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Review
. 2021 Feb 10;23(3):15.
doi: 10.1007/s11926-021-00981-4.

Metabolic Regulation of Tendon Inflammation and Healing Following Injury

Jessica E Ackerman #  1 , Katherine T Best #  1 , Samantha N Muscat  1 , Alayna E Loiselle  2
Affiliations
Review

Metabolic Regulation of Tendon Inflammation and Healing Following Injury

Jessica E Ackerman et al. Curr Rheumatol Rep. .

Abstract

Purpose of review: This review seeks to provide an overview of the role of inflammation and metabolism in tendon cell function, tendinopathy, and tendon healing. We have summarized the state of knowledge in both tendon and enthesis.

Recent findings: Recent advances in the field include a substantial improvement in our understanding of tendon cell biology, including the heterogeneity of the tenocyte environment during homeostasis, the diversity of the cellular milieu during in vivo tendon healing, and the effects of inflammation and altered metabolism on tendon cell function in vitro. In addition, the mechanisms by which altered systemic metabolism, such as diabetes, disrupts tendon homeostasis continue to be better understood. A central conclusion of this review is the critical need to better define fundamental cellular and signaling mechanisms of inflammation and metabolism during tendon homeostasis, tendinopathy, and tendon healing in order to identify therapies to enhance or maintain tendon function.

Keywords: Enthesis; Inflammation; Metabolism; Tendinopathy; Tendon; Tendon healing.

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Conflict of interest statement

Conflict of Interest

Jessica Ackerman, Katherine Best, Samantha Muscat and Alayna Loiselle declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Overview of the review. Section 1 summarizes the effects of inflammation and metabolic alterations on in vitro tendon cell function, with a particular emphasis on the role of inflammation-induced hypoxia and oxidative stress, as well as the impact of high glucose on tendon cell function. Section 2 summarizes the impact of inflammation on both the tendon enthesis and mid-substance tendinopathy, as well as how alterations in systemic metabolic function, including Diabetes can promote tendinopathy. Section 3 focuses on the effects of inflammation, including hypoxia, hyperoxia and oxidative stress on the healing process, and the effects of systemic metabolic disorders on the tendon healing process. This figure was created using Biorender.com.
Figure 2.
Figure 2.
Summary of the impact of Type II Diabetes on tendon homeostasis and healing of acute tendinopathy. This figure was created using Biorender.com.
See this image and copyright information in PMC

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