TY - JOUR
T1 - Local biochemical and morphological differences in human Achilles tendinopathy
T2 - a case control study
AU - Pingel, Jessica
AU - Fredberg, U.
AU - Qvortrup, Klaus
AU - Larsen, Jytte Overgaard
AU - Schjerling, Peter
AU - Heinemeier, Katja Maria
AU - Kjær, Michael
AU - Langberg, Henning
PY - 2012
Y1 - 2012
N2 - Background: The incidence of Achilles tendinopathy is high and underlying etiology as well as biochemical and morphological pathology associated with the disease is largely unknown. The aim of the present study was to describe biochemical and morphological differences in chronic Achilles tendinopathy. The expressions of growth factors, inflammatory mediators and tendon morphology were determined in both chronically diseased and healthy tendon parts. Methods. Thirty Achilles tendinopathy patients were randomized to an expression-study (n = 16) or a structural-study (n = 14). Biopsies from two areas in the Achilles tendon were taken and structural parameters: fibril density, fibril size, volume fraction of cells and the nucleus/cytoplasm ratio of cells were determined. Further gene expressions of various genes were analyzed. Results: Significantly smaller collagen fibrils and a higher volume fraction of cells were observed in the tendinopathic region of the tendon. Markers for collagen and its synthesis collagen 1, collagen 3, fibronectin, tenascin-c, transforming growth factor-β fibromodulin, and markers of collagen breakdown matrix metalloproteinase-2, matrix metalloproteinase-9 and metallopeptidase inhibitor-2 were significantly increased in the tendinopathic region. No altered expressions of markers for fibrillogenesis, inflammation or wound healing were observed. Conclusion: The present study indicates that an increased expression of factors stimulating the turnover of connective tissue is present in the diseased part of tendinopathic tendons, associated with an increased number of cells in the injured area as well as an increased number of smaller and thinner fibrils in the diseased tendon region. As no fibrillogenesis, inflammation or wound healing could be detected, the present data supports the notion that tendinopathy is an ongoing degenerative process.
AB - Background: The incidence of Achilles tendinopathy is high and underlying etiology as well as biochemical and morphological pathology associated with the disease is largely unknown. The aim of the present study was to describe biochemical and morphological differences in chronic Achilles tendinopathy. The expressions of growth factors, inflammatory mediators and tendon morphology were determined in both chronically diseased and healthy tendon parts. Methods. Thirty Achilles tendinopathy patients were randomized to an expression-study (n = 16) or a structural-study (n = 14). Biopsies from two areas in the Achilles tendon were taken and structural parameters: fibril density, fibril size, volume fraction of cells and the nucleus/cytoplasm ratio of cells were determined. Further gene expressions of various genes were analyzed. Results: Significantly smaller collagen fibrils and a higher volume fraction of cells were observed in the tendinopathic region of the tendon. Markers for collagen and its synthesis collagen 1, collagen 3, fibronectin, tenascin-c, transforming growth factor-β fibromodulin, and markers of collagen breakdown matrix metalloproteinase-2, matrix metalloproteinase-9 and metallopeptidase inhibitor-2 were significantly increased in the tendinopathic region. No altered expressions of markers for fibrillogenesis, inflammation or wound healing were observed. Conclusion: The present study indicates that an increased expression of factors stimulating the turnover of connective tissue is present in the diseased part of tendinopathic tendons, associated with an increased number of cells in the injured area as well as an increased number of smaller and thinner fibrils in the diseased tendon region. As no fibrillogenesis, inflammation or wound healing could be detected, the present data supports the notion that tendinopathy is an ongoing degenerative process.
KW - Achilles Tendon
KW - Biopsy
KW - Case-Control Studies
KW - Chi-Square Distribution
KW - Chronic Disease
KW - Collagenases
KW - Denmark
KW - Fibrillar Collagens
KW - Gene Expression Regulation
KW - Genetic Markers
KW - Humans
KW - Inflammation Mediators
KW - Intercellular Signaling Peptides and Proteins
KW - Microscopy, Electron, Transmission
KW - Polymerase Chain Reaction
KW - RNA, Messenger
KW - Tendinopathy
KW - Tissue Inhibitor of Metalloproteinases
U2 - 10.1186/1471-2474-13-53
DO - 10.1186/1471-2474-13-53
M3 - Journal article
C2 - 22480275
SN - 1471-2474
VL - 13
JO - B M C Musculoskeletal Disorders
JF - B M C Musculoskeletal Disorders
IS - 53
ER -