Flexor Tendon: Development, Healing, Adhesion Formation, and Contributing Growth Factors

Titan, Ashley L.; Foster, Deshka S.; Chang, James; Longaker, Michael T.

doi:10.1097/prs.0000000000006048

Cited by 99 publications

(70 citation statements)

References 123 publications

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“…Peritendinous adhesion of tendons after hand surgery (Titan et al, 2019) can cause dysfunction of the extremities and requires complicated re-operative surgery. Despite the availability of modern surgical techniques and advanced rehabilitation protocols, peritendinous adhesion remains a challenge for hand surgeons.…”

Section: Introductionmentioning

confidence: 99%

An Integrative Dual-Layer Poly-L-Lactic Acid Fibrous Membrane Prevents Peritendinous Adhesions

Wang

Yao

et al. 2020

Front. Bioeng. Biotechnol.

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Anti-adhesion membranes are prospective scaffolds for preventing peritendinous adhesion after injury. However, currently available scaffolds have some limitations, such as low efficacy for anti-adhesion, low quality of tendon healing, and unknown drug interactions. Thus, in this study, we designed an innovative structure involving an integrated dual-layer poly(L-lactic acid) (PLLA) electrospun membrane for preventing peritendonous adhesion by promoting tendon gliding. We investigated the surface morphology and wettability of the fiber scaffold. The adhesion and proliferation of fibroblasts were low on the PLLA fibrous membrane. Compared with single-layer membranes, the dual-layer PLLA fiber scaffold reduced adhesion to the tissues. The gliding space persisted until recovery in chicken extensor flexor tendons in vivo. Thus, this innovative PLLA membrane scaffold could prevent adhesion and promote gliding to facilitate tendon healing.

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Section: Introductionmentioning

confidence: 99%

An Integrative Dual-Layer Poly-L-Lactic Acid Fibrous Membrane Prevents Peritendinous Adhesions

Wang

Yao

et al. 2020

Front. Bioeng. Biotechnol.

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“…It aids in collagen and glycosaminoglycan synthesis and helps maintain stem cells in a undifferentiated state (Shida et al, 2001). Another important growth factor is insulin-like growth factor-I (IGF-I) which plays a crucial role in muscle and bone regeneration (Adams and McCue, 1998;Trippel, 1998;Titan et al, 2019). IGF-I mediates to be largely proliferation and differentiation of satellite cells as well as recruitment of bone marrow stem cells (Musaro et al, 2004;Provenzano et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Potential of Soluble Decellularized Extracellular Matrix for Musculoskeletal Tissue Engineering – Comparison of Various Mesenchymal Tissues

Hanai

Jacob

Nakagawa

et al. 2020

Front. Cell Dev. Biol.

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BackgroundIt is well studied that preparations of decellularized extracellular matrix (ECM) obtained from mesenchymal tissues can function as biological scaffolds to regenerate injured musculoskeletal tissues. Previously, we reported that soluble decellularized ECMs derived from meniscal tissue demonstrated excellent biocompatibility and produced meniscal regenerate with native meniscal anatomy and biochemical characteristics. We therefore hypothesized that decellularized mesenchymal tissue ECMs from various mesenchymal tissues should exhibit tissue-specific bioactivity. The purpose of this study was to test this hypothesis using porcine tissues, for potential applications in musculoskeletal tissue engineering.MethodsNine types of porcine tissue, including cartilage, meniscus, ligament, tendon, muscle, synovium, fat pad, fat, and bone, were decellularized using established methods and solubilized. Although the current trend is to develop tissue specific decellularization protocols, we selected a simple standard protocol across all tissues using Triton X-100 and DNase/RNase after mincing to compare the outcome. The content of sulfated glycosaminoglycan (sGAG) and hydroxyproline were quantified to determine the biochemical composition of each tissue. Along with the concentration of several growth factors, known to be involved in tissue repair and/or maturation, including bFGF, IGF-1, VEGF, and TGF-β1. The effect of soluble ECMs on cell differentiation was explored by combining them with 3D collagen scaffold culturing human synovium derived mesenchymal stem cells (hSMSCs).ResultsThe decellularization of each tissue was performed and confirmed both histologically [hematoxylin and eosin (H&E) and 4’,6-diamidino-2-phenylindole (DAPI) staining] and on the basis of dsDNA quantification. The content of hydroxyproline of each tissue was relatively unchanged during the decellularization process when comparing the native and decellularized tissue. Cartilage and meniscus exhibited a significant decrease in sGAG content. The content of hydroxyproline in meniscus-derived ECM was the highest when compared with other tissues, while sGAG content in cartilage was the highest. Interestingly, a tissue-specific composition of most of the growth factors was measured in each soluble decellularized ECM and specific differentiation potential was particularly evident in cartilage, ligament and bone derived ECMs.ConclusionIn this study, soluble decellularized ECMs exhibited differences based on their tissue of origin and the present results are important going forward in the field of musculoskeletal regeneration therapy.

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“…During the early stages of tendon regeneration, immobilizing the tendon tissue is critical for faster healing; however, at the same time, applying mechanical load onto the tendon tissue during the healing processes has also been shown to decrease the formation of post-operative tendon adhesions [ 9 ]. In addition, proper selection of the incision line and an appropriate choice of suture materials are known to be critical for preventing tendon adhesions [ 10 ]. Therefore, there has been tremendous interest in the development of anti-adhesive agents for the suppression of adhesion formation between tendons and the surrounding connective tissue [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Hyaluronic Acid Treatment Improves Healing of the Tenorrhaphy Site by Suppressing Adhesions through Extracellular Matrix Remodeling in a Rat Model

et al. 2021

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Due to the limited supply of vessels and nerves, acute or chronic tendon injuries often result in significant and persistent complications, such as pain and sprains, as well as the loss of joint functions. Among these complications, tendon adhesions within the surrounding soft tissue have been shown to significantly impair the range of motion. In this study, to elucidate the effects of a hyaluronic acid (HA) injection at the site of tenorrhaphy on tendon adhesion formation, we used a full transection model of a rat’s Achilles tendon to investigate the anti-adhesive function of HA. Our initial findings showed that significantly lower adhesion scores were observed in the HA-treated experimental group than in the normal saline-treated control group, as determined by macroscopic and histological evaluations. Hematoxylin and eosin, as well as picrosirius red staining, showed denser and irregular collagen fibers, with the larger number of infiltrating inflammatory cells in the control group indicating severe adhesion formation. Furthermore, we observed that the expression of tendon adhesion markers in operated tendon tissue, such as collagen type I, transforming growth factor-β1, and plasminogen activator inhibitor-1, was suppressed at both the gene and protein levels following HA treatment. These results suggest that HA injections could reduce tendon adhesion formation by significantly ameliorating inflammatory-associated reactions.

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Flexor Tendon: Development, Healing, Adhesion Formation, and Contributing Growth Factors

Cited by 99 publications

References 123 publications

An Integrative Dual-Layer Poly-L-Lactic Acid Fibrous Membrane Prevents Peritendinous Adhesions

An Integrative Dual-Layer Poly-L-Lactic Acid Fibrous Membrane Prevents Peritendinous Adhesions

Potential of Soluble Decellularized Extracellular Matrix for Musculoskeletal Tissue Engineering – Comparison of Various Mesenchymal Tissues

Hyaluronic Acid Treatment Improves Healing of the Tenorrhaphy Site by Suppressing Adhesions through Extracellular Matrix Remodeling in a Rat Model

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