Application of Tendon Stem/Progenitor Cells and Platelet-Rich Plasma to Treat Tendon Injuries

Abstract

Tendon injuries like tendinopathy are a serious healthcare problem in the United States. However, current treatments for tendon injuries are largely palliative. Biologics treatments, including tendon stem/progenitor cells (TSCs) and platelet rich plasma (PRP) hold great potential to effectively treat tendon injuries. TSCs are tendon specific stem cells and have the ability to differentiate into tenocytes, the resident tendon cells responsible for tendon homeostasis and tendon repair in case of an injury. TSCs can also self-renew and thus can replenish the tendon with tendon cells (TSCs and tenocytes) to maintain a healthy tendon. The action of PRP can be complementary; PRP can augment and accelerate tendon healing by supplying abundant growth factors contained in platelets, and fibrin matrix, which functions as a natural conducive scaffold to facilitate tissue healing. This article provides a summary of the findings in recent basic and clinical studies on the applications of TSCs and PRP to the treatment of tendon injuries. It also outlines the challenges facing their applications in clinical settings. In particular, the controversy surrounding the efficacy of PRP treatment for tendon injuries are analyzed and solutions are suggested.

Biologics and stem cell‐based therapies for rotator cuff repair

“…Collectively, these two stem cell types have been differentiated into almost every connective tissue lineage, including bone, cartilage, tendon, and the intervertebral disk . More recently, cells with self‐renewal capacity, clonogenicity, and multilineage potential have been isolated from tendon tissue . In the original characterization of these tendon stem/progenitor cells (TSPCs), it was suggested that these cells may reside within the tendon proper and comprise a subpopulation of tenocytes .…”

“…[97][98][99][100][101] More recently, cells with self-renewal capacity, clonogenicity, and multilineage potential have been isolated from tendon tissue. [102][103][104][105][106] In the original characterization of these tendon stem/progenitor cells (TSPCs), it was suggested that these cells may reside within the tendon proper and comprise a subpopulation of tenocytes. 102 Other studies, however, suggest that TSPCs may be located within the epitenon, which is the thin epithelial layer surrounding all tendons.…”

Current State for Clinical Use of Stem Cells and Platelet-Rich Plasma

“…8.3) [59]. Clinical trials have studied the effects of PRP injection as a primary treatment or augmentation of current therapies for patellar tendinopathy, Achilles tendinosis, and lateral epicondylitis [60].…”

“…MSCs hold promise in the use of tendinopathy [60]. As ongoing and future research advances our understanding of tendinopathy basic science, the role of angiogenesis in tendon healing, and the link between histology and clinical findings, the use of MSCs will likely continue to play an increasing role in treatment of this common yet often recalcitrant pathology.…”

Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis.

“…This therapy is widely experimented in different fields of medicine to test its potential role to enhance tissue re-generation [13][14][15][16][17]. In a recent non-controlled prospective trial, the safety, toler -Fig 1. a) Free-hand technique with US probe placed parallel to the femur neck; b) sagittal US showing synovium/capsule (long arrow), the needle situated in the articulation (three short arrows), and the femoral head (H); c) PRP ultrasound-guided IA injections ability and efficacy of PRP IA injections have been the subject of a preliminary report on 40 hip OA patients at 7 weeks' and 6 months' follow-up [18].…”