaterials.4c00414] [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] [Indexed: 05/14/2024]
Abstract
Current in vitro models poorly represent the healthy or diseased tendon microenvironment, limiting the translation of the findings to clinics. The present work aims to establish a physiologically relevant in vitro tendon platform that mimics biophysical aspects of a healthy and tendinopathic tendon matrix using a decellularized bovine tendon and to characterize tendon cells cultured using this platform. Bovine tendons were subjected to various decellularization techniques, with the efficacy of decellularization determined histologically. The biomechanical and architectural properties of the decellularized tendons were characterized using an atomic force microscope. Tendinopathy-mimicking matrices were prepared by treating the decellularized tendons with collagenase for 3 h or collagenase-chondroitinase (CC) for 1 h. The tendon tissue collected from healthy and tendinopathic patients was characterized using an atomic force microscope and compared to that of decellularized matrices. Healthy human tendon-derived cells (hTDCs) from the hamstring tendon were cultured on the decellularized matrices for 24 or 48 h, with cell morphology characterized using f-actin staining and gene expression characterized using real-time PCR. Tendon matrices prepared by freeze-thawing and 48 h nuclease treatment were fully decellularized, and the aligned structure and tendon stiffness (1.46 MPa) were maintained. Collagenase treatment prepared matrices with a disorganized architecture and reduced stiffness (0.75 MPa), mimicking chronic tendinopathy. Treatment with CC prepared matrices with a disorganized architecture without altering stiffness, mimicking early tendinopathy (1.52 MPa). hTDCs on a healthy tendon matrix were elongated, and the scleraxis (SCX) expression was maintained. On tendinopathic matrices, hTDCs had altered morphological characteristics and lower SCX expression. The expression of genes related to actin polymerization, matrix degradation and remodeling, and immune cell invasion were higher in hTDCs on tendinopathic matrices. Overall, the present study developed a physiological in vitro system to mimic healthy tendons and early and late tendinopathy, and it can be used to better understand tendon cell characteristics in healthy and diseased states.
Collapse
Affiliation(s)
- Subhajit Konar
- Department of Nutrition and Dietetics, University of Auckland, Auckland 1142, New Zealand
| | - Sophia Leung
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland 1142, New Zealand
| | - Mei Lin Tay
- Department of Surgery, University of Auckland, Auckland 1142, New Zealand
| | - Brendan Coleman
- Department of Orthopaedics, Middlemore Hospital, Auckland 1640, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland 1142, New Zealand
| | - Jillian Cornish
- Department of Medicine, University of Auckland, Auckland 1142, New Zealand
| | - Dorit Naot
- Department of Nutrition and Dietetics, University of Auckland, Auckland 1142, New Zealand
| | - David S Musson
- Department of Nutrition and Dietetics, University of Auckland, Auckland 1142, New Zealand
| |
Collapse
|
4
|
Kasula V, Padala V, Gupta N, Doyle D, Bagheri K, Anastasio A, Adams SB. The Use of Extracellular Vesicles in Achilles Tendon Repair: A Systematic Review. Biomedicines 2024; 12:942. [PMID: 38790904 PMCID: PMC11117955 DOI: 10.3390/biomedicines12050942] [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: 03/20/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/26/2024] Open
Abstract
Achilles tendon (AT) pathologies are common musculoskeletal conditions that can significantly impair function. Despite various traditional treatments, recovery is often slow and may not restore full functionality. The use of extracellular vesicles (EVs) has emerged as a promising therapeutic option due to their role in cell signaling and tissue regeneration. This systematic review aims to consolidate current in vivo animal study findings on the therapeutic effects of EVs on AT injuries. An extensive literature search was conducted using the PubMed, Scopus, and Embase databases for in vivo animal studies examining the effects of EVs on AT pathologies. The extracted variables included but were not limited to the study design, type of EVs used, administration methods, efficacy of treatment, and proposed therapeutic mechanisms. After screening, 18 studies comprising 800 subjects were included. All but one study reported that EVs augmented wound healing processes in the AT. The most proposed mechanisms through which this occurred were gene regulation of the extracellular matrix (ECM), the enhancement of macrophage polarization, and the delivery of therapeutic microRNAs to the injury site. Further research is warranted to not only explore the therapeutic potential of EVs in the context of AT pathologies, but also to establish protocols for their clinical application.
Collapse
Affiliation(s)
- Varun Kasula
- Department of Orthopedic Surgery, Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA
| | - Vikram Padala
- Department of Orthopedic Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Nithin Gupta
- Department of Orthopedic Surgery, Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA
| | - David Doyle
- Department of Orthopedic Surgery, Central Michigan University College of Medicine, Saginaw, MI 48602, USA
| | - Kian Bagheri
- Department of Orthopedic Surgery, Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA
| | - Albert Anastasio
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Samuel Bruce Adams
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| |
Collapse
|
5
|
Squier K, Mousavizadeh R, Damji F, Beck C, Hunt M, Scott A. In vitro collagen biomarkers in mechanically stimulated human tendon cells: a systematic review. Connect Tissue Res 2024; 65:89-101. [PMID: 38375562 DOI: 10.1080/03008207.2024.2313582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/25/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE The aim of this study was to comprehensively examine and summarize the available in vitro evidence regarding the relationship between mechanical stimulation and biomarkers of collagen synthesis in human-derived tendon cells. METHODS Systematic review with narrative analyses and risk of bias assessment guided by the Health Assessment and Translation tool. The electronic databases MEDLINE (Ovid), EMBASE (Ovid), CENTRAL (Ovid) and COMPENDEX (Engineering Village) were systematically searched from inception to 3 August 2023. Inclusion criteria encompassed English language, original experimental, or quasi-experimental in vitro publications that subjected human tendon cells to mechanical stimulation, with collagen synthesis (total collagen, type I, III, V, XI, XII, and XIV) and related biomarkers (matrix metalloproteinases, transforming growth factor β, scleraxis, basic fibroblast growth factor) as outcomes. RESULTS Twenty-one publications were included. A pervasive definite high risk of bias was evident in all included studies. Owing to incomplete outcome reporting and heterogeneity in mechanical stimulation protocols, planned meta-analyses were unfeasible. Reviewed data suggested that human tendon cells respond to mechanical stimulation with increased synthesis of collagen (e.g., COL1A1, procollagen, total soluble collagen, etc.), scleraxis and several matrix metalloproteinases. Results also indicate that mechanical stimulation dose magnitude may influence synthesis in several biomarkers. CONCLUSIONS A limited number of studies, unfortunately characterized by a definite high risk of bias, suggest that in vitro mechanical stimulation primarily increases type I collagen synthesis by human tendon cells. Findings from this systematic review provide researchers and clinicians with biological evidence concerning the possible beneficial influence of exercise and loading on cellular-level tendon adaptation.
