Tendon healing is a complex process involving inflammation, proliferation, and remodeling, eventually achieving a state of hypocellularity and hypovascularity. Currently, few treatments can satisfactorily restore the structure and function of native tendon. Bioactive glass (BG) has been shown to possess immunomodulatory and angiogenic properties. In this study, we investigated whether an injectable hydrogel fabricated of BG and sodium alginate (SA) could be applied to enhance tenogenesis following suture repair of injured tendon. We demonstrated that BG/SA hydrogel significantly accelerated tenogenesis without inducing heterotopic ossification based on histological analysis. The therapeutic effect could attribute to increased angiogenesis and M1 to M2 phenotypic switch of macrophages within 7 days post-surgery. Morphological characterization demonstrated that BG/SA hydrogel partially reverted the pathological changes of Achilles tendon, including increased length and cross-sectional area (CSA). Finally, biomechanical test showed that BG/SA hydrogel significantly improved ultimate load, failure stress, and tensile modulus of the repaired tendon. In conclusion, administration of an injectable BG/SA hydrogel can be a novel and promising therapeutic approach to augment Achilles tendon healing in conjunction with surgical intervention.

中文翻译：

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具有免疫调节和血管生成特性的可注射生物活性玻璃/海藻酸钠水凝胶可促进肌腱愈合

肌腱愈合是一个复杂的过程，涉及炎症、增殖和重塑，最终达到细胞减少和血管减少的状态。目前，很少有治疗方法能够令人满意地恢复原生肌腱的结构和功能。生物活性玻璃 (BG) 已被证明具有免疫调节和血管生成特性。在这项研究中，我们研究了由 BG 和海藻酸钠 (SA) 制成的可注射水凝胶是否可用于增强受伤肌腱缝合修复后的肌腱生成。我们证明，基于组织学分析，BG/SA 水凝胶可显着加速肌腱形成，而不会诱导异位骨化。治疗效果可能归因于术后 7 天内血管生成增加和巨噬细胞 M1 到 M2 表型转换。形态学表征表明，BG/SA 水凝胶部分恢复了跟腱的病理变化，包括增加的长度和横截面积 (CSA)。最后，生物力学测试表明，BG/SA 水凝胶显着改善了修复肌腱的极限载荷、失效应力和拉伸模量。总之，可注射 BG/SA 水凝胶的给药可能是一种新颖且有前途的治疗方法，可以结合手术干预来促进跟腱愈合。