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Expression of chondro-osteogenic BMPs in clinical samples of patellar tendinopathy

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The pathogenesis of patellar tendinopathy remains unclear. Expression of BMP-2/-4/-7 was reported in an ossified failed tendon healing animal model of patellar tendinopathy. This study aimed to investigate the expression of these chondro-osteogenic BMPs in clinical samples of patellar tendinopathy.

Methods

Patellar tendon samples were collected from 16 consecutive patients with patellar tendinopathy and 16 consecutive controls undergoing anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft in the authors’ hospital after getting their consent. The expression of BMP-2/-4/-7 was examined in all samples using immunohistochemistry. Ossification observed in two tendinopathy samples was characterized by histology, alizarin red S staining, alcian blue staining, TRAP staining and immunohistochemical staining of Sox9, osteopontin (OPN) and osteocalcin (OCN).

Results

Regions of hypo- and hyper-cellularity and vascularity, with loss of crimp structure of collagen matrix, were observed in patellar tendinopathy samples. Round cells and in some cases, cells with typical chondrocyte phenotype were observed. For the ossified tendinopathy samples with positive alizarin red S staining, OPN-positive and Sox9-positive chondrocyte-like cells in alcian blue-stained extracellular matrix, OCN-positive osteoblast-like cells and TRAP-positive multi-nucleated cells were observed around the ossified deposits. No expression of BMP-2/-4/-7 was observed in healthy patellar tendons. However, the expression of BMP-2/-4/-7 was observed in all patellar tendinopathy samples with or without ossification.

Conclusions

Clinical samples of patellar tendinopathy showed ectopic expression of BMP-2/-4/-7. This was not evident in control samples from healthy patellar tendons.

Level of evidence

Prognostic studies, Level III.

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References

  1. Ai X, Cappuzzello J, Hall AK (1999) Activin and bone morphogenetic proteins induce calcitonin gene-related peptide in embryonic sensory neurons in vitro. Mol Cell Neurosci 14:506–518

    Article  PubMed  CAS  Google Scholar 

  2. Archambault JM, Jelinsky SA, Lake SP et al (2007) Rat supraspinatus tendon expresses cartilage markers with overuse. J Orthop Res 25:617–624

    Article  PubMed  CAS  Google Scholar 

  3. Bi Y, Ehirchiou D, Kilts TM et al (2007) Identification of tendon stem/progenitor cells and the role of the extracellular matrix in their niche. Nat Med 13:1219–1227

    Article  PubMed  CAS  Google Scholar 

  4. Bucelli RC, Gonsiorek EA, Kim WY et al (2008) Statins decrease expression of the proinflammatory neuropeptides calcitonin gene-related peptide and substance P in sensory neurons. J Pharmacol Exp Ther 324:1172–1180

    Article  PubMed  CAS  Google Scholar 

  5. Clegg PD, Strassburg S, Smith RK (2007) Cell phenotypic variation in normal and damaged tendons. Int J Exp Pathol 88:227–235

    Article  PubMed  Google Scholar 

  6. Coleman BD, Khan KM, Kiss ZS et al (2000) Open and arthroscopic patellar tenotomy for chronic patellar tendinopathy. A retrospective outcome study. Victorian Institute of Sport Tendon Study Group. Am J Sports Med 28:183–190

    PubMed  CAS  Google Scholar 

  7. Fenwick S, Harrall R, Hackney R et al (2002) Endochondral ossification in Achilles and patella tendinopathy. Rheumatology (Oxford) 41:474–476

    Article  CAS  Google Scholar 

  8. Fu SC, Wang W, Pau HM, et al (2002) Increased expression of transforming growth factor-beta1 in patellar tendinosis. Clin Orthop Relat Res 400:174–183

    Google Scholar 

  9. Johnson DP, Wakeley CJ, Watt I (1996) Magnetic resonance imaging of patellar tendonitis. J Bone Joint Surg Br 78(3):452–457

    PubMed  CAS  Google Scholar 

  10. Kannus P, Jozsa L (1991) Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 73(10):1507–1525

    PubMed  CAS  Google Scholar 

  11. Khan KM, Bonar F, Desmond PM et al (1996) Patellar tendinosis (jumper’s knee): findings at histopathologic examination, US, and MR imaging. Victorian Institute of Sport Tendon Study Group. Radiology 200:821–827

    PubMed  CAS  Google Scholar 

  12. Khan KM, Cook JL, Bonar F et al (1999) Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med 27:393–408

    Article  PubMed  CAS  Google Scholar 

  13. Knippenberg M, Helder MN, Zandieh Doulabi B et al (2006) Osteogenesis versus chondrogenesis by BMP-2 and BMP-7 in adipose stem cells. Biochem Biophys Res Commun 342:902–908

    Article  PubMed  CAS  Google Scholar 

  14. Leadbetter WB (1992) Cell-matrix response in tendon injury. Clin Sports Med 11:533–578

    PubMed  CAS  Google Scholar 

  15. Li H, Jiang LS, Dai LY (2007) Hormones and growth factors in the pathogenesis of spinal ligament ossification. Eur Spine J 16:1075–1084

    Article  PubMed  Google Scholar 

  16. Lian O, Dahl J, Ackermann PW et al (2006) Pronociceptive and antinociceptive neuromediators in patellar tendinopathy. Am J Sports Med 34:1801–1808

