Background:

Tenocytes derived from tendons have been reported to be effective in the treatment of rotator cuff tears through the expression of extracellular matrix proteins. Human dermal fibroblasts, known to express collagen types I and III as tenocytes do, may likely be substitutes for tenocytes to enhance healing rotator cuff tears.

Purpose:

To demonstrate the capability of human dermal fibroblasts to enhance healing of rotator cuff tears.

Study Design:

Controlled laboratory study.

Methods:

The cellular properties and expression profiles of growth factors were compared between human dermal fibroblasts and tenocytes. In both cell types, a series of extracellular matrix proteins were analyzed along with matrix metalloproteinases and tissue inhibitors of metalloproteinases involved in the collagenolytic system. A total of 35 rabbits were divided into 5 groups: normal (n = 2), saline control (n = 9), fibrin control (n = 9), low dose of human fibroblasts (HF-LD; n = 9), and high dose of human fibroblasts (HF-HD; n = 6). Cells were injected into the sutured lesions at 6 weeks after creation of bilateral rotator cuff tears, followed by histological and biomechanical analyses at 12 weeks.

Results:

Human dermal fibroblasts exhibited a protein expression pattern similar to that of tenocytes. More specifically, the expression levels of collagen types I and III were comparable between fibroblasts and tenocytes. The histological analysis of 30 surviving rabbits showed that collagen fibers were more continuous and better oriented with a more mature interface between the tendon and bone in the sutured lesions in the HF-LD and HF-HD groups. Most importantly, biomechanical strength, measured using the load to failure at the injection site, was 58.8 ± 8.9 N/kg in the HF-HD group, increasing by approximately 2-fold (P = .0003) over the saline control group.

Conclusion:

Human dermal fibroblasts, showing cellular properties comparable with tenocytes, effectively enhanced healing of chronic rotator cuff tears in rabbits.

Clinical Relevance:

Human dermal fibroblasts can be used in place of tenocytes to enhance healing of rotator cuff tears.

中文翻译：

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使用人真皮成纤维细胞修复肩袖肌腱：慢性肩袖撕裂兔模型的组织学和生物力学分析

背景：

据报道，源自肌腱的肌腱细胞通过表达细胞外基质蛋白可有效治疗肩袖撕裂。众所周知，人类真皮成纤维细胞像肌腱细胞一样表达 I 型和 III 型胶原蛋白，可能是肌腱细胞的替代品，以促进肩袖撕裂的愈合。

目的：

展示人类真皮成纤维细胞促进肩袖撕裂愈合的能力。

学习规划：

受控实验室研究。

方法：

比较了人真皮成纤维细胞和肌腱细胞之间生长因子的细胞特性和表达谱。在这两种细胞类型中，分析了一系列细胞外基质蛋白以及参与胶原溶解系统的基质金属蛋白酶和金属蛋白酶的组织抑制剂。总共 35 只兔子被分为 5 组：正常（n = 2）、盐水对照（n = 9）、纤维蛋白对照（n = 9）、低剂量人成纤维细胞（HF-LD；n = 9）和高剂量的人成纤维细胞（HF-HD；n = 6）。在产生双侧肩袖撕裂后第 6 周将细胞注射到缝合的病变中，然后在第 12 周进行组织学和生物力学分析。

结果：

人真皮成纤维细胞表现出与肌腱细胞相似的蛋白质表达模式。更具体地说，I 型和 III 型胶原蛋白的表达水平在成纤维细胞和肌腱细胞之间相当。30只存活兔的组织学分析表明，HF-LD和HF-HD组缝合病变中胶原纤维更连续，定向更好，肌腱和骨骼之间的界面更成熟。最重要的是，使用注射部位的失效载荷测量的生物力学强度在 HF-HD 组中为 58.8 ± 8.9 N/kg，比盐水对照组增加了大约 2 倍 ( P = .0003)。

结论：

人类真皮成纤维细胞显示出与肌腱细胞相当的细胞特性，可有效促进兔子慢性肩袖撕裂的愈合。

临床相关性：

人真皮成纤维细胞可用于代替肌腱细胞以促进肩袖撕裂的愈合。