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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.
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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
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Williams S, Ligas C, Oloff L, Klein TE. The Role of Epigenomics in Mapping Potential Precursors for Foot and Ankle Tendinopathy: A Systematic Review. Foot Ankle Spec 2023; 16:446-454. [PMID: 37165881 DOI: 10.1177/19386400231170967] [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] [Indexed: 05/12/2023]
Abstract
Tendinopathy of the foot and ankle is a common clinical problem for which the exact etiology is poorly understood. The field of epigenetics has been a recent focus of this investigation. The purpose of this article was to review the genomic advances in foot and ankle tendinopathy that could potentially be used to stratify disease risk and create preventative or therapeutic agents. A multi-database search of PubMed, Cochrane, Google Scholar, and clinicaltrials.gov from January 1, 2000 to July 1, 2022 was performed. A total of 18 articles met inclusion and exclusion criteria for this review. The majority of such research utilized case-control candidate gene association to identify different genetic risk factors associated with chronic tendinopathy. Polymorphisms in collagen genes COL5A1, COL27A1, and COL1A1 were noted at a significantly higher frequency in Achilles tendinopathy versus control groups. Other allelic variations that were observed at an increased incidence in Achilles tendinopathy were TNC and CASP8. The extracellular matrix (ECM) demonstrated macroscopic changes in Achilles tendinopathy, including an increase in aggrecan and biglycan mRNA expression, and increased expression of multiple matrix metalloproteinases. Cytokine expression was also influenced in pathology and aberrantly demonstrated dynamic response to mechanical load. The pathologic accumulation of ECM proteins and cytokine expression alters the adaptive response normal tendon has to physiologic stress, further propagating the risk for tendinopathy. By identifying and understanding the epigenetic mediators that lead to tendinopathy, therapeutic agents can be developed to target the exact underlying etiology and minimize side effects.Level of Evidence: Level IV: Systematic Review of Level II-IV Studies.
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Affiliation(s)
- Samantha Williams
- Department of Podiatric Surgery, Silicon Valley Reconstructive Foot and Ankle Fellowship, Palo Alto Medical Foundation, Mountain View, California
| | - Chandler Ligas
- Department of Podiatric Surgery, Silicon Valley Reconstructive Foot and Ankle Fellowship, Palo Alto Medical Foundation, Mountain View, California
| | - Lawrence Oloff
- Department of Podiatric Surgery, Silicon Valley Reconstructive Foot and Ankle Fellowship, Palo Alto Medical Foundation, Mountain View, California
- St. Mary's Medical Center, San Francisco, California
| | - Teri E Klein
- Departments of Biomedical Data Science and Medicine, Stanford Center for Biomedical Informatics Research (BMIR), and Stanford University, Stanford, California
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Should it Stay or Should it Go? Thinking Critically About Posterior Tibial Tendon Excision in Flatfoot Correction. TECHNIQUES IN FOOT AND ANKLE SURGERY 2019. [DOI: 10.1097/btf.0000000000000254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hammerman M, Blomgran P, Dansac A, Eliasson P, Aspenberg P. Different gene response to mechanical loading during early and late phases of rat Achilles tendon healing. J Appl Physiol (1985) 2017; 123:800-815. [PMID: 28705996 DOI: 10.1152/japplphysiol.00323.2017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 11/22/2022] Open
Abstract
Mechanical loading stimulates tendon healing both when applied in the inflammatory phase and in the early remodeling phase of the process, although not necessarily via the same mechanisms. We investigated the gene response to mechanical loading in these two phases of tendon healing. The right Achilles tendon in rats was transected, and the hindlimbs were unloaded by tail suspension. The rats were exposed to 5 min of treadmill running 3 or 14 days after tendon transection. Thereafter, they were resuspended for 15 min or 3 h until euthanasia. The controls were suspended continuously. Gene analysis was first performed by microarray analysis followed by quantitative RT-PCR on selected genes, focusing on inflammation. Fifteen minutes after loading, the most important genes seemed to be the transcription factors EGR1 and C-FOS, regardless of healing phase. These transcription factors might promote tendon cell proliferation and differentiation, stimulate collagen production, and regulate inflammation. Three hours after loading on day 3, inflammation was strongly affected. Seven inflammation-related genes were upregulated according to PCR: CCL20, CCL7, IL-6, NFIL3, PTX3, SOCS1, and TLR2. These genes can be connected to macrophages, T cells, and recruitment of leukocytes. According to Ingenuity Pathway Analysis, the recruitment of leukocytes was increased by loading on day 3, which also was confirmed by histology. This inflammation-related gene response was not seen on day 14 Our results suggest that the immediate gene response after mechanical loading is similar in the early and late phases of healing but the late gene response is different.NEW & NOTEWORTHY This study investigates the direct effect of mechanical loading on gene expression during different healing phases in tendon healing. One isolated episode of mechanical loading was studied in otherwise unloaded healing tendons. This enabled us to study a time sequence, i.e., which genes were the first ones to be regulated after the loading episode.
