Abstract
Tendons are remarkable tissues that transmit force from muscle to bone during joint movement. They are remarkable because they withstand tensile forces that are orders of magnitude greater than can be withstood by isolated cells. The ability of the cells to survive is directly attributable to the stress shielding properties of the collagen-rich extracellular matrix of the tissue. A further remarkable feature is that the vast majority (>98%) of the collagen is never turned over; it is synthesized during embryonic through early adult development and persists for the lifetime of the person. How the collagen is synthesized, and importantly, how it is protected from fatigue failure for decades of countless loading cycles, remains a mystery. A recent discovery is that tendons are peripheral circadian clock tissues in which the expression of ~5% of the transcriptome is rhythmic during 24h. Evidence is emerging that a fraction of the total amount of collagen is synthesized and removed on a daily basis without being incorporated into the lifelong permanent collagen. This review provides some of the background, and summarizes the findings, of these latest discoveries. Detailed descriptions of tendon development, collagen synthesis and collagen fibrillogenesis can be found in excellent reviews (cited here) and will not be a major part of this review.
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