Xu Hongtao, Zhu Yanlun, Xu Jiankun, Tong Wenxue, Hu Shiwen, Chen Yi-Fan, Deng Shuai, Yao Hao, Li Jie, Lee Chien-Wei, Chan Hon Fai
Musculoskeletal Research Laboratory, Department of Orthopedics and Traumatology The Chinese University of Hong Kong Hong Kong SAR China.
Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences The Chinese University of Hong Kong Hong Kong SAR China.
Bioeng Transl Med. 2022 Jun 3;8(1):e10345. doi: 10.1002/btm2.10345. eCollection 2023 Jan.
Tendon healing is a complex process involving inflammation, proliferation, and remodeling, eventually achieving a state of hypocellularity and hypovascularity. Currently, few treatments can satisfactorily restore the structure and function of native tendon. Bioactive glass (BG) has been shown to possess immunomodulatory and angiogenic properties. In this study, we investigated whether an injectable hydrogel fabricated of BG and sodium alginate (SA) could be applied to enhance tenogenesis following suture repair of injured tendon. We demonstrated that BG/SA hydrogel significantly accelerated tenogenesis without inducing heterotopic ossification based on histological analysis. The therapeutic effect could attribute to increased angiogenesis and M1 to M2 phenotypic switch of macrophages within 7 days post-surgery. Morphological characterization demonstrated that BG/SA hydrogel partially reverted the pathological changes of Achilles tendon, including increased length and cross-sectional area (CSA). Finally, biomechanical test showed that BG/SA hydrogel significantly improved ultimate load, failure stress, and tensile modulus of the repaired tendon. In conclusion, administration of an injectable BG/SA hydrogel can be a novel and promising therapeutic approach to augment Achilles tendon healing in conjunction with surgical intervention.
肌腱愈合是一个复杂的过程，涉及炎症、增殖和重塑，最终达到细胞减少和血管减少的状态。目前，很少有治疗方法能令人满意地恢复天然肌腱的结构和功能。生物活性玻璃（BG）已被证明具有免疫调节和血管生成特性。在本研究中，我们调查了由BG和海藻酸钠（SA）制成的可注射水凝胶是否可用于增强损伤肌腱缝合修复后的腱形成。基于组织学分析，我们证明BG/SA水凝胶显著加速了腱形成，且未诱导异位骨化。治疗效果可归因于术后7天内血管生成增加以及巨噬细胞从M1型向M2型的表型转变。形态学特征表明，BG/SA水凝胶部分逆转了跟腱的病理变化，包括长度和横截面积（CSA）增加。最后，生物力学测试表明，BG/SA水凝胶显著提高了修复肌腱的极限负荷、破坏应力和拉伸模量。总之，注射BG/SA水凝胶可能是一种与手术干预相结合增强跟腱愈合的新颖且有前景的治疗方法。