Collapse
Affiliation(s)
- Kipling Squier
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at VCH, Vancouver Coastal Health Research Institute, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Rouhollah Mousavizadeh
- Centre for Aging SMART at VCH, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Faraz Damji
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Charlotte Beck
- Woodward Library, University of British Columbia, Vancouver, Canada
| | - Michael Hunt
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at VCH, Vancouver Coastal Health Research Institute, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Alexander Scott
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at VCH, Vancouver Coastal Health Research Institute, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
6
|
Zamboulis DE, Marr N, Lenzi L, Birch HL, Screen HRC, Clegg PD, Thorpe CT. The Interfascicular Matrix of Energy Storing Tendons Houses Heterogenous Cell Populations Disproportionately Affected by Aging. Aging Dis 2024; 15:295-310. [PMID: 37307816 PMCID: PMC10796100 DOI: 10.14336/ad.2023.0425-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/25/2023] [Indexed: 06/14/2023] Open
Abstract
Energy storing tendons such as the human Achilles and equine superficial digital flexor tendon (SDFT) are prone to injury, with incidence increasing with aging, peaking in the 5th decade of life in the human Achilles tendon. The interfascicular matrix (IFM), which binds tendon fascicles, plays a key role in energy storing tendon mechanics, and aging alterations to the IFM negatively impact tendon function. While the mechanical role of the IFM in tendon function is well-established, the biological role of IFM-resident cell populations remains to be elucidated. Therefore, the aim of this study was to identify IFM-resident cell populations and establish how these populations are affected by aging. Cells from young and old SDFTs were subjected to single cell RNA-sequencing, and immunolabelling for markers of each resulting population used to localise cell clusters. Eleven cell clusters were identified, including tenocytes, endothelial cells, mural cells, and immune cells. One tenocyte cluster localised to the fascicular matrix, whereas nine clusters localised to the IFM. Interfascicular tenocytes and mural cells were preferentially affected by aging, with differential expression of genes related to senescence, dysregulated proteostasis and inflammation. This is the first study to establish heterogeneity in IFM cell populations, and to identify age-related alterations specific to IFM-localised cells.
Collapse
Affiliation(s)
- Danae E. Zamboulis
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, NW1 0TU, UK.
| | - Neil Marr
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, NW1 0TU, UK.
| | - Luca Lenzi
- Centre for Genomic Research, University of Liverpool, Liverpool, L69 7ZB, UK.
| | - Helen L. Birch
- Department of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK.
| | - Hazel R. C. Screen
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, E1 4NS, UK.
| | - Peter D. Clegg
- Department of Musculoskeletal and AgingScience, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK.
| | - Chavaunne T. Thorpe
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, NW1 0TU, UK.
| |
Collapse
|
7
|
Steffen D, Mienaltowski M, Baar K. Spatial gene expression in the adult rat patellar tendon. Matrix Biol Plus 2023; 19-20:100138. [PMID: 38124714 PMCID: PMC10731370 DOI: 10.1016/j.mbplus.2023.100138] [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] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Tendons are dense connective tissues with relatively few cells which makes studying the molecular profile of the tissue challenging. There is not a consensus on the spatial location of various cell types within a tendon, nor the accompanying transcriptional profile. In the present study, we used two male rat patellar tendon samples for sequencing-based spatial transcriptomics to determine the gene expression profile. We integrated our data with a mouse Achilles single cell dataset to predict the cell type composition of the patellar tendon as a function of location within the tissue. The spatial location of the predicated cell types suggested that there were two populations of tendon fibroblasts, one located in the tendon midsubstance, while the other localized with red blood cells, pericytes, and immune cells to the tendon peripheral connective tissue. Of the highest expressed spatially variable genes, there were multiple genes with known function in tendon: Col1a1, Col1a2, Dcn, Fmod, Sparc, and Comp. Further, a novel spatially regulated gene (AABR07000398.1) with no known function was identified. The spatial gene expression of tendon associated genes (Scx, Thbs4, Tnmd, Can, Bgn, Lum, Adamts2, Lox, Ppib, Col2a1, Col3a1, Col6a2) was also visualized. Both patellar tendon samples had similar expression patterns for all these genes. This dataset provides new spatial insights into gene expression in a healthy tendon.
Collapse
Affiliation(s)
- Danielle Steffen
- Department of Neurobiology, Physiology & Behavior, University of California Davis, Davis, CA, United States
| | - Michael Mienaltowski
- Department of Animal Science, University of California Davis, Davis, CA, United States
| | - Keith Baar
- Department of Neurobiology, Physiology & Behavior, University of California Davis, Davis, CA, United States
- Physiology and Membrane Biology, University of California Davis, Davis, CA, United States
- VA Northern California Health Care System, Mather, CA 95655, United States
| |
Collapse
|
8
|
Little D, Amadio PC, Awad HA, Cone SG, Dyment NA, Fisher MB, Huang AH, Koch DW, Kuntz AF, Madi R, McGilvray K, Schnabel LV, Shetye SS, Thomopoulos S, Zhao C, Soslowsky LJ. Preclinical tendon and ligament models: Beyond the 3Rs (replacement, reduction, and refinement) to 5W1H (why, who, what, where, when, how). J Orthop Res 2023; 41:2133-2162. [PMID: 37573480 PMCID: PMC10561191 DOI: 10.1002/jor.25678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 08/14/2023]
Abstract
Several tendon and ligament animal models were presented at the 2022 Orthopaedic Research Society Tendon Section Conference held at the University of Pennsylvania, May 5 to 7, 2022. A key objective of the breakout sessions at this meeting was to develop guidelines for the field, including for preclinical tendon and ligament animal models. This review summarizes the perspectives of experts for eight surgical small and large animal models of rotator cuff tear, flexor tendon transection, anterior cruciate ligament tear, and Achilles tendon injury using the framework: "Why, Who, What, Where, When, and How" (5W1H). A notable conclusion is that the perfect tendon model does not exist; there is no single gold standard animal model that represents the totality of tendon and ligament disease. Each model has advantages and disadvantages and should be carefully considered in light of the specific research question. There are also circumstances when an animal model is not the best approach. The wide variety of tendon and ligament pathologies necessitates choices between small and large animal models, different anatomic sites, and a range of factors associated with each model during the planning phase. Attendees agreed on some guiding principles including: providing clear justification for the model selected, providing animal model details at publication, encouraging sharing of protocols and expertise, improving training of research personnel, and considering greater collaboration with veterinarians. A clear path for translating from animal models to clinical practice was also considered as a critical next step for accelerating progress in the tendon and ligament field.
Collapse
Affiliation(s)
- Dianne Little
- Department of Basic Medical Sciences, The Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Peter C Amadio
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Hani A Awad
- Department of Orthopaedics, Department of Biomedical Engineering, The Center for Musculoskeletal Research, University of Rochester, Rochester, New York, USA
| | - Stephanie G Cone
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
| | - Nathaniel A Dyment
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Matthew B Fisher
- Joint Department of Biomedical Engineering, College of Engineering, North Carolina State University-University of North Carolina at Chapel Hill, Raleigh, North Carolina, USA
| | - Alice H Huang
- Department of Orthopedic Surgery, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Drew W Koch
- Department of Clinical Sciences, College of Veterinary Medicine, and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Andrew F Kuntz
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rashad Madi
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kirk McGilvray
- Department of Mechanical Engineering, School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Lauren V Schnabel
- Department of Clinical Sciences, College of Veterinary Medicine, and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
| | - Snehal S Shetye
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stavros Thomopoulos
- Department of Orthopedic Surgery, Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Chunfeng Zhao
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Louis J Soslowsky
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
9
|
Bloom ET, Lin LM, Locke RC, Giordani A, Krassan E, Peloquin JM, Silbernagel KG, Parreno J, Santare MH, Killian ML, Elliott DM. Overload in a Rat In Vivo Model of Synergist Ablation Induces Tendon Multiscale Structural and Functional Degeneration. J Biomech Eng 2023; 145:081003. [PMID: 37184932 PMCID: PMC10782872 DOI: 10.1115/1.4062523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/16/2023]
Abstract
Tendon degeneration is typically described as an overuse injury with little distinction made between magnitude of load (overload) and number of cycles (overuse). Further, in vivo, animal models of tendon degeneration are mostly overuse models, where tendon damage is caused by a high number of load cycles. As a result, there is a lack of knowledge of how isolated overload leads to degeneration in tendons. A surgical model of synergist ablation (SynAb) overloads the target tendon, plantaris, by ablating its synergist tendon, Achilles. The objective of this study was to evaluate the structural and functional changes that occur following overload of plantaris tendon in a rat SynAb model. Tendon cross-sectional area (CSA) and shape changes were evaluated by longitudinal MR imaging up to 8 weeks postsurgery. Tissue-scale structural changes were evaluated by semiquantified histology and second harmonic generation microscopy. Fibril level changes were evaluated with serial block face scanning electron microscopy (SBF-SEM). Functional changes were evaluated using tension tests at the tissue and microscale using a custom testing system allowing both video and microscopy imaging. At 8 weeks, overloaded plantaris tendons exhibited degenerative changes including increases in CSA, cell density, collagen damage area fraction (DAF), and fibril diameter, and decreases in collagen alignment, modulus, and yield stress. To interpret the differences between overload and overuse in tendon, we introduce a new framework for tendon remodeling and degeneration that differentiates between the inputs of overload and overuse. In summary, isolated overload induces multiscale degenerative structural and functional changes in plantaris tendon.
