DiIorio Sarah E, Young Bill, Parker Jennifer B, Griffin Michelle F, Longaker Michael T
Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
Biomedicines. 2024 Apr 12;12(4):859. doi: 10.3390/biomedicines12040859.
Tendon regeneration has emerged as an area of interest due to the challenging healing process of avascular tendon tissue. During tendon healing after injury, the formation of a fibrous scar can limit tendon strength and lead to subsequent complications. The specific biological mechanisms that cause fibrosis across different cellular subtypes within the tendon and across different tendons in the body continue to remain unknown. Herein, we review the current understanding of tendon healing, fibrosis mechanisms, and future directions for treatments. We summarize recent research on the role of fibroblasts throughout tendon healing and describe the functional and cellular heterogeneity of fibroblasts and tendons. The review notes gaps in tendon fibrosis research, with a focus on characterizing distinct fibroblast subpopulations in the tendon. We highlight new techniques in the field that can be used to enhance our understanding of complex tendon pathologies such as fibrosis. Finally, we explore bioengineering tools for tendon regeneration and discuss future areas for innovation. Exploring the heterogeneity of tendon fibroblasts on the cellular level can inform therapeutic strategies for addressing tendon fibrosis and ultimately reduce its clinical burden.
由于无血管肌腱组织的愈合过程具有挑战性,肌腱再生已成为一个备受关注的领域。在肌腱损伤后的愈合过程中,纤维瘢痕的形成会限制肌腱强度并导致后续并发症。导致肌腱内不同细胞亚型以及身体不同肌腱发生纤维化的具体生物学机制仍然未知。在此,我们综述了目前对肌腱愈合、纤维化机制以及未来治疗方向的理解。我们总结了近期关于成纤维细胞在整个肌腱愈合过程中的作用的研究,并描述了成纤维细胞和肌腱的功能及细胞异质性。该综述指出了肌腱纤维化研究中的空白,重点在于表征肌腱中不同的成纤维细胞亚群。我们强调了该领域可用于增强我们对诸如纤维化等复杂肌腱病变理解的新技术。最后,我们探索用于肌腱再生的生物工程工具,并讨论未来的创新领域。在细胞水平上探索肌腱成纤维细胞的异质性可为解决肌腱纤维化的治疗策略提供依据,并最终减轻其临床负担。
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