Review Article
Biological and Mechanical Factors and Epigenetic Regulation Involved in Tendon Healing
Table 1
Influencing factors in tendon healing process.
| Factor | Effects on tendon healing | |
| Mechanical factors | Overloading | Helps the middle tendon repair but inhibits healing at the enthesis. | [139, 177–179] | Underloading | Inhibits the middle tendon repair but helps healing at the enthesis. | [177–180] |
| Transcription factors | Scx, EGR1, and Mohawk | Promote tendon repair and regeneration and provide conditions conducive to cell differentiation. | [2] |
| Signaling | TGF-β | Involved in initial inflammatory responses, collagen synthesis, and angiogenesis. | [79] | VEGF | Promotes angiogenesis and fibroblast proliferation and activates the synthesis of other growth factors. | [79] | FGF | Involved in inflammation, angiogenesis, cell proliferation, and collagen synthesis. | [79] | PDGF | Promotes angiogenesis, ECM synthesis, tenoblast migration, and differentiation. | [79] | IGF | Promotes collagen synthesis in fibroblasts and ECM synthesis. | [79] | BMP | Improves molecular, organizational, and mechanical properties of healing tendon. | [181–184] |
| Epigenetic regulation | miRNA and lncRNA | Guide tendon stem cell differentiation and tissue regeneration, promote tendon healing, and reduce adhesion. | [161–163] |
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EGR1: early growth response 1; Scx: scleraxis; TGF-β: transformational growth factor-beta; VEGF: vascular endothelial growth factor; FGF: fibroblast growth factor; PDGF: platelet-derived growth factor; ECM: extracellular matrix; IGF: insulin-like growth factor; BMP: bone morphogenetic protein.
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