Collapse
Affiliation(s)
- Ellen T Bloom
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716
| | - Lily M Lin
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716
| | - Ryan C Locke
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA 19104; Translational Musculoskeletal Research Center, CMCVAMC, Philadelphia, PA 19104
| | - Alyssa Giordani
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716
| | - Erin Krassan
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716
| | - John M Peloquin
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716
| | | | - Justin Parreno
- Department of Biological Sciences, University of Delaware, Newark, DE 19716
| | - Michael H Santare
- Department of Mechanical Engineering, University of Delaware, Newark, DE 19716
| | - Megan L Killian
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI 48104
| | - Dawn M Elliott
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716
| |
Collapse
|
10
|
Park E, Lee YJ, Kim C, Eom TJ. Azimuth mapping of fibrous tissue in linear dichroism-sensitive photoacoustic microscopy. PHOTOACOUSTICS 2023; 31:100510. [PMID: 37228578 PMCID: PMC10203768 DOI: 10.1016/j.pacs.2023.100510] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023]
Abstract
Photoacoustic imaging (PAI) has emerged as a molecular-selective imaging technology based on optical absorption contrast. Dichroism-sensitive photoacoustic (DS-PA) imaging has been reported, where the absorption coefficient has a vector characteristic, featuring dimensions of contrast in polarization and wavelength. Herein, we present a DS-PA microscopy (DS-PAM) system that implements optical anisotropy contrast and molecular selectivity. Moreover, we propose mathematical solutions to fully derive dichroic properties. A wavelength for the PAI of collagenous tissue was used, and the proposed algorithms were validated using linear dichroic materials. We successfully mapped dichroic information in fibrous tissue imaging based on the degree of anisotropy and axis orientation, and also deduced mechanical assessment from the tissue arrangement. The proposed DS-PAM system and algorithms have great potential in various diagnostic fields using polarimetry, such as musculoskeletal and cardiovascular systems.
Collapse
Affiliation(s)
- Eunwoo Park
- Department of Convergence IT Engineering, Electrical Engineering, Mechanical Engineering, Medical Science and Engineering, Graduate School of Artificial Intelligence, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Gyeongbuk 37673, the Republic of Korea
| | - Yong-Jae Lee
- Engineering Research Center for Color-Modulated Extra-Sensory Perception Technology, Pusan National University, Busan 46241, the Republic of Korea
| | - Chulhong Kim
- Department of Convergence IT Engineering, Electrical Engineering, Mechanical Engineering, Medical Science and Engineering, Graduate School of Artificial Intelligence, and Medical Device Innovation Center, Pohang University of Science and Technology (POSTECH), Pohang, Gyeongbuk 37673, the Republic of Korea
| | - Tae Joong Eom
- Engineering Research Center for Color-Modulated Extra-Sensory Perception Technology, Pusan National University, Busan 46241, the Republic of Korea
- Department of Congo-Mechatronics Engineering, Pusan National University, Busan 46241, Republic of Korea
| |
Collapse
|
11
|
Pedaprolu K, Szczesny SE. Mouse Achilles tendons exhibit collagen disorganization but minimal collagen denaturation during cyclic loading to failure. J Biomech 2023; 151:111545. [PMID: 36944295 PMCID: PMC10069227 DOI: 10.1016/j.jbiomech.2023.111545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 02/21/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
While overuse is a prominent risk factor for tendinopathy, the fatigue-induced structural damage responsible for initiating tendon degeneration remains unclear. Denaturation of collagen molecules and collagen fiber disorganization have been observed within certain tendons in response to fatigue loading. However, no studies have investigated whether these forms of tissue damage occur in Achilles tendons, which commonly exhibit tendinopathy. Therefore, the objective of this study was to determine whether mouse Achilles tendons undergo collagen denaturation and collagen fiber disorganization when cyclically loaded to failure. Consistent with previous testing of other energy-storing tendons, we found that cyclic loading of mouse Achilles tendons produced collagen disorganization but minimal collagen denaturation. To determine whether the lack of collagen denaturation is unique to mouse Achilles tendons, we monotonically loaded the Achilles and other mouse tendons to failure. We found that the patellar tendon was also resistant to collagen denaturation, but the flexor digitorum longus (FDL) tendon and tail tendon fascicles were not. Furthermore, the Achilles and patellar tendons had a lower tensile strength and modulus. While this may be due to differences in tissue structure, it is likely that the lack of collagen denaturation during monotonic loading in both the Achilles and patellar tendons was due to failure near their bony insertions, which were absent in the FDL and tail tendons. These findings suggest that mouse Achilles tendons are resistant to collagen denaturation in situ and that Achilles tendon degeneration may not be initiated by mechanically-induced damage to collagen molecules.
Collapse
Affiliation(s)
- Krishna Pedaprolu
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, United States
| | - Spencer E Szczesny
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, United States; Department of Orthopaedics and Rehabilitation, Pennsylvania State University, Hershey, PA, United States.
| |
Collapse
|
12
|
Waugh CM, Mousavizadeh R, Lee J, Screen HRC, Scott A. The impact of mild hypercholesterolemia on injury repair in the rat patellar tendon. J Orthop Res 2023. [PMID: 36866829 DOI: 10.1002/jor.25546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/16/2023] [Accepted: 03/01/2023] [Indexed: 03/04/2023]
Abstract
Hypercholesterolemia is associated with tendon pathology and injury prevalence. Lipids can accumulate in the tendon's extracellular spaces, which may disrupt its hierarchical structure and the tenocytes physicochemical environment. We hypothesized that the tendon's ability to repair after injury would be attenuated with elevated cholesterol levels, leading to inferior mechanical properties. Fifty wild-type (sSD) and 50 apolipoprotein E knock-out rats (ApoE-/ - ) were given a unilateral patellar tendon (PT) injury at 12 weeks old; the uninjured limb served as a control. Animals were euthanized at 3-, 14,- or 42-days postinjury and PT healing was investigated. ApoE-/ - serum cholesterol was double that of SD rats (mean: 2.12 vs. 0.99 mg/mL, p < 0.001) and cholesterol level was related to the expression of several genes after injury; notably rats with higher cholesterol demonstrated a blunted inflammatory response. There was little physical evidence of tendon lipid content or differences in injury repair between groups, therefore we were not surprised that tendon mechanical or material properties did not differ between strains. The young age and the mild phenotype of our ApoE-/ - rats might explain these findings. Hydroxyproline content was positively related to total blood cholesterol, but this result did not translate to observable biomechanical differences, perhaps due to the narrow range of cholesterol levels observed. Tendon inflammatory and healing activity is modulated at the mRNA level even with a mild hypercholesterolemia. These important initial impacts need to be investigated as they may contribute to the known consequences of cholesterol on tendons in humans.
