Regenerative Tendon and Ligament Healing: Opportunities with Recombinant Human Platelet-Derived Growth Factor BB-Homodimer

Abstract

Intrinsic tendon healing in response to injury is a reparative process that often results in formation of scar tissue with functional and mechanical properties inferior to those of the native tendon. Development of therapies that can promote regenerative, rather than reparative, healing hold the promise of improving patient recovery from tendon and ligament injuries by producing tissue that is morphologically and functionally equivalent to the native tissue. One therapeutic approach that has been a frequent topic of investigation in the preclinical literature is the use of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to augment tendon and ligament repair. The chemotactic, mitogenic, and pro-angiogenic properties of rhPDGF-BB have been shown to result in recruitment and proliferation of tenogenic cells and a commensurate boost in extracellular matrix deposition and organization, improving the morphological and biomechanical properties of healing tendons and ligaments. The outcomes of the preclinical studies reviewed here strongly suggest that rhPDGF-BB will provide a new therapeutic opportunity to improve the treatment of injured tendons and ligaments.

Tendon Tissue Engineering and Its Role on Healing of the Experimentally Induced Large Tendon Defect Model in Rabbits: A Comprehensive In Vivo Study

“…The morphologic results were confirmed by the serum PDGF level. Positive correlation between the PDGF level and quality of the healing response and higher values of hydroxyproline has previously been reported [49]. Hee et al [49] showed that this growth factor is chemotactic, mitogenic, and pro-angiogenic.…”

Role of Embedded Pure Xenogenous Bovine Platelet Gel on Experimental Tendon Healing, Modelling and Remodelling

“…These beneficial results may also be due to the role of PDGFs [21,36]. Zhang and Wang [37] showed that PRPclot releasate, due to its growth factors, promotes differentiation of tendon stem cells into active tenocytes, exhibiting high proliferation rates and collagen production capability.…”

“…Various forms of platelets such as platelet-rich plasma, platelet fibrin glue or platelet gel and direct injection of pure platelets have been used to accelerate tendon healing in vivo [13][14][15][16][17][18]. Currently, platelets are the focus of many studies due to their growth factors [19][20][21]. Recent studies suggest that the healing efficacy of the platelets could be due to their ability to induce inflammation, which is important for tendon healing [13,16,[22][23][24].…”

“…CI-PDS-PG vs 18[14][15][16][17][18][19][20][21] CI-PDS vs 18.5[15][16][17][18][19][20][21][22] CI vs 28[24][25][26][27][28][29][30][31][32] Control , p \ 0.05) compared with those treated with artificial tendon (CI-PDS), collagen implant or left untreated (control, no implant).…”

Role of xenogenous bovine platelet gel embedded within collagen implant on tendon healing: an in vitro and in vivo study

“…In a review, Hee et al 39 stated that PDGF-BB is chemotactic, mitogenic, and pro-angiogenic. It regulates proliferation of tendon cells and induces extracellular matrix deposition and organization.…”