Abstract

Diseased and injured tendons develop fibrosis, driven by factors including TGF-β, BMPs and CTGF. IL-1β and its signal transducer Erk1/2 are known to regulate TGF-β expression in animal tendons. We utilised tissues and cells isolated from patients with shoulder tendon tears and tendons of healthy volunteers to advance understanding of how inflammation induces fibrosis in diseased human tendons. ERK1/2 expression was reduced in torn (diseased) compared to healthy patient tendon tissues. We next investigated the fibrotic responses of tendon-derived cells isolated from healthy and diseased human tendon tissues in an inflammatory milieu. IL-1β treatment induced profound ERK1/2 signalling, TGFB1 and BMP2 mRNA expression in diseased compared to healthy tendon-derived cells. In the diseased cells, the ERK1/2 inhibitor (PD98059) completely blocked the IL-1β-induced TGFB1 and partially reduced BMP2 mRNA expression. Conversely, the same treatment of healthy cells did not modulate IL-1β-induced TGFB1 or BMP2 mRNA expression. ERK1/2 inhibition did not attenuate IL-1β-induced CTGF mRNA expression in healthy or diseased tendon cells. These findings highlight differences between ERK1/2 signalling pathway activation and expression of TGF-β1 and BMP-2 between healthy and diseased tendon tissues and cells, advancing understanding of inflammation induced fibrosis during the development of human tendon disease and subsequent repair.

Highlights

  • Diseased and injured tendons develop fibrosis, driven by factors including TGF-β, bone morphogenetic proteins (BMPs) and connective tissue growth factor (CTGF)

  • Having shown diminished tissue expression of active ERK1/2 in diseased tendon tissues, we investigated whether IL-1β treatment induces ERK1/2 signalling pathway activation in tendon-derived cells of healthy and torn supraspinatus tendons in an in vitro cell culture model

  • This study shows for the first time that diseased human tendon-derived cells exhibit dysregulated gene expression of fibrotic mediators in response to IL-1β treatment compared to healthy tendon-derived cells

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Summary

Introduction

Diseased and injured tendons develop fibrosis, driven by factors including TGF-β, BMPs and CTGF. Transforming growth factor beta (TGF-β) and its closely related growth factors including connective tissue growth factor (CTGF) and bone morphogenetic proteins (BMPs) have important roles in cell proliferation, differentiation and ECM metabolism[11,12] These factors are implicated as mediators of fibrosis by studies of fibrotic diseases in other organs. To date no studies have investigated how inflammatory cytokines regulate fibrotic mediators including TGF-β, CTGF and BMP during the development of a human tendon disease and subsequent repair. The aim of this study was to identify the mechanism by which inflammatory cytokines regulate fibrotic mediators including TGF-β, CTGF and BMP in tendon-derived cells of healthy and diseased patient tissues. We hypothesised that the ERK1/2 signalling pathway regulates IL-1β-induced expression of these fibrotic mediators in tendon-derived cells isolated from patients with end-stage torn rotator cuff tendons

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