Mesenchymal Stem Cells From a Hypoxic Culture Improve and Engraft Achilles Tendon Repair

Huang, Tung-Fu; Yew, Tu-Lai; Chiang, En-Rung; Ma, Hsiao-Li; Hsu, Chih–Yuan; Hsu, Shan‐hui; Hsu, Yuan-Tong; Hung, Shih‐Chieh

doi:10.1177/0363546513480786

Cited by 76 publications

(70 citation statements)

References 47 publications

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“…The most important aspect of Achilles tendon injury is that they heal at a slower rate than other connective tissues because of the reduced cellular component of the tendon tissue. Therefore, various studies have attempted to accelerate Achilles tendon healing using drugs, cytokines and cell therapy [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The effect of administration of double stranded MicroRNA-210 on acceleration of Achilles tendon healing in a rat model

Usman

Nakasa

Shoji

et al. 2015

Journal of Orthopaedic Science

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Section: Introductionmentioning

confidence: 99%

The effect of administration of double stranded MicroRNA-210 on acceleration of Achilles tendon healing in a rat model

Usman

Nakasa

Shoji

et al. 2015

Journal of Orthopaedic Science

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“…In addition, when different factors are added they inhere the potential to differentiate into tenocytes [77][78][79][80][81][82] . Animal studies revealed that both, PRP and MSCs, have the potential to improve histological and biomechanical properties of regenerated tendons [29][30][31]71,72,75,[91][92][93]95,97,98 . Application of MSCs even resulted in regeneration of the enthesis in a rat model 7,91,92 .…”

Section: Discussionmentioning

confidence: 99%

“…An improved regeneration after application of MSCs could be observed in a rat achilles tendon defect model in several studies 95,97 . Furthermore, Schnabel et al revealed positive effects of autologous MSCs in tendinitis.…”

Section: Animal Studiesmentioning

confidence: 96%

Growth factor delivery vehicles for tendon injuries: Mesenchymal stem cells and Platelet Rich Plasma

Guevara-Álvarez

Schmitt

Russell

et al. 2014

MLTJ

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SummaryBackground: tendon tissue shows limited regeneration potential with formation of scar tissue and inferior mechanical properties. The capacity of several growth factors to improve the healing response and decrease scar formation is described in different preclinical studies. Besides the application of isolated growth factors, current research focuses on two further strategies to improve the healing response in tendon injuries: platelet rich plasma (PRP) and mesenchymal stem cells (MSCs). Objective: the present review focuses on these two options and describes their potential to improve tendon healing. Results: in vitro experiments and animal studies showed promising results for the use of PRP, however clinical controlled studies have shown a tendency of reduced pain related symptoms but no significant differences in overall clinical scores. On the other hand MSCs are not totally arrived in clinical use so that there is still a lack of randomized controlled trials. In basic research experiments they show an extraordinary paracrine activity, anti-inflammatory effect and the possibility to differentiate in tenocytes when different activating-factors are added. Conclusion: preclinical studies have shown promising results in improving tendon re-

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“…Huang et al found that failure load for the normoxic MSC group was 2.7 N/mm 2 at 4 weeks vs. 1.7 N/ mm 2 for untreated controls. Culturing MSCs in a hypoxic environment (1 % O 2 ) significantly more than doubled failure load (5.5 N/mm 2 ) relative to normoxic MSCs [103]. Okamoto also found MSCs to be more effective than bone marrow cells (BMCs).…”

Section: Stem Cells Bone Marrow Stem Cellsmentioning

confidence: 96%

“…Injections of MSCs into midsubstance Achilles tendon ruptures increased ultimate failure load in a rat model [103,104]. Huang et al found that failure load for the normoxic MSC group was 2.7 N/mm 2 at 4 weeks vs. 1.7 N/ mm 2 for untreated controls.…”

Section: Stem Cells Bone Marrow Stem Cellsmentioning

confidence: 99%

Biologic and Tissue Engineering Strategies for Tendon Repair

Sigal

Grande

Dines

et al. 2016

Regen. Eng. Transl. Med.

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This review summarizes recent developments in biologic treatments-including growth factors, platelet-rich plasma (PRP), stem cells, and cell-seeded scaffolds-for tendon repair. Growth and differentiation faction-5 (GDF-5), insulin-related growth factor-1 (IGF-1), and basic fibroblast growth factor (bFGF) all improved extracellular matrix (ECM) production and tensile strength of treated tendons; however, no clinical trials were done on GDF-5. Platelet-derived growth factor-BB (PDGF-BB) improved proliferation and ECM production, but did not consistently improve mechanical properties. The literature was mixed on the efficacy of PRP for the treatment of chronic and acute tendinopathies. However, PRP did cause any complications, and its benefits may be enhanced once an ideal, standardized composition is developed. Therefore, PRP may be a valid treatment, especially once nonsurgical management options have failed. Mesenchymal stem cells (MSCs) significantly and substantially improved the quality of tendon repairs and demonstrated the ability to regenerate an enthesis. Adipose-derived stem cells (ADSCs) have similar effects and are easier to harvest. The periosteum may also regenerate the tendon-bone attachment. Tenocytes, meanwhile, may be ideal for midsubstance tendon repairs. Cell-seeded scaffolds-especially ECMderived scaffolds-were demonstrated to improve ECM production, enhancing the healing abilities of tenocytes or stem cells while providing early mechanical support to healing tendons.Each of these treatments demonstrated enhanced healing compared to common surgical techniques; moreover, patient outcomes may be enhanced by combining these treatments. Lay SummaryTendon injuries are very prevalent and can be debilitating. Tendon heals poorly, and the scar tissue that forms is weak and susceptible to reinjury. A major focus of orthopedic research is regenerative medicine, encouraging the formation of healthy tendon rather than mechanically inferior scar tissue. This review summarizes the recent scientific literature on biologic treatments for tendon repair, such as growth factors, platelet-rich plasma, and stem cells. The purpose of which is to show which treatments are promising candidates for clinical use and research, helping to guide physicians and to lay out a path for future research.

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Mesenchymal Stem Cells From a Hypoxic Culture Improve and Engraft Achilles Tendon Repair

Abstract: The present study provides evidence that transplantation of hypoxic MSCs may be a promising therapy for the treatment of Achilles tendon ruptures.

Cited by 76 publications

References 47 publications

The effect of administration of double stranded MicroRNA-210 on acceleration of Achilles tendon healing in a rat model

The effect of administration of double stranded MicroRNA-210 on acceleration of Achilles tendon healing in a rat model

Growth factor delivery vehicles for tendon injuries: Mesenchymal stem cells and Platelet Rich Plasma

Biologic and Tissue Engineering Strategies for Tendon Repair

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