Abstract
Tendon tissues have limited healing capacity. The incidence of tendon injuries and the unsatisfactory functional outcomes of tendon repair are driving the search for alternative therapeutic approaches envisioning tendon regeneration. Cellular therapies aim at delivering adequate, regeneration-competent cell types to the injured tendon and toward ultimately promoting its reconstruction and recovery of functionality. Mesenchymal stem cells (MSCs) either obtained from tendons or from non-tendon sources, like bone marrow (BM-MSCs) or adipose tissue (ASCs), have been receiving increasing attention over the years toward enhancing tendon healing. Evidences from in vitro and in vivo studies suggest MSCs can contribute to accelerate and improve the quality of tendon healing. Nonetheless, the exact mechanisms underlying these repair events are yet to be fully elucidated. This review provides an overview of the main challenges in the field of cell-based regenerative therapies, discussing the role of MSCs in boosting tendon regeneration, particularly through their capacity to enhance the tenogenic properties of tendon resident cells.
Highlights
Cells are Nature’s tissue engineers, intervening, through a spatiotemporal coordinated manner, in tissue homeostasis, disease development, tissue repair/healing, and regeneration
These outcomes suggest a beneficial effect of BM-Mesenchymal stem cells (MSCs) secretome, which has been demonstrated to include several growth factors, cytokines and other soluble molecules intervening in cellular growth and/or maintenance and signal transduction processes [83]
Evidences from both in vitro and in vivo studies suggest that tendon resident cells, including tendon MSCs (TSPCs or tendon-derived stem cells (TDSCs)), may be the main orchestrators directing tendon-regenerative processes
Summary
Cells are Nature’s tissue engineers, intervening, through a spatiotemporal coordinated manner, in tissue homeostasis, disease development, tissue repair/healing, and regeneration. Despite the fact that different approaches can be considered, all rely on controlling to some extent cellular responses, which implies knowing the biology of the tIantr.gJ.eMtolt.iSscsi.u20e1.9, W20,ixtFhOinR PtEhEeR RhEuVmIEWan body, tendons are highly prone to fibrotic heal2inofg19through excessive and disorganized deposition of the extracellular matrix (ECM) [3]. This repair process is differentatiragleltys roefguanlaytesdtrabteetgwy eeennvifseitoanlinagndtisasduue ltretgeenndeorantiotins.suTehsus[,5–d7e]s.pite the fact that different. The cellular and molecular mechanisms intervening in tendon development, homeostasis and repair are still to be fully uncovered, it is evident that an interplay between biophysical and biochemical signals coordinates cellular function and impacts tenogenic differentiation of stem cells
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