Year: 2018
Type: article
Abstract: Tendinopathy is one of the most frequent and clinically challenging musculoskeletal conditions. The treatment for tendinopathy is often multimodal, including exercise, thermal modalities, and corticosteroids, among others.1 Classically, tendinopathy has been viewed as mostly a non-inflammatory condition, but recent work has provided compelling evidence to the contrary.2 In patients with tendinopathy, a marked accumulation of macrophages was observed in biopsied tendon tissue. Diseased tendons also contained abundant quantities of stromal fibroblasts that were primed for inflammation, as indicated by the expression of the markers podoplanin, CD106, and CD248, along with TLR4. Gene expression analysis further identified activation of pro-inflammatory pathways that might contribute to the neovascularization often observed in tendinopathy. As stromal fibroblasts play important roles in regulating extracellular matrix turnover, these findings are also consistent with another recent report demonstrating increased collagen turnover in patients with tendinopathy.3 These two papers represent important advancements in our understanding of the treatment of tendinopathy, as targeted therapeutics that modulate the activity of immune cells and activated stromal fibroblasts could prevent the breakdown of the healthy tendon extracellular matrix and inhibit the accumulation of pathological scar tissue. However, an important limiting factor in the development of immunomodulating therapies for tendon disorders is the lack of a widely accepted small animal model of tendinopathy that could serve as a preclinical screening tool. Therefore, there is a need for further descriptive studies focused on immune cell biology in humans with tendon disease, and to develop a rodent model that recapitulates the pathological changes observed in tendinopathy.
Source: Translational Sports Medicine
DOI: 10.1002/tsm2.26
Author: C. Mendias
Institutions: Hospital for Special Surgery, Weill Cornell Medicine
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2803523091