Abstract
Although of several studies that associate chronic hyperglycemia with tendinopathy, the connection between morphometric changes as witnessed by magnetic resonance (MR) images, nanostructural changes, and inflammatory markers have not yet been fully established. Therefore, the present study has as a hypothesis that the Achilles tendons of rats with diabetes mellitus (DM) exhibit structural changes. The animals were randomly divided into two experimental groups: Control Group (n = 06) injected with a vehicle (sodium citrate buffer solution) and Diabetic Group (n = 06) consisting of rats submitted to intraperitoneal administration of streptozotocin. MR was performed 24 days after the induction of diabetes and images were used for morphometry using ImageJ software. Morphology of the collagen fibers within tendons was examined using Atomic Force microscopy (AFM). An increase in the dimension of the coronal plane area was observed in the diabetic group (8.583 ± 0.646 mm2/100g) when compared to the control group (4.823 ± 0.267 mm2/100g) resulting in a significant difference (p = 0.003) upon evaluating the Achilles tendons. Similarly, our analysis found an increase in the size of the transverse section area in the diabetic group (1.328 ± 0.103 mm2/100g) in comparison to the control group (0.940 ± 0.01 mm2/100g) p = 0.021. The tendons of the diabetic group showed great irregularity in fiber bundles, including modified grain direction and jagged junctions and deformities in the form of collagen fibrils bulges. Despite the morphological changes observed in the Achilles tendon of diabetic animals, IL1 and TNF-α did not change. Our results suggest that DM promotes changes to the Achilles tendon with important structural modifications as seen by MR and AFM, excluding major inflammatory changes.
Highlights
Tendinopathy is a major health problem in people older than 25 years
Qualitative analysis of in vivo magnetic resonance (MR) images before and after gadolinium injection In the qualitative evaluation of the macroscopic organization of the tendons of the control group no changes were noted in the control group (0/6)
It is important to stress that the fibrils with structural changes were not measured, as they frequently did not present a nano-structure organized in a uniaxial plane or sometimes had rupture of the fibrils and absence of the rings, which did not occur in the healthy group (S1 Fig)
Summary
The main symptom is pain in the tendon that undermines performance This typically results from excessive use, the severity depending on the magnitude, frequency and duration of the stimulus overloading the tendon [1]. The tendon, in the presence of pathological processes, shows altered morphology In most cases, it is characterized by intratendinous degeneration and disorganization of collagen fibers. An increase in production of collagen fibers occurs; due to their disorganized pattern, the tendon fibers are friable and prone to premature rupture [5,6]. It is the characteristic of stress that may result in tendon injury [7,8]
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