Controlled release of curcumin from curcumin-loaded nanomicelles to prevent peritendinous adhesion during Achilles tendon healing in rats

Abstract

We introduced curcumin-loaded nanomicelles into a tendon-healing model to evaluate their effects on tendon healing and adhesion. Three groups consisting of 36 rats underwent rupture and repair of the Achilles tendon. The treatment group received an injection of curcumin-loaded nanomicelles (gold nanorods [GNRs]-1/curcumin in polymeric nanomicelles [curc@PMs] at a dosage of 0.44 mg curcumin/kg in 0.1 mL saline) into the surgical site and exposed to laser postoperatively at weeks 1, 2, and 3, for three times 10 seconds each, on the surgical site in the rats that underwent tendon rupture and repair, while the other two groups received 0.44 mg curcumin/kg in 0.1 mL saline and 0.1 mL of saline, respectively. The specimens were harvested at 4 weeks and subjected to biomechanical and histological evaluation. The scoring results of tendon adhesion indicated that GNRs-1/curc@PMs group was in the lowest grade of peritendinous adhesions compared to the other groups. Histological assessment further confirmed the preventive effect of GNRs-1/curc@PMs on tendon adhesion. These findings indicated greater tendon strength with less adhesion in the group treated with GNRs-1/curc@PMs combined with laser exposure, and that nanoparticle-based therapy may be applied to prevent adhesion in clinical patients.

Dynamic exacerbation in inflammation and oxidative stress during the formation of peritendinous adhesion resulted from acute tendon injury

“…Peritendinous adhesion is one of the most common complications occurred during the healing process of injured tendon [ 1 , 21 , 22 ]. It binds the flexor tendons, restricts tendon gliding, and consequently leads to poor joint function [ 23 , 24 ]. Numerous attempts have been explored to prevent adhesion formation [ 2 – 5 , 7 – 10 , 13 , 14 , 21 , 25 ].…”

“…or physical barriers such as collagen membranes [ 26 ], PGA membranes [ 27 ], etc. [ 24 ] were proved to positively affect adhesion formation. However, the mechanisms underneath remain unclear.…”

Is Curcumine Useful in the Treatment and Prevention of the Tendinopathy and Myotendinous Junction Injury? A Scoping Review

“…Although it might not influence the study, this is unknown. Finally, except in three studies, it is common for the investigator to work blindly without knowing from which animal the sample came, but this is not indicated [ 88 , 89 , 90 , 91 , 92 ].…”

“…Rodent studies [ 88 , 89 , 90 , 94 , 95 , 96 ] conclude that curcumin seems to promote tendon-to-bone healing associated with anti-inflammatory and antioxidation effects, with a better functional recovery. Finally, the human studies [ 91 , 92 ] related to surgery procedures include a better pain score, concomitant with the usual treatment, and patient satisfaction. In relation to Table 1 and Table 2 , which evaluate the effect of the use of curcumin against DOMS in the MTJ, due to eccentric work, a lower presence of pain perception and lower creatine kinase (CK) values seem a common result, although there are those that do not observe changes [ 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 ].…”

Impact of High-Molecular-Weight Hyaluronic Acid on Gene Expression in Rabbit Achilles Tenocytes In Vitro

“…On the other hand, adhesion formation with the surrounding tissue hampers proper motion and may lead to joint stiffness [ 3 ]. The problem of adhesion formation is particularly pronounced in intrasynovial tendons [ 4 ], such as the flexor tendons of the hand; however, it has also been reported for the Achilles tendon (AT) [ 5 , 6 ]. When the tendon and the tendon sheath are injured, a mismatch in the fibrinolytic balance during wound healing may result in the formation of excessive fibrin that, in turn, acts like a glue and leads to unwanted adhesions [ 7 ].…”