Prospect of tissue-engineered tendons in clinical applications: how to improve mechanical properties, tissue integration and late-stage degradation

doi:10.3969/j.issn.2095-4344.2015.29.023

Abstract

Abstract:

BACKGROUND: Tissue-engineered tendons have been used to repair the damaged tendon tissue. Use of tissue-engineered tendons for repair of tendon injury has become a hot spot in this research field.
OBJECTIVE: To elaborate the types, advantages and disadvantages of seed cells, the design method, advantages and disadvantages of scaffold materials, and the factors that induced the formation of tendon, so as to promote the optimization of each joint, all of which benefit for mature construction of tissue-engineered tendons.
METHODS: The related reviews and paper reports of tendon tissue engineering published from January 2000 to January 2015 were retrieved from Chinese Biomedical Literature Database (CBM), China Knowledge Resources Database (CNKI) series database, Chinese Citation Database and PubMed database. The key words were “tissue engineering; tendon; tendon defect”. The research progress of seed cells, scaffold material and induction factors were analyzed.
RESULTS AND COMCLUSION: The recent research of tissue-engineered tendons for repair of tendon injury has
been summarized. Seed cells, scaffold, induction factors were discussed. Tendon stem cells, as a kind of seed cells, are currently the first choice in the process of tissue engineering tendon research, because tendon stem cells have the homology of the homogenous or autologous tendons and possess strong differentiation and proliferation capacities. However, there have been no systematic schemes regarding acquisition and proliferation and culture of tendon stem cells. The currently designed tissue-engineered tendons cannot meet the clinical requirements because of poor mechanical properties of tendon tissue, poor integration with the host tissue, being susceptible to degradation in late period and functional disuse. Induction factors are the laft key factors for tissue-engineered tendons for repair of tendon injury. The selection and use of induction factors are prerequisites for the regulation of tendon tissue development. But the categories of induction factors and the association and interrelationship between induction factors have not been fully clear and studies are needed to further investigate these uncertainties.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Tendons, Tendon Injuries, Stents, Stem Cells

CLC Number:

R318

Xu Peng-cheng, Wang Ji-hong, Wen Shu-zheng, Guo Wen. Prospect of tissue-engineered tendons in clinical applications: how to improve mechanical properties, tissue integration and late-stage degradation[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(29): 4710-4714.

Figures/Tables 1

References

[1] Caliari SR, Harley BA. Composite growth factor supplementation strategies to enhance tenocyte bioactivity in aligned collagen-GAG scaffolds. Tissue Eng Part A. 2013; 19(9-10):1100-1112.

[2] James R, Toti US, Laurencin CT, et al. Electrospun nanofibrous scaffolds for engineering soft connective tissues. Methods Mol Biol. 2011;726:243-258.

[3] Schmitt T, Fox PM, Woon CY, et al. Human flexor tendon tissue engineering: in vivo effects of stem cell reseeding. Plast Reconstr Surg. 2013;132(4):567e-576e.

[4] Gott M, Ast M, Lane LB, et al. Tendon phenotype should dictate tissue engineering modality in tendon repair: a review. Discov Med. 2011;12(62):75-84.

[5] Longo UG, Lamberti A, Maffulli N, et al. Tissue engineered biological augmentation for tendon healing: a systematic review. Br Med Bull. 2011;98:31-59.

[6] Nau T, Teuschl A. Regeneration of the anterior cruciate ligament: Current strategies in tissue engineering. World J Orthop. 2015;6(1):127-136.

[7] Benjamin M, Ralphs JR. The cell and developmental biology of tendons and ligaments. Int Rev Cytol. 2000;196: 85-130.

[8] Xu Y, Dong S, Zhou Q, et al. The effect of mechanical stimulation on the maturation of TDSCs-poly(L-lactide-co-e- caprolactone)/collagen scaffold constructs for tendon tissue engineering. Biomaterials. 2014;35(9):2760-2772.

[9] Cooper JA Jr, Bailey LO, Carter JN, et al. Evaluation of the anterior cruciate ligament, medial collateral ligament, achilles tendon and patellar tendon as cell sources for tissue-engineered ligament. Biomaterials. 2006; 27(13):2747-2754.

[10] Costa MA, Wu C, Pham BV, et al. Tissue engineering of flexor tendons: optimization of tenocyte proliferation using growth factor supplementation. Tissue Eng. 2006;12(7): 1937-1943.

[11] Liu H, Fan H, Toh SL, et al. A comparison of rabbit mesenchymal stem cells and anterior cruciate ligament fibroblasts responses on combined silk scaffolds. Biomaterials. 2008;29(10):1443-1453.

[12] 陈兵,丁小邦,刘方军,等.皮肤成纤维细胞构建组织工程化肌腱的初步研究[J].中华医学杂志,2002,82(16):1105-1107.

[13] Liu W, Chen B, Deng D, et al. Repair of tendon defect with dermal fibroblast engineered tendon in a porcine model. Tissue Eng. 2006;12(4):775-788.

[14] Filomeno P, Dayan V, Touriño C. Stem cell research and clinical development in tendon repair. Muscles Ligaments Tendons J. 2012;2(3):204-211.

[15] 宋阳,雷星.肌腱修复的组织工程研究进展[J].医学综述,2013, 19(9):1581-1583.

