Review of the vascularisation of the human Achilles tendon

Theobald, Peter; Benjamin, M.; Nokes, Leonard Derek Martin; Pugh, Neil D.

doi:10.1016/j.injury.2005.02.012

Cited by 78 publications

(52 citation statements)

References 25 publications

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“…Rat TDSCs expressed α-SMA, suggesting their possible relationship to perivascular cells [8]. However, it should be noted that tendon is relatively avascular and receives its blood supply mainly from the endotendon and paratendon [51], whereas TDSCs were isolated from the tendon mid-substance after removing all the peritendinous connective tissues [8,14]. Indeed, the stem/precursor cellrelated markers such as nestin and Musashi-1 were expressed in tendon cells embedded in the dense ECM besides the perivascular region [48].…”

Section: Physiological Nichementioning

confidence: 96%

Tendon-Derived Stem Cells (TDSCs): From Basic Science to Potential Roles in Tendon Pathology and Tissue Engineering Applications

Lui

Chan

2011

Stem Cell Rev and Rep

140

119

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Traditionally, tendons are considered to only contain tenocytes that are responsible for the maintenance, repair and remodeling of tendons. Stem cells, which are termed tendon-derived stem cells (TDSCs), have recently been identified in tendons. This review aims to summarize the current information about the in vitro characteristics of TDSCs, including issues related to TDSC isolation and culture, their cell morphology, immunophenotypes, proliferation and differentiation characteristics and senescence during in vitro passaging. The challenges in studying the functions of these cells are also discussed. The niche where TDSCs resided essentially provides signals that are conducive to the maintenance of definitive stem cell properties of TDSCs. Yet the niche may also induce pathologies by imposing an aberrant function on TDSCs or other targets. The possible niche factors of TDSCs are herein discussed. We presented current evidences supporting the potential pathogenic role of TDSCs in the development of tendinopathy with reference to the recent findings on the altered biological responses of these cells in response to their potential niche factors. The use of resident stem cells may promote engraftment and differentiation of transplanted cells in tendon and tendon-bone junction repair because the tendon milieu is an ideal and familiar environment to the transplanted cells. Evidences are presented to show the potential advantages and results of using TDSCs as a new cell source for tendon and tendon-bone junction repair. Issues pertaining to the use of TDSCs for tissue repair are also discussed.

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Section: Physiological Nichementioning

confidence: 96%

Tendon-Derived Stem Cells (TDSCs): From Basic Science to Potential Roles in Tendon Pathology and Tissue Engineering Applications

Lui

Chan

2011

Stem Cell Rev and Rep

140

119

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“…Despite numerous published studies over the past 50 years describing the blood supply of the Achilles tendon (Lagergren and Lindholm, 1959;Langberg et al, 1972;Carr and Norris, 1989;Niculescu and Matusz, 1988;Schmidt-Rohlfing et al, 1992;Karcz et al, 1996;Sanz-Hospital et al, 1997;Langberg et al, 1998;Taylor and Pan, 1998;Zantop et al, 2003;Theobald et al, 2005;Attinger et al, 2006), there has been no uniformity in describing its topography. In fact, despite these previous works, no previous studies have explored how the Achilles tendon is supplied, and rather the assumption has been made that it is supplied evenly and equally from its two source arteries.…”

Section: Introductionmentioning

confidence: 99%

The arterial anatomy of the Achilles tendon: Anatomical study and clinical implications

et al. 2009

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The Achilles tendon is the most frequently ruptured tendon in the lower limb and accounts for almost 20% of all large tendon injuries. Despite numerous published studies describing its blood supply, there has been no uniformity in describing its topography. The current study comprises a detailed anatomical study of both the intrinsic and extrinsic arterial supply of the Achilles tendon, providing the detail sought from studies calling for improved planning of surgical procedures where damage to the vascularity of the Achilles tendon is likely. A dissection, microdissection, histological, and angiographic study was undertaken on 20 cadaveric lower limbs from 16 fresh and four embalmed cadavers. The Achilles tendon is supplied by two arteries, the posterior tibial and peroneal arteries. Three vascular territories were identified, with the midsection supplied by the peroneal artery, and the proximal and distal sections supplied by the posterior tibial artery. The midsection of the Achilles tendon was markedly more hypovascular that the rest of the tendon. The Achilles tendon is at highest risk of rupture and surgical complications at its midsection. Individuals with particularly poor supply of the midsection may be at increased risk of tendon rupture, and approaches to the tendon operatively should consider the route of supply by the peroneal artery to this susceptible part of the tendon.

