McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6081, United States.
J Biomech. 2012 Apr 30;45(7):1288-92. doi: 10.1016/j.jbiomech.2012.01.030. Epub 2012 Feb 28.
During neonatal development, tendons undergo a well orchestrated process whereby extensive structural and compositional changes occur in synchrony to produce a normal tissue. Conversely, during the repair response to injury, structural and compositional changes occur, but a mechanically inferior tendon is produced. As a result, developmental processes have been postulated as a potential paradigm for elucidation of mechanistic insight required to develop treatment modalities to improve adult tissue healing. The objective of this study was to compare and contrast normal development with injury during early and late developmental healing. Using backwards multiple linear regressions, quantitative and objective information was obtained into the structure-function relationships in tendon. Specifically, proteoglycans were shown to be significant predictors of modulus during early developmental healing but not during late developmental healing or normal development. Multiple independent parameters predicted percent relaxation during normal development, however, only biglycan and fibril diameter parameters predicted percent relaxation during early developmental healing. Lastly, multiple differential predictors were observed between early development and early developmental healing; however, no differential predictors were observed between late development and late developmental healing. This study presents a model through which objective analysis of how compositional and structural parameters that affect the development of mechanical parameters can be quantitatively measured. In addition, information from this study can be used to develop new treatment and therapies through which improved adult tendon healing can be obtained.
在新生儿发育过程中,肌腱经历了一个精心协调的过程,在此过程中,广泛的结构和组成变化同时发生,以产生正常组织。相反,在受伤后的修复反应中,会发生结构和组成变化,但产生的是机械性能较差的肌腱。因此,发育过程被认为是阐明开发改善成人组织愈合的治疗方法所需的机械洞察力的潜在范例。本研究的目的是比较和对比早期和晚期发育性愈合过程中的正常发育和损伤。通过向后多元线性回归,获得了肌腱结构-功能关系的定量和客观信息。具体而言,蛋白聚糖被证明是早期发育性愈合过程中模量的重要预测因子,但不是晚期发育性愈合或正常发育的重要预测因子。多个独立参数预测了正常发育过程中的松弛百分比,然而,只有核心蛋白聚糖和原纤维直径参数预测了早期发育性愈合过程中的松弛百分比。最后,在早期发育和早期发育性愈合之间观察到多个不同的预测因子;然而,在晚期发育和晚期发育性愈合之间没有观察到不同的预测因子。本研究提出了一种模型,通过该模型可以定量测量影响机械参数发育的组成和结构参数的客观分析。此外,本研究的信息可用于开发新的治疗方法和疗法,从而获得改善的成人肌腱愈合。