    Article  PubMed  Google Scholar 

  17. Lian OB, Engebretsen L, Bahr R (2005) Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med 33:561–567

    Article  PubMed  Google Scholar 

  18. Lui PP, Chan KM (2011) Tendon-derived stem cells (TDSCs): from basic science to potential roles in tendon pathology and tissue engineering applications. Stem Cell Rev. doi:10.1007/s12015-011-9276-0

  19. Lui PP, Fu SC, Chan LS et al (2009) Chondrocyte phenotype and ectopic ossification in collagenase-induced tendon degeneration. J Histochem Cytochem 57:91–100

    Article  PubMed  CAS  Google Scholar 

  20. Lui PP, Chan LS, Fu SC et al (2010) Expression of sensory neuropeptides in tendon is associated with failed healing and activity-related tendon pain in collagenase-induced tendon injury. Am J Sports Med 38:757–764

    Article  PubMed  Google Scholar 

  21. Neuwirth J, Fuhrmann RA, Veit A et al (2006) Expression of bioactive bone morphogenetic proteins in the subacromial bursa of patients with chronic degeneration of the rotator cuff. Arthritis Res Ther 8:R92

    Article  PubMed  Google Scholar 

  22. Rui YF, Lui PP, Chan LS et al (2011) Does erroneous differentiation of tendon-derived stem cells contribute to the pathogenesis of calcifying tendinopathy? Chin Med J (Engl) 24:606–610

    Google Scholar 

  23. Rui YF, Lui PP, Ni M et al (2011) Mechanical loading increased BMP-2 expression which promoted osteogenic differentiation of tendon-derived stem cells. J Orthop Res 29:390–396

    Article  PubMed  CAS  Google Scholar 

  24. Sato K, Miura T, Iwata H (1988) Cartilaginous transdifferentiation of rat tenosynovial cells under the influence of bone morphogenetic protein in tissue culture. Clin Orthop Relat Res 236:233–239

    PubMed  Google Scholar 

  25. Seib FP, Franke M, Jing D et al (2009) Endogenous bone morphogenetic proteins in human bone marrow-derived multipotent mesenchymal stromal cells. Eur J Cell Biol 88:257–271

    Article  PubMed  CAS  Google Scholar 

  26. Siddhivarn C, Banes A, Champagne C et al (2007) Mechanical loading and delta12prostaglandin J2 induce bone morphogenetic protein-2, peroxisome proliferator-activated receptor gamma-1, and bone nodule formation in an osteoblastic cell line. J Periodontal Res 42:383–392

    Article  PubMed  CAS  Google Scholar 

  27. Takeuchi E, Sugamoto K, Nakase T et al (2001) Localization and expression of osteopontin in the rotator cuff tendons in patients with calcifying tendinitis. Virchows Arch 438:612–617

    Article  PubMed  CAS  Google Scholar 

  28. Tan SC, Chan O (2008) Achilles and patellar tendinopathy: current understanding of pathophysiology and management. Disabil Rehabil 30:1608–1615

    Article  PubMed  Google Scholar 

  29. Warden SJ, Brukner P (2003) Patellar tendinopathy. Clin Sports Med 22:743–759

    Article  PubMed  Google Scholar 

  30. Yee Lui PP, Wong YM, Rui YF et al (2011) Expression of chondro-osteogenic BMPs in ossified failed tendon healing model of tendinopathy. J Orthop Res 29:816–821

    Article  PubMed  Google Scholar 

  31. Yu JS, Popp JE, Kaeding CC et al (1995) Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendinitis. AJR Am J Roentgenol 165:115–118

    PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by equipment/resources donated by the Hong Kong Jockey Club Charities Trust.

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Authors and Affiliations

  1. Department of Orthopaedics, Zhongda Hospital, Southeast University, 87 Ding Jia Qiao, Nanjing, 210009, Jiangsu, China

    Yun Feng Rui

  2. Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Yun Feng Rui, Pauline Po Yee Lui, Yin Mei Wong, Yuk Wa Lee & Kai Ming Chan

  3. The Hong Kong Jockey Club Sports Medicine and Health Sciences Centre, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Yun Feng Rui, Pauline Po Yee Lui, Yin Mei Wong, Yuk Wa Lee & Kai Ming Chan

  4. Program of Stem Cell and Regeneration, School of Biomedical Science, The Chinese University of Hong Kong, Hong Kong SAR, China

    Pauline Po Yee Lui

  5. Department of Orthopaedics, Clintec, Karolinska Institutet, Stockholm, Sweden

    Christer Gustav Rolf

  6. Rm. 74025, 5/F, Clinical Sciences Building, Prince of Wales Hospital, Hong Kong SAR, China

    Pauline Po Yee Lui

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  1. Yun Feng Rui
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Corresponding author

Correspondence to Pauline Po Yee Lui.

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Rui, Y.F., Lui, P.P.Y., Rolf, C.G. et al. Expression of chondro-osteogenic BMPs in clinical samples of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc 20, 1409–1417 (2012). https://doi.org/10.1007/s00167-011-1685-8

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  • DOI: https://doi.org/10.1007/s00167-011-1685-8

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