Repair of tendinopathic tendons

描述(申请人提供)：肌腱病，或退行性肌腱，每年影响数以百万计的美国人的职业和运动环境。肌腱病会引起疼痛和不适，影响工作表现，降低生活质量。尽管肌腱病的发病率很高，但目前的治疗方法并不能有效地恢复退行性肌腱的正常结构和功能。近年来，富含血小板血浆(PRP)已成为治疗肌腱病的热门选择，然而，PRP治疗是否有效在骨科/运动医学界仍存在巨大争议。该项目的总体目标是通过确定临床相关的PRP治疗，以及肌腱干细胞(TSCs)和工程化肌腱基质(ETM)在细胞、组织和功能水平上对经验证的兔腱病变模型的影响来解决这一问题。本项目的具体目的是：1)评价PRP治疗对注射PRP修复肌腱病态肌腱的影响；2)评价PRP治疗对肌腱病态肌腱修复的影响；3)评价加入ETM对肌腱病态肌腱修复的影响。鉴于PRP疗法在美国骨科/运动医学中被广泛用于肌腱病的治疗，这项研究具有非常重要的意义，尽管几乎没有可用的科学数据来支持或驳斥它的使用。这项研究也具有很高的创新性，因为将首次探索自然愈合生长因子(PRP)、肌腱特异性再生细胞(TSCs)和肌腱特异性基质(ETM)的有效组合，以促进肌腱病态肌腱的修复。我们预计，这项研究的结果将导致这种联合疗法在临床上的应用，以有效修复或可能再生肌腱病变，从而使仅在美国就有数百万肌腱病变患者受益。

DESCRIPTION (provided by applicant): Tendinopathy, or degenerative tendons, affects millions of Americans in both occupational and athletic settings each year. Tendinopathy causes pain and discomfort, impairs work performance, and reduces quality of life. In spite of its high prevalence, current treatments of tendinopathy are not effective in restoring normal structure and function to degenerated tendons. In recent years, platelet-rich plasma (PRP) has been a popular treatment option for tendinopathy; however, whether PRP treatment is effective remains a huge controversy in orthopaedic/sports medicine. The overall objective of this project is to address this issue by defining the effects of clinically-relevant PRP treatments, along with tendon stem cells (TSCs) and engineered tendon matrix (ETM), on a validated rabbit tendinopathy model at the cellular, tissue, and functional levels. The specific aims of this project are: 1) to evaluate the effects of PRP treatment on the repair of tendinopathic tendons by PRP injection; 2) to evaluate the effects of PRP treatment on the repair of tendinopathic tendons by implantation of PRP with TSCs; and 3) to evaluate the effects of adding ETM on the repair of tendinopathic tendons. This study is highly significant in light of the fact that PRP treatment is widely used in orthopaedic/sports medicine for tendinopathy treatment in the United States despite little available scientific data that support or refute its usages. This study is also highly innovative since a potent combination of natural healing growth factors (PRP), tendon-specific regenerative cells (TSCs), and tendon specific matrix (ETM) will be explored for the first time to enhance the repair of tendinopathic tendons. We anticipate that the findings of this study will lead to the application of this combination therapy clinically to effectively repair or possibly regenerate tendinopathic tendons, thus benefiting millions of tendinopathic patients in the United States alone.