The high failure rate of surgical repair for tendinopathies has spurred interest in adjunct therapies, including exosomes (EVs). Mesenchymal stromal cell (MSC)-derived EVs (MSCdEVs) have been of particular interest as they improve several metrics of tendon healing in animal models. However, research has shown that EVs derived from tissue-native cells, such as tenocytes, are functionally distinct and may better direct tendon healing. To this end, we investigated the differential regulation of human primary macrophage transcriptomic responses and cytokine secretion by tenocyte-derived EVs (TdEVs) compared with MSCdEVs. Compared with MSCdEVs, TdEVs upregulated TNFa-NFkB and TGFB signaling and pathways associated with osteoclast differentiation in macrophages while decreasing secretion of several pro-inflammatory cytokines. Conditioned media of these TdEV educated macrophages drove increased tenocyte migration and decreased MMP3 and MMP13 expression. In contrast, MSCdEV education of macrophages drove increased gene expression pathways related to INFa, INFg and protection against oxidative stress while increasing cytokine expression of MCP1 and IL6. These data demonstrate that EV cell source differentially impacts the function of key effector cells in tendon healing and that TdEVs, compared with MSCdEVs, promote a more favorable tendon healing phenotype within these cells.
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http://dx.doi.org/10.1089/ten.tea.2024.0143 | DOI Listing |
J Orthop Res
January 2025
Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Achilles tendon ruptures significantly impair long-term patient function, with two-thirds of patients experiencing persistent functional deficits. Although nonsurgical treatment has gained popularity due to its perceived lower risk of complications, the specific effects of this approach on tendon healing, muscle function, and overall performance remain poorly understood. Directly comparing surgical and nonsurgical treatment options in a clinical population is challenging given the diverse nature of the patient population.
View Article and Find Full Text PDFActa Biomater
January 2025
Clinical Center for Sports Medicine, Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, P. R. China.. Electronic address:
Interface friction impedes tissue healing and stimulates interface cells to produce matrix metalloproteinases (MMPs); however, the precise mechanisms underlying matrix degradation, and the formation of fibrous scars remain unclear. This research involved the development of interface lubricating microspheres that inhibit the PI3K/AKT/mTOR signaling pathway in tenocytes. This inhibition significantly decreased MMP-13 expression and increased COL-1 production, thereby facilitating interface repair and regeneration.
View Article and Find Full Text PDFTissue Eng Part A
January 2025
Orthopaedic and Bioengineering Research Laboratory, Colorado State University, Fort Collins, Colorado, USA.
Cureus
December 2024
Trauma and Orthopaedics, Royal Devon and Exeter University Hospital, Devon, GBR.
Chronic tendinopathy is a degenerative condition characterized by persistent pain, functional limitations, and tendon thickening, often resulting from repetitive overuse or failed tendon healing. Left untreated, it can progress to tendon rupture, prolonged disability, and impaired quality of life. Management typically includes conservative therapies, such as physical therapy, corticosteroid (CS) injections for short-term relief, and platelet-rich plasma (PRP) as a regenerative therapy with potential long-term benefits.
View Article and Find Full Text PDFTech Hand Up Extrem Surg
January 2025
Department of Orthopaedics, Virginia Commonwealth University Health System, Central Virginia Veteran Affairs Health Care System, Richmond, VA.
Managing rerupture of the triceps brachii tendon after surgical repair is challenging due to poor tissue quality, retraction, and adhesions. This clinical scenario often requires augmentation with native tissue or tendon allografts. Traditional techniques include V-Y advancement, reinforced triceps advancement with double row or suture bridge fixation, and allograft tendon augmentation.
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