Collapse
Affiliation(s)
- Charlie M Waugh
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,School of Engineering and Materials Science, Queen Mary, University of London, London, UK
| | - Rouhollah Mousavizadeh
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jenny Lee
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Hazel R C Screen
- School of Engineering and Materials Science, Queen Mary, University of London, London, UK
| | - Alexander Scott
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
13
|
Inguito KL, Schofield MM, Faghri AD, Bloom ET, Heino M, West VC, Ebron KMM, Elliott DM, Parreno J. Stress deprivation of tendon explants or Tpm3.1 inhibition in tendon cells reduces F-actin to promote a tendinosis-like phenotype. Mol Biol Cell 2022; 33:ar141. [PMID: 36129771 PMCID: PMC9727789 DOI: 10.1091/mbc.e22-02-0067] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Actin is a central mediator between mechanical force and cellular phenotype. In tendons, it is speculated that mechanical stress deprivation regulates gene expression by reducing filamentous (F)-actin. However, the mechanisms regulating tenocyte F-actin remain unclear. Tropomyosins (Tpms) are master regulators of F-actin. There are more than 40 Tpm isoforms, each having the unique capability to stabilize F-actin subpopulations. We investigated F-actin polymerization in stress-deprived tendons and tested the hypothesis that stress fiber-associated Tpm(s) stabilize F-actin to regulate cellular phenotype. Stress deprivation of mouse tail tendon down-regulated tenogenic and up-regulated protease (matrix metalloproteinase-3) mRNA levels. Concomitant with mRNA modulation were increases in G/F-actin, confirming reduced F-actin by tendon stress deprivation. To investigate the molecular regulation of F-actin, we identified that tail, Achilles, and plantaris tendons express three isoforms in common: Tpm1.6, 3.1, and 4.2. Tpm3.1 associates with F-actin in native and primary tenocytes. Tpm3.1 inhibition reduces F-actin, leading to decreases in tenogenic expression, increases in chondrogenic expression, and enhancement of protease expression in mouse and human tenocytes. These expression changes by Tpm3.1 inhibition are consistent with tendinosis progression. A further understanding of F-actin regulation in musculoskeletal cells could lead to new therapeutic interventions to prevent alterations in cellular phenotype during disease progression.
Collapse
Affiliation(s)
- Kameron L. Inguito
- Departments of Biological Sciences, University of Delaware, Newark, DE 19716
| | - Mandy M. Schofield
- Departments of Biological Sciences, University of Delaware, Newark, DE 19716
| | - Arya D. Faghri
- Departments of Biological Sciences, University of Delaware, Newark, DE 19716
| | - Ellen T. Bloom
- Biomedical Engineering, University of Delaware, Newark, DE 19716
| | - Marissa Heino
- Departments of Biological Sciences, University of Delaware, Newark, DE 19716,Biomedical Engineering, University of Delaware, Newark, DE 19716
| | - Valerie C. West
- Biomedical Engineering, University of Delaware, Newark, DE 19716
| | | | - Dawn M. Elliott
- Biomedical Engineering, University of Delaware, Newark, DE 19716
| | - Justin Parreno
- Departments of Biological Sciences, University of Delaware, Newark, DE 19716,Biomedical Engineering, University of Delaware, Newark, DE 19716,*Address correspondence to: Justin Parreno ()
| |
Collapse
|
14
|
Park JH, Chung SG, Jun JY, Lee JJ, Lee K. Quantitative analysis of tendon histopathology using digital pathology in rat models with Achilles tendon injury. Connect Tissue Res 2022; 63:463-474. [PMID: 34974783 DOI: 10.1080/03008207.2021.2011251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Although digital image analysis methods that quantify histopathologic features have emerged, no validated quantitative methods are available to evaluate tendon injury. This study aimed to propose and validate a quantitative analysis method to identify the histopathologic features of tendon injuries. The histopathologic features of two Achilles tendon injury models (a partial full-thickness defect model and a collagenase injection model) using Sprague-Dawley rats were evaluated by semiquantitative grading and a quantitative analysis method using a digital pathology software at weeks 1 and 4 after tendon injury (six tendons per group at each time point). The outcome variables between tendon injury models and between time points were compared, and the correlation between semiquantitative scores and the results of the quantitative analysis was investigated. The proposed analysis method quantified the severity of the histopathological features after tendon injury. Quantitative analysis differentiated the cell morphology between tendon injury models and time points better than semiquantitative scoring. The results from quantitative measurements correlated significantly with the semiquantitative scores. The proposed quantitative method can be effective in evaluating the histopathology of tendon injuries.
Collapse
Affiliation(s)
- Jae Hyeon Park
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Sun G Chung
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Institute of Aging, Seoul National University, Seoul, Republic of Korea
| | - Ji-Young Jun
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin-Ju Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyoungbun Lee
- Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea
| |
Collapse
|
15
|
Eisner LE, Rosario R, Andarawis-Puri N, Arruda EM. The Role of the Non-Collagenous Extracellular Matrix in Tendon and Ligament Mechanical Behavior: A Review. J Biomech Eng 2022; 144:1128818. [PMID: 34802057 PMCID: PMC8719050 DOI: 10.1115/1.4053086] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Indexed: 12/26/2022]
Abstract
Tendon is a connective tissue that transmits loads from muscle to bone, while ligament is a similar tissue that stabilizes joint articulation by connecting bone to bone. The 70-90% of tendon and ligament's extracellular matrix (ECM) is composed of a hierarchical collagen structure that provides resistance to deformation primarily in the fiber direction, and the remaining fraction consists of a variety of non-collagenous proteins, proteoglycans, and glycosaminoglycans (GAGs) whose mechanical roles are not well characterized. ECM constituents such as elastin, the proteoglycans decorin, biglycan, lumican, fibromodulin, lubricin, and aggrecan and their associated GAGs, and cartilage oligomeric matrix protein (COMP) have been suggested to contribute to tendon and ligament's characteristic quasi-static and viscoelastic mechanical behavior in tension, shear, and compression. The purpose of this review is to summarize existing literature regarding the contribution of the non-collagenous ECM to tendon and ligament mechanics, and to highlight key gaps in knowledge that future studies may address. Using insights from theoretical mechanics and biology, we discuss the role of the non-collagenous ECM in quasi-static and viscoelastic tensile, compressive, and shear behavior in the fiber direction and orthogonal to the fiber direction. We also address the efficacy of tools that are commonly used to assess these relationships, including enzymatic degradation, mouse knockout models, and computational models. Further work in this field will foster a better understanding of tendon and ligament damage and healing as well as inform strategies for tissue repair and regeneration.
