Therapeutic Effects of Doxycycline on the Quality of Repaired and Unrepaired Achilles Tendons

Abstract

The inhibition of MMPs at the optimal stage of the repair process may accelerate Achilles tendon repair and improve biomechanical properties, especially when paired with surgical management.

Efficacy of Combining PRP and MMP Inhibitors in Treating Moderately Damaged Tendons Ex Vivo

“…Inhibiting MMPs (broadly and selectively) has also been considered as a therapeutic option for tendinopathy . However, in this study, MMPIs (either NI or BI) alone did not improve the biomechanical or histological properties of tendons.…”

“…However, in this study, MMPIs (either NI or BI) alone did not improve the biomechanical or histological properties of tendons. It should be noted that most of the studies that reported beneficial effects of MMPIs on tendon healing were conducted in vivo with tendinopathy created through surgical intervention . This condition might explain the difference between our results and those studies.…”

“…Therefore, inhibiting MMPs has been considered a potential healing approach to stop the pathological process of tendinopathy. Greater collagen organization, as well as a reduction in collagen degradation, limited MMP activity, and increased mechanical strength, have been reported as effects of the use of broad‐spectrum matrix MMPIs (BI; e.g., doxycycline and ɑ‐2‐macroglobulin) in surgically induced tendinopathy models. MMPIs have also been used in clinical trials to improve tendon healing: The most common conditions that have been treated by injection of the MMPI aprotinin in clinics are Achilles, patellar, and hamstring tendinopathies .…”

<p>Doxycycline-Embedded Nanofibrous Membranes Help Promote Healing of Tendon Rupture</p>

“…[12][13][14][15][16][17] Inhibition of matrix metalloproteinase (MMP) has been the treatment of choice for tendinopathy. [18][19][20][21] Systemic daily administration of doxycycline orally has been demonstrated to improve collagen fibril organization through inhibition of local MMP activity, which accelerates matrix remodeling, increases equilibrium modulus, and decreases creep strain of surgically repaired Achilles tendons in rats. [20][21][22] Common side effects of doxycycline include esophageal erosion, heartburn, nausea, vomiting, diarrhea, and gastritis.…”

“…[18][19][20][21] Systemic daily administration of doxycycline orally has been demonstrated to improve collagen fibril organization through inhibition of local MMP activity, which accelerates matrix remodeling, increases equilibrium modulus, and decreases creep strain of surgically repaired Achilles tendons in rats. [20][21][22] Common side effects of doxycycline include esophageal erosion, heartburn, nausea, vomiting, diarrhea, and gastritis. 23 This may reflect patients' inability to tolerate the high systemic drug concentrations required to achieve adequate exposure of the drug at the target site.…”