Julius Wolff Institute, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany.
Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
Int J Mol Sci. 2018 Jan 30;19(2):404. doi: 10.3390/ijms19020404.
Reasons for the development of chronic tendon pathologies are still under debate and more basic knowledge is needed about the different diseases. The aim of the present study was therefore to characterize different acute and chronic Achilles tendon disorders. Achilles tendon samples from patients with chronic tendinopathy ( = 7), chronic ruptures ( = 6), acute ruptures ( = 13), and intact tendons ( = 4) were analyzed. The histological score investigating pathological changes was significantly increased in tendinopathy and chronic ruptures compared to acute ruptures. Inflammatory infiltration was detected by immunohistochemistry in all tendon pathology groups, but was significantly lower in tendinopathy compared to chronic ruptures. Quantitative real-time PCR (qRT-PCR) analysis revealed significantly altered expression of genes related to collagens and matrix modeling/remodeling (matrix metalloproteinases, tissue inhibitors of metalloproteinases) in tendinopathy and chronic ruptures compared to intact tendons and/or acute ruptures. In all three tendon pathology groups markers of inflammation ( () , , , , , , , ), inflammatory cells ( () , , , ), fat metabolism (, , , ), and innervation , , ) were detectable, but only in acute ruptures significantly regulated compared to intact tendons. The study gives an insight into structural and molecular changes of pathological processes in tendons and might be used to identify targets for future therapy of tendon pathologies.
慢性肌腱病的发病原因仍存在争议，需要更多关于不同疾病的基础知识。因此，本研究的目的是描述不同的急性和慢性跟腱疾病。对患有慢性肌腱病（=7）、慢性跟腱断裂（=6）、急性跟腱断裂（=13）和完整肌腱（=4）的患者的跟腱样本进行了分析。研究发现，与急性跟腱断裂相比，肌腱病和慢性跟腱断裂患者的组织学评分显著升高，表明存在病理性变化。免疫组织化学检测到所有肌腱病理组均存在炎症浸润，但与慢性跟腱断裂相比，肌腱病患者的炎症浸润程度较低。实时定量 PCR（qRT-PCR）分析显示，与完整肌腱和/或急性跟腱断裂相比，肌腱病和慢性跟腱断裂患者的胶原和基质建模/重塑相关基因（基质金属蛋白酶、金属蛋白酶组织抑制剂）的表达显著改变。在所有三组肌腱病理组中，炎症标志物（()、()、()、()、()、()、()、()）、炎症细胞（()、()、()）、脂肪代谢（()、()、()）和神经支配（()、()、()）均可见，但与完整肌腱相比，仅在急性跟腱断裂组中显著调节。本研究深入了解了肌腱病理过程的结构和分子变化，可为未来的肌腱病治疗提供靶点。
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