Collapse
Affiliation(s)
- Lainie E Eisner
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109; Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - Ryan Rosario
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109
| | - Nelly Andarawis-Puri
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14853
| | - Ellen M Arruda
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109; Professor Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109; Professor Program in Macromolecular Science and Engineering, University of Michigan, Ann Arbor, MI 48109
| |
Collapse
|
16
|
Konar S, Bolam SM, Coleman B, Dalbeth N, McGlashan SR, Leung S, Cornish J, Naot D, Musson DS. Changes in Physiological Tendon Substrate Stiffness Have Moderate Effects on Tendon-Derived Cell Growth and Immune Cell Activation. Front Bioeng Biotechnol 2022; 10:800748. [PMID: 35295642 PMCID: PMC8918575 DOI: 10.3389/fbioe.2022.800748] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/07/2022] [Indexed: 11/29/2022] Open
Abstract
Tendinopathy is characterised by pathological changes in tendon matrix composition, architecture, and stiffness, alterations in tendon resident cell characteristics, and fibrosis, with inflammation also emerging as an important factor in tendinopathy progression. The sequence of pathological changes in tendinopathy and the cellular effects of the deteriorating matrix are largely unknown. This study investigated the effects of substrate stiffness on tendon-derived cells (TDCs) and THP-1 macrophages using PDMS substrates representing physiological tendon stiffness (1.88 MPa), a stiff gel (3.17 MPa) and a soft gel (0.61 MPa). Human TDCs were cultured on the different gel substrates and on tissue culture plastic. Cell growth was determined by alamarBlue™ assay, cell morphology was analysed in f-actin labelled cells, and phenotypic markers were analysed by real-time PCR. We found that in comparison to TDCs growing on gels with physiological stiffness, cell growth increased on soft gels at 48 h (23%, p = 0.003). Cell morphology was similar on all three gels. SCX expression was slightly reduced on the soft gels (1.4-fold lower, p = 0.026) and COL1A1 expression increased on the stiff gels (2.2-fold, p = 0.041). Culturing THP-1 macrophages on soft gels induced increased expression of IL1B (2-fold, p = 0.018), and IL8 expression was inhibited on the stiffer gels (1.9-fold, p = 0.012). We also found that culturing TDCs on plastic increased cell growth, altered cell morphology, and inhibited the expression of SCX, SOX9, MMP3, and COL3. We conclude that TDCs and macrophages respond to changes in matrix stiffness. The magnitude of responses measured in TDCs were minor on the range of substrate stiffness tested by the gels. Changes in THP-1 macrophages suggested a more inflammatory phenotype on substrates with non-physiological stiffness. Although cell response to subtle variations in matrix stiffness was moderate, it is possible that these alterations may contribute to the onset and progression of tendinopathy.
Collapse
Affiliation(s)
- Subhajit Konar
- Department of Nutrition and Dietetics, University of Auckland, Auckland, New Zealand
| | - Scott M. Bolam
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Brendan Coleman
- Department of Orthopaedics, Middlemore Hospital, Auckland, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Sue R. McGlashan
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Sophia Leung
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Jillian Cornish
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Dorit Naot
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - David S. Musson
- Department of Nutrition and Dietetics, University of Auckland, Auckland, New Zealand
- *Correspondence: David S. Musson,
| |
Collapse
|
17
|
Zhang X, Wang D, Mak KLK, Tuan RS, Ker DFE. Engineering Musculoskeletal Grafts for Multi-Tissue Unit Repair: Lessons From Developmental Biology and Wound Healing. Front Physiol 2021; 12:691954. [PMID: 34504435 PMCID: PMC8421786 DOI: 10.3389/fphys.2021.691954] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/22/2021] [Indexed: 12/13/2022] Open
Abstract
In the musculoskeletal system, bone, tendon, and skeletal muscle integrate and act coordinately as a single multi-tissue unit to facilitate body movement. The development, integration, and maturation of these essential components and their response to injury are vital for conferring efficient locomotion. The highly integrated nature of these components is evident under disease conditions, where rotator cuff tears at the bone-tendon interface have been reported to be associated with distal pathological alterations such as skeletal muscle degeneration and bone loss. To successfully treat musculoskeletal injuries and diseases, it is important to gain deep understanding of the development, integration and maturation of these musculoskeletal tissues along with their interfaces as well as the impact of inflammation on musculoskeletal healing and graft integration. This review highlights the current knowledge of developmental biology and wound healing in the bone-tendon-muscle multi-tissue unit and perspectives of what can be learnt from these biological and pathological processes within the context of musculoskeletal tissue engineering and regenerative medicine. Integrating these knowledge and perspectives can serve as guiding principles to inform the development and engineering of musculoskeletal grafts and other tissue engineering strategies to address challenging musculoskeletal injuries and diseases.
Collapse
Affiliation(s)
- Xu Zhang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Shatin, China
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, China
| | - Dan Wang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Shatin, China
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, China
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
- Key Laboratory for Regenerative Medicine, Ministry of Education, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, China
| | - King-Lun Kingston Mak
- Bioland Laboratory (Guangzhou Regenerative Medicine and Health-Guangdong Laboratory), Guangzhou, China
| | - Rocky S. Tuan
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Shatin, China
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, China
| | - Dai Fei Elmer Ker
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Shatin, China
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, China
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
- Key Laboratory for Regenerative Medicine, Ministry of Education, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, China
| |
Collapse
|
18
|
Kapsokalyvas D, Rosas R, Janssen RWA, Vanoevelen JM, Nabben M, Strauch M, Merhof D, van Zandvoort MAMJ. Multiview deconvolution approximation multiphoton microscopy of tissues and zebrafish larvae. Sci Rep 2021; 11:10160. [PMID: 33980963 PMCID: PMC8115086 DOI: 10.1038/s41598-021-89566-w] [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: 12/17/2020] [Accepted: 03/30/2021] [Indexed: 02/03/2023] Open
Abstract
Imaging in three dimensions is necessary for thick tissues and small organisms. This is possible with tomographic optical microscopy techniques such as confocal, multiphoton and light sheet microscopy. All these techniques suffer from anisotropic resolution and limited penetration depth. In the past, Multiview microscopy-imaging the sample from different angles followed by 3D image reconstruction-was developed to address this issue for light sheet microscopy based on fluorescence signal. In this study we applied this methodology to accomplish Multiview imaging with multiphoton microscopy based on fluorescence and additionally second harmonic signal from myosin and collagen. It was shown that isotropic resolution was achieved, the entirety of the sample was visualized, and interference artifacts were suppressed allowing clear visualization of collagen fibrils and myofibrils. This method can be applied to any scanning microscopy technique without microscope modifications. It can be used for imaging tissue and whole mount small organisms such as heart tissue, and zebrafish larva in 3D, label-free or stained, with at least threefold axial resolution improvement which can be significant for the accurate quantification of small 3D structures.
Collapse
Affiliation(s)
- Dimitrios Kapsokalyvas
- grid.5012.60000 0001 0481 6099Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands ,grid.412301.50000 0000 8653 1507Institute for Molecular Cardiovascular Research (IMCAR), University Hospital RWTH Aachen University, Aachen, Germany
| | - Rodrigo Rosas
- grid.5012.60000 0001 0481 6099Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Rob W. A. Janssen
- grid.5012.60000 0001 0481 6099Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Jo M. Vanoevelen
- grid.5012.60000 0001 0481 6099Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Miranda Nabben
- grid.5012.60000 0001 0481 6099Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Martin Strauch
- grid.1957.a0000 0001 0728 696XInstitute of Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany
| | - Dorit Merhof
- grid.1957.a0000 0001 0728 696XInstitute of Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany
| | - Marc A. M. J. van Zandvoort
- grid.5012.60000 0001 0481 6099Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands ,grid.412301.50000 0000 8653 1507Institute for Molecular Cardiovascular Research (IMCAR), University Hospital RWTH Aachen University, Aachen, Germany
| |
Collapse
|
19
|
Blache U, Wunderli SL, Hussien AA, Stauber T, Flückiger G, Bollhalder M, Niederöst B, Fucentese SF, Snedeker JG. Inhibition of ERK 1/2 kinases prevents tendon matrix breakdown. Sci Rep 2021; 11:6838. [PMID: 33767224 PMCID: PMC7994809 DOI: 10.1038/s41598-021-85331-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/26/2021] [Indexed: 12/14/2022] Open
Abstract
Tendon extracellular matrix (ECM) mechanical unloading results in tissue degradation and breakdown, with niche-dependent cellular stress directing proteolytic degradation of tendon. Here, we show that the extracellular-signal regulated kinase (ERK) pathway is central in tendon degradation of load-deprived tissue explants. We show that ERK 1/2 are highly phosphorylated in mechanically unloaded tendon fascicles in a vascular niche-dependent manner. Pharmacological inhibition of ERK 1/2 abolishes the induction of ECM catabolic gene expression (MMPs) and fully prevents loss of mechanical properties. Moreover, ERK 1/2 inhibition in unloaded tendon fascicles suppresses features of pathological tissue remodeling such as collagen type 3 matrix switch and the induction of the pro-fibrotic cytokine interleukin 11. This work demonstrates ERK signaling as a central checkpoint to trigger tendon matrix degradation and remodeling using load-deprived tissue explants.
