Repair of tendinopathic tendons

描述（由申请人提供）：肌腱病或退行性肌腱，每年影响数百万美国人的职业和运动环境。肌腱病导致疼痛和不适，损害工作表现，并降低生活质量。尽管其患病率很高，但目前对肌腱病的治疗不能有效地恢复退化肌腱的正常结构和功能。近年来，富血小板血浆（PRP）已成为肌腱病的流行治疗选择;然而，PRP治疗是否有效仍然是骨科/运动医学中的一个巨大争议。本项目的总体目标是通过在细胞、组织和功能水平上确定临床相关PRP治疗（沿着肌腱干细胞（TSC）和工程化肌腱基质（ETM））对经验证的兔肌腱病模型的影响来解决这一问题。本项目的具体目的是：1）通过PRP注射评价PRP治疗对肌腱病变肌腱修复的影响; 2）通过植入PRP和TSC评价PRP治疗对肌腱病变肌腱修复的影响; 3）评价添加ETM对肌腱病变肌腱修复的影响。鉴于PRP治疗在美国广泛用于肌腱病治疗的骨科/运动医学，尽管支持或反驳其用途的可用科学数据很少，本研究具有高度意义。这项研究也是高度创新的，因为将首次探索天然愈合生长因子（PRP），肌腱特异性再生细胞（TSC）和肌腱特异性基质（ETM）的有效组合，以增强肌腱病变肌腱的修复。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，以有效地修复或可能再生肌腱病肌腱，从而使数百万肌腱病患者受益。

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.