Purpose
Tendons are difficult to heal owing to their hypocellularity and hypovascularity.
Our laboratory has developed a tendon-derived hydrogel (tHG) that significantly improves
tendon healing in an animal model. We hypothesized that a potential mechanism for
improved healing with tHG is through the attraction of systemic stem cells.
Methods
Homing of systemic adipose-derived stem cells (ADSCs) to tendon injuries was assessed
with acute and chronic injury models. Injury sites were treated with saline or tHG,
and animals given a tail vein injection (TVI) of labeled ADSCs 1 week after treatment.
One week following TVI, rats were harvested for histology. To further evaluate a potential
difference in homing to tHG, a subcutaneous injection (SQI) model was used. Rats were
treated with an SQI of saline, silicone, ADSCs in media, tHG, tHG + fibroblasts (FBs),
or tHG + ADSCs on day 0. One week after SQI, rats underwent TVI with labeled ADSCs.
Samples were harvested 2 or 3 weeks after SQI for analysis. Flow cytometry confirmed
homing in the SQI model.
Results
Systemically delivered ADSCs homed to both acute tendon and chronic tendon-bone interface
(TBI) injury sites. Despite their presence at the injury site, there was no difference
in the number of macrophages, amount of cell proliferation, or angiogenesis 1 week
after stem cell delivery. In an SQI model, ADSCs homed to tHG. There was no difference
in the number of ADSCs homing to tHG alone versus tHG + ADSCs. However, there was
an increase in the number of living cells, general immune cells, and T-cells present
at tHG + ADSC versus tHG alone.
Conclusions
The ADSCs home to tendon injury sites and tHG. We believe the attraction of additional
systemic ADSCs is one mechanism for improved tendon and TBI healing with tHG.
Clinical relevance
Treatment of tendon and TBI injuries with tHG can augment healing via homing of systemic
stem cells.
Key words
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Article info
Publication history
Published online: June 27, 2020
Accepted:
May 7,
2020
Received:
August 17,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
