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  • Review Article
  • Published:

Tendon injury: from biology to tendon repair

Nature Reviews Rheumatology volume 11, pages 223–233 (2015)Cite this article

Subjects

Key Points

  • Tendon is a mechanosensitive tissue

  • Abnormal loading leads to tendon injuries

  • Mechanical forces are converted to biochemical signals that elicit cellular responses by tendon cells

  • Similar mechanical and biological signals are involved in tendon development, homeostasis and repair

  • A better understanding of the interaction between forces, intracellular pathways and gene transcription in the context of tendon biology is needed

  • Understanding mechanobiology in tendon development, homeostasis and repair is critical to designing therapies for tendon injury

Abstract

Tendon is a crucial component of the musculoskeletal system. Tendons connect muscle to bone and transmit forces to produce motion. Chronic and acute tendon injuries are very common and result in considerable pain and disability. The management of tendon injuries remains a challenge for clinicians. Effective treatments for tendon injuries are lacking because the understanding of tendon biology lags behind that of the other components of the musculoskeletal system. Animal and cellular models have been developed to study tendon-cell differentiation and tendon repair following injury. These studies have highlighted specific growth factors and transcription factors involved in tenogenesis during developmental and repair processes. Mechanical factors also seem to be essential for tendon development, homeostasis and repair. Mechanical signals are transduced via molecular signalling pathways that trigger adaptive responses in the tendon. Understanding the links between the mechanical and biological parameters involved in tendon development, homeostasis and repair is prerequisite for the identification of effective treatments for chronic and acute tendon injuries.

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Figure 1: Tendon architecture.
Figure 2: Tendon mechanobiology.

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Acknowledgements

The authors thank S. Gournet for assistance with illustrations. The authors' work is supported by funding from the National Institute of Health and Medical Research (INSERM). D.D. also receives support from the Fondation pour la Recherche Médicale (FRM), Agence national de la recherche (ANR), Association Française contre les Myopathies, Centre national de la recherche scientifique (CNRS) and Pierre & Marie Curie University (UPMC), Fondation Arthritis Courtin and Société Française de Rhumatologie.

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Authors and Affiliations

  1. Service de chirurgie orthopédique et traumatologique, INSERM UMR_S938, DHU i2B, Assistance Publique-Hopitaux de Paris, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, Paris, 75012, France

    Geoffroy Nourissat

  2. Service de rhumatologie, INSERM UMR_S938, DHU i2B, Assistance Publique-Hopitaux de Paris, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, Paris, 75012, France

    Francis Berenbaum

  3. Centre national de la recherche scientifique UMR 7622, IBPS Developmental Biology Laboratory, F-75005, 5005, Paris, France

    Delphine Duprez

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  1. Geoffroy Nourissat
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All authors contributed to researching data for the article, providing a substantial contribution to discussions of the content, writing the article, and to the review and/or editing of the manuscript before submission.

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Correspondence to Francis Berenbaum.

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Nourissat, G., Berenbaum, F. & Duprez, D. Tendon injury: from biology to tendon repair. Nat Rev Rheumatol 11, 223–233 (2015). https://doi.org/10.1038/nrrheum.2015.26

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