Collapse
Affiliation(s)
- Ulrich Blache
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Stefania L Wunderli
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Amro A Hussien
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Tino Stauber
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Gabriel Flückiger
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Maja Bollhalder
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Barbara Niederöst
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Sandro F Fucentese
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jess G Snedeker
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
| |
Collapse
|
20
|
Liu J, Xu MY, Wu J, Zhang H, Yang L, Lun DX, Hu YC, Liu B. Picrosirius-Polarization Method for Collagen Fiber Detection in Tendons: A Mini-Review. Orthop Surg 2021; 13:701-707. [PMID: 33689233 PMCID: PMC8126917 DOI: 10.1111/os.12627] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 12/31/2022] Open
Abstract
Although the structure and composition of collagen have been studied by polarized light microscopy since the early 19th century, many studies and reviews have paid little or no attention to the morphological problems of histopathological diagnosis. The morphology of collagen fibers is critical in guiding mechanical and biological properties in both normal and pathological tendons. Highlighting the organization and spatial distribution of tendon‐containing collagen fibers can be very useful for visualizing a tendon's ultrastructure, biochemical and indirect mechanical properties, which benefits other researchers and clinicians. Picrosirius red (PSR) staining, relying on the birefringence of collagen fibers, is one of the best understood histochemical methods that can highly and specifically underline fibers better than other common staining techniques when combined with polarized light microscopy (PLM). Polarized light microscopy provides complementary information about collagen fibers, such as orientation, type and spatial distribution, which is important for a comprehensive assessment of collagen alteration in a tendon. Here, this brief review serves as a simplistic and important primer to research developments in which differential staining of collagen types by the Picrosirius‐polarization method is increasing in diverse studies of the medical field, mainly in the assessment of the morphology, spatial distribution, and content of collagen in tendons.
Collapse
Affiliation(s)
- Jie Liu
- Tianjin Medical University, Tianjin, China
| | | | - Jing Wu
- Center for Medical Device Evaluation NMPA, Beijing, China
| | | | - Li Yang
- Tianjin Hospital, Tianjin, China
| | | | | | - Bin Liu
- Center for Medical Device Evaluation NMPA, Beijing, China
| |
Collapse
|
21
|
Huang Z, Yin Z, Xu J, Fei Y, Heng BC, Jiang X, Chen W, Shen W. Tendon Stem/Progenitor Cell Subpopulations and Their Implications in Tendon Biology. Front Cell Dev Biol 2021; 9:631272. [PMID: 33681210 PMCID: PMC7930382 DOI: 10.3389/fcell.2021.631272] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/27/2021] [Indexed: 12/28/2022] Open
Abstract
Tendon harbors a cell population that possesses stem cell characteristics such as clonogenicity, multipotency and self-renewal capacity, commonly referred to as tendon stem/progenitor cells (TSPCs). Various techniques have been employed to study how TSPCs are implicated in tendon development, homeostasis and healing. Recent advances in single-cell analysis have enabled much progress in identifying and characterizing distinct subpopulations of TSPCs, which provides a more comprehensive view of TSPCs function in tendon biology. Understanding the mechanisms of physiological and pathological processes regulated by TSPCs, especially a particular subpopulation, would greatly benefit treatment of diseased tendons. Here, we summarize the current scientific literature on the various subpopulations of TSPCs, and discuss how TSPCs can contribute to tissue homeostasis and pathogenesis, as well as examine the key modulatory signaling pathways that determine stem/progenitor cell state. A better understanding of the roles that TSPCs play in tendon biology may facilitate the development of novel treatment strategies for tendon diseases.
Collapse
Affiliation(s)
- Zizhan Huang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedics Research Institute, Zhejiang University, Hangzhou, China.,Institute of Sports Medicine, Zhejiang University, Hangzhou, China
| | - Zi Yin
- Institute of Sports Medicine, Zhejiang University, Hangzhou, China.,Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Hangzhou, China.,China Orthopedic Regenerative Medicine (CORMed), Hangzhou, China
| | - Jialu Xu
- Department of Infectious Diseases, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yang Fei
- Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedics Research Institute, Zhejiang University, Hangzhou, China.,Institute of Sports Medicine, Zhejiang University, Hangzhou, China
| | - Boon Chin Heng
- School of Stomatology, Peking University, Beijing, China
| | - Xuesheng Jiang
- Department of Orthopedic Surgery, Huzhou Hospital, Zhejiang University, Huzhou, China
| | - Weishan Chen
- Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedics Research Institute, Zhejiang University, Hangzhou, China
| | - Weiliang Shen
- Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedics Research Institute, Zhejiang University, Hangzhou, China.,Institute of Sports Medicine, Zhejiang University, Hangzhou, China.,Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Hangzhou, China.,China Orthopedic Regenerative Medicine (CORMed), Hangzhou, China
| |
Collapse
|
22
|
Eekhoff JD, Steenbock H, Berke IM, Brinckmann J, Yanagisawa H, Wagenseil JE, Lake SP. Dysregulated assembly of elastic fibers in fibulin-5 knockout mice results in a tendon-specific increase in elastic modulus. J Mech Behav Biomed Mater 2021; 113:104134. [PMID: 33045519 PMCID: PMC8146012 DOI: 10.1016/j.jmbbm.2020.104134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
Abstract
Elastic fiber assembly is coordinated in part by fibulin-5, a matricellular protein. When fibulin-5 is not available to guide elastogenesis, elastin forms into disconnected globules instead of the dense elastic fiber core found in healthy tissues. Despite the growing evidence for a significant role of elastic fibers in tendon mechanics and the clinical relevance to cutis laxa, a human disease which can be caused by a mutation in the gene encoding fibulin-5, it is unknown how malformed elastic fibers affect tendon function. Therefore, this study investigated the effects of dysregulated elastic fiber assembly in tendons from fibulin-5 knockout mice in comparison to wild-type controls. Due to evidence for a more prominent role of elastic fibers in tendons with higher functional demands, both the energy-storing Achilles tendon and the more positional tibialis anterior tendon were evaluated. The linear modulus of knockout Achilles tendons was increased compared to controls, yet there was no discernible change in mechanical properties of the tibialis anterior tendon across genotypes. Transmission electron microscopy confirmed the presence of malformed elastic fibers in knockout tendons while no other changes to tendon composition or structure were found. The mechanism behind the increase in linear modulus in fibulin-5 knockout Achilles tendons may be greater collagen engagement due to decreased regulation of strain-induced structural reorganization. These findings support the theory of a significant, functionally distinct role of elastic fibers in tendon mechanics.