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“…For tendons, there was also evidence that the vasculature of tendon tissue might harbor stem cells [13]. However, tendon mid-substance is hypovascular compared with other tissues and receives its blood supply mainly from the endotenon and paratenon [14]. TDSCs isolated from the tendon mid-substance, while positive for alpha smooth muscle actin [5], were not positive for other pericyte-related markers [3,15].…”

mentioning

confidence: 99%

In Vivo Identity of Tendon Stem Cells and the Roles of Stem Cells in Tendon Healing

Tan

Lui

Lee

2013

Stem Cells and Development

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We investigated the spatial distribution of stem cells in tendons and the roles of stem cells in early tendon repair. The relationship between tendon-derived stem cells (TDSCs) isolated in vitro and tendon stem cells in vivo was also explored. Iododeoxyuridine (IdU) label-retaining method was used for labeling stem cells in rat patellar tendons with and without injury. Co-localization of label-retaining cells (LRCs) with different markers was done by immunofluorescent staining. TDSCs were isolated from patellar tendon mid-substance after IdU pulsing, and the expression of different markers in fresh and expanded cells was done by immunofluorescent staining. More LRCs were found at the peritenon and tendon-bone junction compared with the mid-substance. Some LRCs at the peritenon were located at the perivascular niche. The LRC number and the expression of proliferative, tendon-related, pluripotency, and pericyte-related markers in LRCs in the window wound increased. Most of the freshly isolated TDSCs expressed IdU, and some TDSCs expressed pericyte-related markers, which were lost during expansion. Both freshly isolated and subcultured TDSCs expressed pluripotency markers, which were absent in LRCs in intact tendons. In conclusion, we identified LRCs at the peritenon, mid-substance, and tendon-bone junction. There were both vascular and non-vascular sources of LRCs at the peritenon, while the source of LRCs at the mid-substance was non-vascular. LRCs participated in tendon repair via migration, proliferation, activation for tenogenesis, and increased pluripotency. Some LRCs in the window wound were pericyte like. Most of the mid-substance TDSCs were LRCs. The pluripotency markers and pericyte-related marker in LRCs might be important for function after injury. Recently, stem/progenitor cells have been isolated from tendon tissues of varies species, including human, horse, rabbit, rat, and mouse [3][4][5][6]. These stem/progenitor cells isolated from tendon tissues exhibited self-renewal and multilineage differentiation potential [3][4][5][6]. Since the origin and identity of these cells were not clear, we called them tendon-derived stem cells (TDSCs) to indicate only the tissue from which the cells were isolated [5].Many studies suggested that the wall of capillaries, small vessels, and large vessels harbored stem/progenitor cells [7][8][9][10][11]. Some studies further suggested that mesenchymal stem cells (MSCs) were derived from pericytes [9,12].Pericytes/perivascular cells from a variety of tissues were reported to exhibit characteristics that were strikingly similar to those of MSCs [7][8][9][10][11]. For tendons, there was also evidence that the vasculature of tendon tissue might harbor stem cells [13]. However, tendon mid-substance is hypovascular compared with other tissues and receives its blood supply mainly from the endotenon and paratenon [14]. TDSCs isolated from the tendon mid-substance, while positive for alpha smooth muscle actin [5], were not positive for other pericyte-related markers [3,15]. Tend...

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Review of the vascularisation of the human Achilles tendon

Cited by 78 publications

References 25 publications

Tendon-Derived Stem Cells (TDSCs): From Basic Science to Potential Roles in Tendon Pathology and Tissue Engineering Applications

Tendon-Derived Stem Cells (TDSCs): From Basic Science to Potential Roles in Tendon Pathology and Tissue Engineering Applications

The arterial anatomy of the Achilles tendon: Anatomical study and clinical implications

In Vivo Identity of Tendon Stem Cells and the Roles of Stem Cells in Tendon Healing

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