Xu Zihan, Hou Wenjing, Zhang Tao, Chen Rui, Skutella Thomas
Department of Neuroanatomy, Group for Regeneration and Reprogramming, Institute for Anatomy and Cell Biology, Medical Faculty, Heidelberg University, 69120, Heidelberg, Germany.
Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China.
J Orthop Translat. 2025 Mar 20;51:298-311. doi: 10.1016/j.jot.2025.02.003. eCollection 2025 Mar.
Despite the long healing duration of tendon injuries, the outcomes of repairs are frequently suboptimal, resulting in persistent pain and reduced functionality. Current clinical approaches to tendinopathy are primarily symptomatic, encompassing nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, physical therapies, surgical interventions, loading programs, and pain management. Yet, these treatments have protracted timelines and their efficacy remains uncertain. This uncertainty stems largely from an incomplete understanding of tendinopathy's pathogenesis. Unraveling the mechanisms behind tendinopathy is essential for devising novel therapeutic strategies. In this context, this review systematic reviewed more recent cellular and molecular literature in tendinopathy, in order to summarize the up-to-date advancements including the structure and composition of healthy tendons, the pathophysiological changes in tendinopathy, the molecular pathways implicated in various forms of the condition, and current effective treatment methods. This review not only aims to offer insights but also to inspire further investigation into the mechanisms and clinical management of tendinopathy.
A deficient understanding of the molecular mechanisms hampers the advancement of therapeutic strategies and drug development. Consequently, an in-depth examination of these molecular mechanisms is essential for comprehending the etiology of tendinopathy and for devising effective clinical management strategies.
尽管肌腱损伤的愈合时间很长,但修复结果往往不尽人意,导致持续疼痛和功能下降。目前针对肌腱病的临床方法主要是对症治疗,包括使用非甾体抗炎药(NSAIDs)、皮质类固醇注射、物理治疗、手术干预、负荷方案和疼痛管理。然而,这些治疗方法疗程漫长,其疗效仍不确定。这种不确定性很大程度上源于对肌腱病发病机制的不完全理解。阐明肌腱病背后的机制对于设计新的治疗策略至关重要。在此背景下,本综述系统回顾了肌腱病领域最新的细胞和分子文献,以总结最新进展,包括健康肌腱的结构和组成、肌腱病的病理生理变化、与各种形式病症相关的分子途径以及当前有效的治疗方法。本综述不仅旨在提供见解,还旨在激发对肌腱病机制和临床管理的进一步研究。
对分子机制的理解不足阻碍了治疗策略的进步和药物开发。因此,深入研究这些分子机制对于理解肌腱病的病因和制定有效的临床管理策略至关重要。