Collapse
Affiliation(s)
- Jeremy D Eekhoff
- Department of Biomedical Engineering, Washington University in St. Louis, USA
| | - Heiko Steenbock
- Institute of Virology and Cell Biology, University of Lübeck, Germany
| | - Ian M Berke
- Department of Biomedical Engineering, Washington University in St. Louis, USA
| | - Jürgen Brinckmann
- Institute of Virology and Cell Biology, University of Lübeck, Germany; Department of Dermatology, University of Lübeck, Germany
| | - Hiromi Yanagisawa
- Life Science Center for Survival Dynamics, Tsukuba Advanced Research Alliance, University of Tsukuba, Japan
| | - Jessica E Wagenseil
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, USA
| | - Spencer P Lake
- Department of Biomedical Engineering, Washington University in St. Louis, USA; Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, USA; Department of Orthopaedic Surgery, Washington University in St. Louis, USA.
| |
Collapse
|
23
|
Siadat SM, Zamboulis DE, Thorpe CT, Ruberti JW, Connizzo BK. Tendon Extracellular Matrix Assembly, Maintenance and Dysregulation Throughout Life. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1348:45-103. [PMID: 34807415 DOI: 10.1007/978-3-030-80614-9_3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In his Lissner Award medal lecture in 2000, Stephen Cowin asked the question: "How is a tissue built?" It is not a new question, but it remains as relevant today as it did when it was asked 20 years ago. In fact, research on the organization and development of tissue structure has been a primary focus of tendon and ligament research for over two centuries. The tendon extracellular matrix (ECM) is critical to overall tissue function; it gives the tissue its unique mechanical properties, exhibiting complex non-linear responses, viscoelasticity and flow mechanisms, excellent energy storage and fatigue resistance. This matrix also creates a unique microenvironment for resident cells, allowing cells to maintain their phenotype and translate mechanical and chemical signals into biological responses. Importantly, this architecture is constantly remodeled by local cell populations in response to changing biochemical (systemic and local disease or injury) and mechanical (exercise, disuse, and overuse) stimuli. Here, we review the current understanding of matrix remodeling throughout life, focusing on formation and assembly during the postnatal period, maintenance and homeostasis during adulthood, and changes to homeostasis in natural aging. We also discuss advances in model systems and novel tools for studying collagen and non-collagenous matrix remodeling throughout life, and finally conclude by identifying key questions that have yet to be answered.
Collapse
Affiliation(s)
| | - Danae E Zamboulis
- Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Chavaunne T Thorpe
- Comparative Biomedical Sciences, The Royal Veterinary College, University of London, London, UK
| | - Jeffrey W Ruberti
- Department of Bioengineering, Northeastern University, Boston, MA, USA
| | - Brianne K Connizzo
- Department of Biomedical Engineering, Boston University, Boston, MA, USA.
| |
Collapse
|
24
|
Lin AH, Allan AN, Zitnay JL, Kessler JL, Yu SM, Weiss JA. Collagen denaturation is initiated upon tissue yield in both positional and energy-storing tendons. Acta Biomater 2020; 118:153-160. [PMID: 33035697 DOI: 10.1016/j.actbio.2020.09.056] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/04/2020] [Accepted: 09/30/2020] [Indexed: 12/12/2022]
Abstract
Tendons are collagenous soft tissues that transmit loads between muscles and bones. Depending on their anatomical function, tendons are classified as positional or energy-storing with differing biomechanical and biochemical properties. We recently demonstrated that during monotonic stretch of positional tendons, permanent denatured collagen begins accumulating upon departing the linear region of the stress-strain curve. However, it is unknown if this observation is true during mechanical overload of other types of tendons. Therefore, the purpose of this study was to investigate the onset of collagen denaturation relative to applied strain, and whether it differs between the two tendon types. Rat tail tendon (RTT) fascicles and rat flexor digitorum longus (FDL) tendons represented positional and energy-storing tendons, respectively. The samples were stretched to incremental levels of strain, then stained with fluorescently labeled collagen hybridizing peptides (CHPs); the CHP fluorescence was measured to quantify denatured collagen. Denatured collagen in both positional and energy-storing tendons began to increase at the yield strain, upon leaving the linear region of the stress-strain curve as the sample started to permanently deform. Despite significant differences between the two tendon types, it appears that collagen denaturation is initiated at tissue yield during monotonic stretch, and the fundamental mechanism of failure is the same for the two types of tendons. At tissue failure, positional tendons had double the percentage of denatured collagen compared to energy-storing tendons, with no difference between 0% control groups. These results help to elucidate the etiology of subfailure injury and rupture in functionally distinct tendons.
Collapse
Affiliation(s)
- Allen H Lin
- Department of Biomedical Engineering, University of Utah, United States; Scientific Computing and Imaging Institute, University of Utah, United States
| | - Alexandra N Allan
- Department of Biomedical Engineering, University of Utah, United States; Scientific Computing and Imaging Institute, University of Utah, United States
| | - Jared L Zitnay
- Department of Biomedical Engineering, University of Utah, United States; Scientific Computing and Imaging Institute, University of Utah, United States
| | - Julian L Kessler
- Department of Biomedical Engineering, University of Utah, United States
| | - S Michael Yu
- Department of Biomedical Engineering, University of Utah, United States; Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, United States
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, University of Utah, United States; Scientific Computing and Imaging Institute, University of Utah, United States; Department of Orthopaedics, University of Utah, United States.
| |
Collapse
|
25
|
Hill JR, Eekhoff JD, Brophy RH, Lake SP. Elastic fibers in orthopedics: Form and function in tendons and ligaments, clinical implications, and future directions. J Orthop Res 2020; 38:2305-2317. [PMID: 32293749 PMCID: PMC7572591 DOI: 10.1002/jor.24695] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/21/2020] [Accepted: 04/11/2020] [Indexed: 02/04/2023]
Abstract
Elastic fibers are an essential component of the extracellular matrix of connective tissues. The focus of both clinical management and scientific investigation of elastic fiber disorders has centered on the cardiovascular manifestations due to their significant impact on morbidity and mortality. As such, the current understanding of the orthopedic conditions experienced by these patients is limited. The musculoskeletal implications of more subtle elastic fiber abnormalities, whether due to allelic variants or age-related tissue degeneration, are also not well understood. Recent advances have begun to uncover the effects of elastic fiber deficiency on tendon and ligament biomechanics; future research must further elucidate mechanisms governing the role of elastic fibers in these tissues. The identification of population-based genetic variations in elastic fibers will also be essential. Minoxidil administration, modulation of protein expression with micro-RNA molecules, and direct injection of recombinant elastic fiber precursors have demonstrated promise for therapeutic intervention, but further work is required prior to consideration for orthopedic clinical application. This review provides an overview of the role of elastic fibers in musculoskeletal tissue, summarizes current knowledge of the orthopedic manifestations of elastic fiber abnormalities, and identifies opportunities for future investigation and clinical application.
Collapse
Affiliation(s)
- J. Ryan Hill
- Department of Orthopaedic Surgery, Washington University in St. Louis, 425 S. Euclid Avenue, Suite 5505, St. Louis, MO 63110
| | - Jeremy D. Eekhoff
- Department of Biomedical Engineering, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130
| | - Robert H. Brophy
- Department of Orthopaedic Surgery, Washington University in St. Louis, 425 S. Euclid Avenue, Suite 5505, St. Louis, MO 63110
| | - Spencer P. Lake
- Department of Biomedical Engineering, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130,Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130
| |
Collapse
|
26
|
Peterson BE, Szczesny SE. Dependence of tendon multiscale mechanics on sample gauge length is consistent with discontinuous collagen fibrils. Acta Biomater 2020; 117:302-309. [PMID: 33010516 DOI: 10.1016/j.actbio.2020.09.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/27/2022]
Abstract
While collagen fibrils are understood to be the primary load-bearing elements in tendon, controversy still exists on how fibrils functionally transmit load from muscle to bone. Specifically, it's unclear whether fibrils are structurally continuous along the tendon length and bear load independently, or if they are discontinuous and transfer load through interfibrillar shear forces. To address this question, we investigated whether the multiscale mechanics of rat tail tendon fascicles is dependent on sample gauge length. We hypothesized that as the grip-to-grip length is reduced and approaches the length of the collagen fibrils, tendon fascicles will adopt a multiscale mechanical response consistent with structurally continuous fibrils. Our findings show that, for gauge lengths of 20 mm or greater, the local fibril strains are less than the bulk tissue strains, which can be explained by relative sliding between discontinuous collagen fibrils. In contrast, at a 5 mm gauge length, the fibril strains are equivalent to the applied tissue strains, suggesting that the collagen fibrils are structurally continuous between the grips. Additionally, the macroscale tissue modulus is increased at gauge lengths of 5 and 10 mm. Together, these data support the hypothesis that collagen fibrils in rat tail tendon fascicles are discontinuous and also suggest that their length is between 5 and 10 mm. This fundamental information regarding tendon structure-function relationships underscores the importance of the tissue components that transmit load between fibrils and is critical for understanding tendon pathology as well as establishing structural benchmarks for suitable tissue engineered replacements.
