Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug;52(2):70.
doi: 10.3892/ijmm.2023.5273. Epub 2023 Jun 30.

Mesenchymal stem cells: An efficient cell therapy for tendon repair (Review)

Li Jiang #  1 , Jingwei Lu #  1 , Yixuan Chen  1 , Kexin Lyu  1 , Longhai Long  2 , Xiaoqiang Wang  2 , Tianzhu Liu  3 , Sen Li  4
Affiliations
Review

Mesenchymal stem cells: An efficient cell therapy for tendon repair (Review)

Li Jiang et al. Int J Mol Med. 2023 Aug.

Abstract

Tendon injury is a common disorder of the musculoskeletal system caused by overuse or trauma. With increasing incidence of tendon injuries, it is necessary to find an effective treatment. Mesenchymal stem cells (MSCs) are attracting attention because of their high proliferative and self‑renewal capacity. These functions of MSCs show promise in treating a variety of diseases, including immune and musculoskeletal system disorder and cardiovascular disease, and show especially satisfactory effects in the treatment of tendon injury. First, since MSCs have multidirectional differentiation potential, they differentiate into specific cells after induction in vivo and in vitro. Furthermore, MSCs have paracrine functions and can secrete biologically active molecules and exosomes such as cytokines, growth factors and chemokines to promote tissue repair and regeneration. In tendon injury, MSCs promote tendon repair through four mechanisms: Decreasing inflammation and promoting neovascularization and cell proliferation and differentiation. They are also involved in extracellular matrix reorganization by promoting collagen production and transforming type III collagen fibers to type I collagen fibers. The present review summarized preclinical experiments with different sources of MSCs and their mechanisms in tendon repair, as well as the limitations of MSCs in current clinical applications and directions that need to be explored in the future.

Keywords: exosomes; mesenchymal stem cell; tendon healing; tendon injury; tendon repair.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Effective treatment for tendon injury. These treatments are mainly divided into surgical and non-surgical treatments.
Figure 2
Figure 2
Article retrieval and inclusion and exclusion criteria. MSC, mesenchymal stem cell.
Figure 3
Figure 3
Biologically active soluble factors released by MSCs act on the molecular structure of tendons. MSC, mesenchymal stem cell; PDGF, platelet-derived growth factor; bFGF, basic Fibroblast Growth Factor; TGF, Transforming Growth Factor; GDF, Growth Differentiation Factor; EGF, Epidermal Growth Factor; BMP, Bone Morphogenetic Proteins. MSCs are involved in intercellular messaging by secreting exosomes, growth factors such as PDGF, bFGF, TGF-β. They also play a role in the three healing processes of angiogenesis, cell proliferation and matrix remodeling in tendon healing.
Figure 4
Figure 4
MSCs exert immunomodulatory effects by secreting immunomodulatory mediators and extracellular vesicles. MSCs exert immunomodulatory effects by secreting immunomodulatory mediators such as chemokines, cytokines and growth factors. TGF-β1, IL-6 and PGE2 inhibit proliferation of Th1 and Th17 cells, M1-type macrophages and other pro-inflammatory cells. MSCs also express and secrete soluble factors such as PGE2, TGF-β and hepatocyte growth factor. These factors induce proliferation of Tregs, thereby controlling inflammation. Also MSCs can promote the conversion of macrophages from a pro-inflammatory M1 type to an anti-inflammatory M2 type by secreting biologically active ingredients. MSC, mesenchymal stem cell; Th, T helper cells; Treg, regulatory T cells; HGF, Hepatocyte growth factor.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Andarawis-Puri N, Flatow EL, Soslowsky LJ. Tendon basic science: Development, repair, regeneration, and healing. J Orthop Res. 2015;33:780–784. doi: 10.1002/jor.22869. - DOI - PMC - PubMed
    1. Cook JL, Purdam C. Is compressive load a factor in the development of tendinopathy? Br J Sports Med. 2012;46:163–168. doi: 10.1136/bjsports-2011-090414. - DOI - PubMed
    1. Beatty NR, Félix I, Hettler J, Moley PJ, Wyss JF. Rehabilitation and prevention of proximal hamstring tendinopathy. Curr Sports Med Rep. 2017;16:162–171. doi: 10.1249/JSR.0000000000000355. - DOI - PubMed
    1. Silbernagel KG, Hanlon S, Sprague A. Current Clinical concepts: Conservative management of achilles tendinopathy. J Athl Train. 2020;55:438–447. doi: 10.4085/1062-6050-356-19. - DOI - PMC - PubMed
    1. Figueroa D, Figueroa F, Calvo R. Patellar tendinopathy: Diagnosis and treatment. J Am Acad Orthop Surg. 2016;24:e184–e192. doi: 10.5435/JAAOS-D-15-00703. - DOI - PubMed

Grants and funding

The present study was supported by 2022 Sichuan Provincial Science and Technology Plan Project (grant no. 22ZDYF3799), Luzhou Science and Technology Program Project (grant no. 2020-SYF-31), Luzhou Municipal Government-Southwest Medical University Joint Project (grant no. 2021LZXNYD-J10), Sichuan Science and Technology Program Project (grant no. 2022NSFSC0688) and Southwest Medical University Applied Basic Fundamental Research Project (grant no. 2021ZKMS050).