[16] Dressler MR, Butler DL, Boivin GP. Effects of age on the repair ability of mesenchymal stem cells in rabbit tendon. J Orthop Res. 2005;23(2):287-293.

[17] Tan Q, Lui PP, Rui YF, et al. Comparison of potentials of stem cells isolated from tendon and bone marrow for musculoskeletal tissue engineering. Tissue Eng Part A. 2012;18(7-8):840-851.

[18] Bassi G, Pacelli L, Carusone R, et al. Adipose-derived stromal cells (ASCs). Transfus Apher Sci. 2012;47(2):193-198.

[19] Yin Z, Chen X, Chen JL, et al. The regulation of tendon stem cell differentiation by the alignment of nanofibers. Biomaterials. 2010;31(8):2163-2175.

[20] Tan Q, Lui PP, Rui YF, et al. Comparison of potentials of stem cells isolated from tendon and bone marrow for musculoskeletal tissue engineering. Tissue Eng Part A. 2012; 18(7-8):840-851.

[21] Lui PP, Chan KM. Tendon-derived stem cells (TDSCs): from basic science to potential roles in tendon pathology and tissue engineering applications. Stem Cell Rev. 2011;7(4):883-897.

[22] Ni M, Rui YF, Tan Q, et al. Engineered scaffold-free tendon tissue produced by tendon-derived stem cells. Biomaterials. 2013;34(8):2024-2037.

[23] Deng D, Liu W, Xu F, et al. Engineering human neo-tendon tissue in vitro with human dermal fibroblasts under static mechanical strain. Biomaterials. 2009;30(35):6724-6730.

[24] Fang Q, Chen DL, Yang ZM, et al. In vitro and in vivo research on using Antheraea pernyi silk fibroin as tissue engineering tendon scaffolds. Mater Sci Eng C. 2009;29(5): 1527-1534.

[25] Ren J, Yu X, Ren T, et al. Preparation and characterization of fenofibrate-loaded PLA-PEG microspheres. J Mater Sci Mater Med. 2007;18(8):1481-1487.

[26] Kobayashi M, Toguchida J, Oka M. Development of polyvinyl alcohol-hydrogel (PVA-H) shields with a high water content for tendon injury repair. J Hand Surg Br. 2001;26(5):436-440.

[27] Teh TK, Goh JC, Toh SL. Comparative study of random and aliged nanofibrous scaffolds for tendon/ligament tissue engineering. J Biomech. 2008;41(Supplement 1):S527.

[28] Randall KL, Booth BA, Miller AJ, et al. Use of an acellular regenerative tissue matrix in combination with vacuum- assisted closure therapy for treatment of a diabetic foot wound. J Foot Ankle Surg. 2008;47(5):430-433.

[29] 倪栋.通用有限元分析ANSYS7.0实例精解[M].北京:电子工业出版社,2003.

[30] Nerurkar NL, Sen S, Baker BM, et al. Dynamic culture enhances stem cell infiltration and modulates extracellular matrix production on aligned electrospun nanofibrous scaffolds. Acta Biomater. 2011;7(2):485-491.

[31] Andarawis-Puri N, Flatow EL. Tendon fatigue in response to mechanical loading. J Musculoskelet Neuronal Interact. 2011; 11(2):106-114.

[32] Halper J, Kjaer M. Basic components of connective tissues and extracellular matrix: elastin, fibrillin, fibulins, fibrinogen, fibronectin, laminin, tenascins and thrombospondins. Adv Exp Med Biol. 2014;802:31-47.

[33] Legerlotz K, Jones GC, Screen HR, et al. Cyclic loading of tendon fascicles using a novel fatigue loading system increases interleukin-6 expression by tenocytes. Scand J Med Sci Sports. 2013;23(1):31-37.

[34] 雷星,曲彦隆,宋扬,等.循环动态拉力对体外组织工程肌腱的影响[J].中华骨科杂志,2014,34(10):1050-1057.

[35] Lutolf MP, Gilbert PM, Blau HM. Designing materials to direct stem-cell fate. Nature. 2009;462(7272):433-441.

[36] Ito Y, Toriuchi N, Yoshitaka T, et al. The Mohawk homeobox gene is a critical regulator of tendon differentiation. Proc Natl Acad Sci U S A. 2010;107(23):10538-10542.

[37] Liu W, Watson SS, Lan Y, et al. The atypical homeodomain transcription factor Mohawk controls tendon morphogenesis. Mol Cell Biol. 2010;30(20):4797-4807.

[38] Kimura W, Machii M, Xue X, et al. Irxl1 mutant mice show reduced tendon differentiation and no patterning defects in musculoskeletal system development. Genesis. 2011;49(1): 2-9.

[39] Anghileri E, Marconi S, Pignatelli A, et al. Neuronal differentiation potential of human adipose-derived mesenchymal stem cells. Stem Cells Dev. 2008;17(5): 909-916.

[40] Zaminy A, Ragerdi Kashani I, Barbarestani M, et al. Osteogenic differentiation of rat mesenchymal stem cells from adipose tissue in comparison with bone marrow mesenchymal stem cells: melatonin as a differentiation factor. Iran Biomed J. 2008;12(3):133-141.

[41] Gimble J, Guilak F. Adipose-derived adult stem cells: isolation, characterization, and differentiation potential. Cytotherapy. 2003;5(5):362-369.