Collapse
|
27
|
Gumucio JP, Schonk MM, Kharaz YA, Comerford E, Mendias CL. Scleraxis is required for the growth of adult tendons in response to mechanical loading. JCI Insight 2020; 5:138295. [PMID: 32463804 DOI: 10.1172/jci.insight.138295] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
Scleraxis is a basic helix-loop-helix transcription factor that plays a central role in promoting tenocyte proliferation and matrix synthesis during embryonic tendon development. However, the role of scleraxis in the growth and adaptation of adult tendons is not known. We hypothesized that scleraxis is required for tendon growth in response to mechanical loading and that scleraxis promotes the specification of progenitor cells into tenocytes. We conditionally deleted scleraxis in adult mice using a tamoxifen-inducible Cre-recombinase expressed from the Rosa26 locus (ScxΔ) and then induced tendon growth in Scx+ and ScxΔ adult mice via plantaris tendon mechanical overload. Compared with the WT Scx+ group, ScxΔ mice demonstrated blunted tendon growth. Transcriptional and proteomic analyses revealed significant reductions in cell proliferation, protein synthesis, and extracellular matrix genes and proteins. Our results indicate that scleraxis is required for mechanically stimulated adult tendon growth by causing the commitment of CD146+ pericytes into the tenogenic lineage and by promoting the initial expansion of newly committed tenocytes and the production of extracellular matrix proteins.
Collapse
Affiliation(s)
- Jonathan P Gumucio
- Department of Molecular & Integrative Physiology and.,Department of Orthopaedic Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Yalda A Kharaz
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, and Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, Liverpool, United Kingdom
| | - Eithne Comerford
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, and Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, Liverpool, United Kingdom
| | - Christopher L Mendias
- Department of Molecular & Integrative Physiology and.,Department of Orthopaedic Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Hospital for Special Surgery, New York, New York, USA.,Department of Physiology & Biophysics, Weill Cornell Medical College, New York, New York, USA
| |
Collapse
|
28
|
Tissue-specific changes in size and shape of the ligaments and tendons of the porcine knee during post-natal growth. PLoS One 2019; 14:e0219637. [PMID: 31644571 PMCID: PMC6808441 DOI: 10.1371/journal.pone.0219637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/01/2019] [Indexed: 01/15/2023] Open
Abstract
Prior studies have analyzed growth of musculoskeletal tissues between species or across body segments; however, little research has assessed the differences in similar tissues within a single joint. Here we studied changes in the length and cross-sectional area of four ligaments and tendons, (anterior cruciate ligament, patellar tendon, medial collateral ligament, lateral collateral ligament) in the tibiofemoral joint of female Yorkshire pigs through high-field magnetic resonance imaging throughout growth. Tissue lengths increased by 4- to 5-fold from birth to late adolescence across the tissues while tissue cross-sectional area increased by 10–20-fold. The anterior cruciate ligament and lateral collateral ligament showed allometric growth favoring change in length over change in cross-sectional area while the patellar tendon and medial collateral ligament grow in an isometric manner. Additionally, changes in the length and cross-sectional area of the anterior cruciate ligament did not increase as much as in the other ligaments and tendon of interest. Overall, these findings suggest that musculoskeletal soft tissue morphometry can vary within tissues of similar structure and within a single joint during post-natal growth.
Collapse
|
29
|
Onset of neonatal locomotor behavior and the mechanical development of Achilles and tail tendons. J Biomech 2019; 96:109354. [PMID: 31630773 DOI: 10.1016/j.jbiomech.2019.109354] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/21/2019] [Accepted: 09/18/2019] [Indexed: 12/27/2022]
Abstract
Tendon tissue engineering approaches are challenged by a limited understanding of the role mechanical loading plays in normal tendon development. We propose that the increased loading that developing postnatal tendons experience with the onset of locomotor behavior impacts tendon formation. The objective of this study was to assess the onset of spontaneous weight-bearing locomotion in postnatal day (P) 1, 5, and 10 rats, and characterize the relationship between locomotion and the mechanical development of weight-bearing and non-weight-bearing tendons. Movement was video recorded and scored to determine non-weight-bearing, partial weight-bearing, and full weight-bearing locomotor behavior at P1, P5, and P10. Achilles tendons, as weight-bearing tendons, and tail tendons, as non-weight-bearing tendons, were mechanically evaluated. We observed a significant increase in locomotor behavior in P10 rats, compared to P1 and P5. We also found corresponding significant differences in the maximum force, stiffness, displacement at maximum force, and cross-sectional area in Achilles tendons, as a function of postnatal age. However, the maximum stress, strain at maximum stress, and elastic modulus remained constant. Tail tendons of P10 rats had significantly higher maximum force, maximum stress, elastic modulus, and stiffness compared to P5. Our results suggest that the onset of locomotor behavior may be providing the mechanical cues regulating postnatal tendon growth, and their mechanical development may proceed differently in weight-bearing and non-weight-bearing tendons. Further analysis of how this loading affects developing tendons in vivo may inform future engineering approaches aiming to apply such mechanical cues to regulate engineered tendon formation in vitro.
Collapse
|
30
|
Lee AH, Elliott DM. Multi-Scale Loading and Damage Mechanisms of Plantaris and Rat Tail Tendons. J Orthop Res 2019; 37:1827-1837. [PMID: 30977538 PMCID: PMC6790141 DOI: 10.1002/jor.24309] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/21/2019] [Accepted: 03/13/2019] [Indexed: 02/04/2023]
Abstract
Tendinopathy, degeneration of the tendon that leads to pain and dysfunction, is common in both sports and occupational settings, but multi-scale mechanisms for tendinopathy are still unknown. We recently showed that micro-scale sliding (shear) is responsible for both load transfer and damage mechanisms in the rat tail tendon; however, the rat tail tendon is a specialized non-load-bearing tendon, and thus the load transfer and damage mechanisms are still unknown for load-bearing tendons. The objective of this study was to investigate the load transfer and damage mechanisms of load-bearing tendons using the rat plantaris tendon. We demonstrated that micro-scale sliding is a key component for both mechanisms in the plantaris tendon, similar to the tail tendon. Namely, the micro-scale sliding was correlated with applied strain, demonstrating that load was transferred via micro-scale sliding in the plantaris and tail tendons. In addition, while the micro-scale strain fully recovered, the micro-scale sliding was non-recoverable and strain-dependent, and correlated with tissue-scale mechanical parameters. When the applied strain was normalized, the % magnitudes of non-recoverable sliding was similar between the plantaris and tail tendons. Statement of clinical significance: Understanding the mechanisms responsible for the pathogenesis and progression of tendinopathy can improve prevention and rehabilitation strategies and guide therapies and the design of engineered constructs. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1827-1837, 2019.
Collapse
Affiliation(s)
- Andrea H. Lee
- Department of Biomedical Engineering, University of Delaware
| | - Dawn M. Elliott
- Department of Biomedical Engineering, University of Delaware
| |
Collapse
|