Progress with stem cell therapies for tendon tissue regeneration

ABSTRACT

Introduction

Chronic musculoskeletal pain is very prevalent, and accounts for major health-care expenses. Many of the present therapeutic modalities are only partially effective, and great interest is now posed on regenerative medicine.

Areas covered

The authors discuss the role of a variety of regenerative medicine options to induce and favor regeneration and healing of tendon tissue, focusing on the role of mesenchymal stem cell therapy and their derivatives.

Expert opinion

Stem cells, tissue engineering, and growth factors are new strategies for tendon repair and regeneration. MSCs not only can differentiate in tendon cells, but also secrete several cytokines that modulate inflammation and tissue healing. Future studies should be undertaken to overcome current obstacles to clinical translation. Further investigation of cell source, isolation, expansion, and differentiation methods, characterization of the tenogenic differentiation pathways, and clarifications of tendon-specific molecular markers are required. The role of donor variability, tendon type, and anatomic location also requires further understanding and research.

KEYWORDS:

• Regenerative medicine
• tendon
• tendinopathy
• mesenchymal stem cells
• tissue engineering

Article highlights

• The management of tendon healing is challenging and often leads tosuboptimal outcomes

• The regeneration balance of tendon injuries is highly in favor of fibrotic healing, compromising the biomechanical proprieties, elasticity, and promoting adherences

• Mesenchymal stem cells yield growing interest for tendon repair and regeneration.

• MSCs not only can differentiate in tendon cells, but also secrete several cytokines that modulate inflammation, enhancing a regenerative tissue healing.

• Future studies should be undertaken to overcome current obstacles to clinical translation: (1) cells source, isolation, expansion and differentiation methods, (2) characterization of the tenogenic differentiation pathways, (3) clarification of tendon-specific molecular markers and (4) the role of donor variability, tendon type, and anatomic location.

This box summarizes the key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper is not funded.