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Affiliation(s)
- Malin Hammerman
- Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linköping, Sweden
| | - Parmis Blomgran
- Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linköping, Sweden
| | - Arie Dansac
- Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linköping, Sweden
| | - Pernilla Eliasson
- Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linköping, Sweden
| | - Per Aspenberg
- Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linköping, Sweden
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Burri A, Marinova Z, Robinson MD, Kühnel B, Waldenberger M, Wahl S, Kunze S, Gieger C, Livshits G, Williams F. Are Epigenetic Factors Implicated in Chronic Widespread Pain? PLoS One 2016; 11:e0165548. [PMID: 27832094 PMCID: PMC5104434 DOI: 10.1371/journal.pone.0165548] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 10/13/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Chronic widespread musculoskeletal pain (CWP) is the cardinal symptom of fibromyalgia and affects about 12% of the general population. Familial aggregation of CWP has been repeatedly demonstrated with estimated heritabilities of around 50%, indicating a genetic susceptibility. The objective of the study was to explore genome-wide disease-differentially methylated positions (DMPs) for chronic widespread pain (CWP) in a sample of unrelated individuals and a subsample of discordant monozygotic (MZ) twins. METHODOLOGY/PRINCIPLE FINDINGS A total of N = 281 twin individuals from the TwinsUK registry, including N = 33 MZ twins discordant for self-reported CWP, were part of the discovery sample. The replication sample included 729 men and 756 women from a subsample of the KORA S4 survey-an independent population-based cohort from Southern Germany. Epigenome-wide analysis of DNA methylation was conducted using the Illumina Infinium HumanMethylation 450 DNA BeadChip in both the discovery and replication sample. Of our 40 main loci that were carried forward for replication, three CPGs reached significant p-values in the replication sample, including malate dehydrogenase 2 (MDH2; p-value 0.017), tetranectin (CLEC3B; p-value 0.039), and heat shock protein beta-6 (HSPB6; p-value 0.016). The associations between the collagen type I, alpha 2 chain (COL1A2) and monoamine oxidase B (MAOB) observed in the discovery sample-both of which have been previously reported to be biological candidates for pain-could not be replicated. CONCLUSION/SIGNIFICANCE Our results may serve as a starting point to encourage further investigation in large and independent population-based cohorts of DNA methylation and other epigenetic changes as possible disease mechanisms in CWP. Ultimately, understanding the key mechanisms underlying CWP may lead to new treatments and inform clinical practice.
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Affiliation(s)
- Andrea Burri
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- Waitemata Pain Service, Department of Anaesthesia and Perioperative Medicine, North Shore Hospital, Auckland, New Zealand
- Department of Psychology, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland
| | - Zoya Marinova
- Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid 5017, Switzerland
| | - Mark D. Robinson
- SIB Swiss Institute of Bioinformatics, University of Zurich, 8057 Zurich, Switzerland
- Institute of Molecular Life Sciences, University of Zurich, 8057 Zurich, Switzerland
| | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Simone Wahl
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Sonja Kunze
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Christian Gieger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Gregory Livshits
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Twin Research and Genetic Epidemiology, King’s College London, St.Thomas´ Hospital, Westminster Bridge Road SE1 7EH, London, United Kingdom
| | - Frances Williams
- Department of Twin Research and Genetic Epidemiology, King’s College London, St.Thomas´ Hospital, Westminster Bridge Road SE1 7EH, London, United Kingdom
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Subramanian A, Schilling TF. Tendon development and musculoskeletal assembly: emerging roles for the extracellular matrix. Development 2016; 142:4191-204. [PMID: 26672092 DOI: 10.1242/dev.114777] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Tendons and ligaments are extracellular matrix (ECM)-rich structures that interconnect muscles and bones. Recent work has shown how tendon fibroblasts (tenocytes) interact with muscles via the ECM to establish connectivity and strengthen attachments under tension. Similarly, ECM-dependent interactions between tenocytes and cartilage/bone ensure that tendon-bone attachments form with the appropriate strength for the force required. Recent studies have also established a close lineal relationship between tenocytes and skeletal progenitors, highlighting the fact that defects in signals modulated by the ECM can alter the balance between these fates, as occurs in calcifying tendinopathies associated with aging. The dynamic fine-tuning of tendon ECM composition and assembly thus gives rise to the remarkable characteristics of this unique tissue type. Here, we provide an overview of the functions of the ECM in tendon formation and maturation that attempts to integrate findings from developmental genetics with those of matrix biology.
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Affiliation(s)
- Arul Subramanian
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA 92697-2300, USA
| | - Thomas F Schilling
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA 92697-2300, USA
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