Abstract
Apoptosis (programmed cell death) has been identified as a histopathologic feature of tendinopathy. While the precise mechanism(s) that triggers the apoptotic cascade in tendon cells has not been identified, it has been theorized that loss of cellular homeostatic tension following microscopic damage to individual tendon fibrils could be the stimulus for initiating the pathologic events associated with tendinopathy. To determine if loss of homeostatic tension following stress deprivation could induce apoptosis in tendon cells, rat tail tendons were stress-deprived or cyclically loaded (3% strain at 0.17 Hz) for 24 hours under tissue culture conditions. Caspase-3 (an upstream mediator of apoptosis) mRNA expression was evaluated using quantitative polymerase chain reaction and caspase-3 protein synthesis was identified using immunohistochemistry. Apoptotic cells were identified histologically using an antibody for single-stranded DNA. Stress deprivation for 24 hours resulted in an increase in caspase-3 mRNA expression when compared to fresh controls or cyclically loaded tendons. Stress deprivation also increased the percentage of apoptotic cells (10.59% ± 2.80) compared to controls (1.87% ± 1.07) or cyclically loaded tendons (3.73% ± 0.87). These data suggest loss of homeostatic tension following stress deprivation induces apoptosis in rat tail tendon cells.
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References
Arnoczky SP, Lavagnino M, Egerbacher M. The mechanical etiopathogenesis of tendinopathy: is it the over-stimulation or the under-stimulation of tendon cells? Int J Exp Pathol. 2007;88:217–226.
Arnoczky SP, Lavagnino M, Whallon JH, Hoonjan A. In situ cell nucleus deformation in tendons under tensile load; a morphological analysis using confocal laser microscopy. J Orthop Res. 2002;20:29–35.
Arnoczky SP, Tian T, Lavagnino M, Gardner K. Ex vivo static tensile loading inhibits MMP-1 expression in rat tail tendon cells through a cytoskeletally based mechanotransduction mechanism. J Orthop Res. 2004;22:328–333.
Bestwick CS, Maffulli N. Reactive oxygen species and tendinopathy: do they matter? Br J Sports Med. 2004;38:672–674.
Boatright KM, Salvesen GS. Mechanisms of caspase activation. Curr Opin Cell Biol. 2003;15:725–731.
Chen CS, Mrksich M, Huang S, Whitesides GM, Ingber DE. Geometric control of cell life and death. Science. 1997;276:1425–1428.
Cheng W, Li B, Kajstura J, Li P, Wolin MS, Sonnenblick EH, Hintze TH, Olivetti G, Anversa P. Stretch-induced programmed myocyte cell death. J Clin Invest. 1995;96:2247–2259.
Cook JL, Feller JA, Bonar SF, Khan KM. Abnormal tenocyte morphology is more prevalent than collagen disruption in asymptomatic athletes’ patellar tendons. J Orthop Res. 2004;22:334–338.
Cook JL, Khan KM. Etiology of tendinopathy. In: Woo SL, Renstrom P, Arnoczky SP, eds. Tendinopathy in Athletes. Oxford, England: Blackwell Publishing; 2007:10–28.
Dimmeler S, Haendeler J, Rippmann V, Nehls M, Zeiher AM. Shear stress inhibits apoptosis of human endothelial cells. FEBS Lett. 1996;399:71–74.
Duncan RL, Turner CH. Mechanotransduction and the functional response of bone to mechanical strain. Calcif Tissue Int. 1995;57:344–358.
Egerbacher M, Arnoczky SP, Gardner K, Caballero O, Gartner J. Stress-deprivation of tendons results in alterations in the integrin profile and pericellular matrix of tendon cells. Trans Orthop Res Soc. 2006;31:1100.
Fesus L, Davies PJ, Piacentini M. Apoptosis: molecular mechanisms in programmed cell death. Eur J Cell Biol. 1991;56:170–177.
Fluck J, Querfeld C, Cremer A, Niland S, Krieg T, Sollberg S. Normal human primary fibroblasts undergo apoptosis in three-dimensional contractile collagen gels. J Invest Dermatol. 1998;110:153–157.
Graf R, Freyberg M, Kaiser D, Friedl P. Mechanosensitive induction of apoptosis in fibroblasts is regulated by thrombospondin-1 and integrin associated protein (CD47). Apoptosis. 2002;7:493–498.
Grinnell F, Zhu M, Carlson MA, Abrams JM. Release of mechanical tension triggers apoptosis of human fibroblasts in a model of regressing granulation tissue. Exp Cell Res. 1999;248:608–619.
Hannafin JA, Arnoczky SP, Hoonjan A, Torzilli PA. Effect of stress deprivation and cyclic tensile loading on the material and morphologic properties of canine flexor digitorum profundus tendon: an in vitro study. J Orthop Res. 1995;13:907–914.
Hansen KA, Weiss JA, Barton JK. Recruitment of tendon crimp with applied tensile strain. J Biomech Eng. 2002;124:72–77.
Hosaka Y, Teraoka H, Yamamoto E, Ueda H, Takehana K. Mechanism of cell death in inflamed superficial digital flexor tendon in the horse. J Comp Pathol. 2005;132:51–58.
Hsieh MH, Nguyen HT. Molecular mechanism of apoptosis induced by mechanical forces. Int Rev Cytol. 2005;245:45–90.
Ingber DE. Tensegrity: the architectural basis of cellular mechanotransduction. Annu Rev Physiol. 1997;59:575–599.
Jarvinen M, Jozsa L, Kannus P, Jarvinen TL, Kvist M, Leadbetter W. Histopathological findings in chronic tendon disorders. Scand J Med Sci Sports. 1997;7:86–95.
Jozsa L, Reffy A, Kannus P, Demel S, Elek E. Pathological alterations in human tendons. Arch Orthop Trauma Surg. 1990;110:15–21.
Kaiser D, Freyberg MA, Friedl P. Lack of hemodynamic forces triggers apoptosis in vascular endothelial cells. Biochem Biophys Res Commun. 1997;231:586–590.
Kannus P, Jozsa L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am. 1991;73:1507–1525.
Kastelic J, Galeski A, Baer E. The multicomposite structure of tendon. Connect Tissue Res. 1978;6:11–23.
Lavagnino M, Arnoczky SP, Egerbacher M, Gardner KL, Burns ME. Isolated fibrillar damage in tendons stimulates local collagenase mRNA expression and protein synthesis. J Biomech. 2006;39:2355–2362.
Lavagnino M, Arnoczky SP, Frank K, Tian T. Collagen fibril diameter distribution does not reflect changes in the mechanical properties of in vitro stress-deprived tendons. J Biomech. 2005;38:69–75.
Lavagnino M, Arnoczky SP, Tian T, Vaupel Z. Effect of amplitude and frequency of cyclic tensile strain on the inhibition of MMP-1 mRNA expression in tendon cells: an in vitro study. Connect Tissue Res. 2003;44:181–187.
Lawen A. Apoptosis-an introduction. Bioessays. 2003;25:888–896.
Lian O, Scott A, Engebretsen L, Bahr R, Duronio V, Khan K. Excessive apoptosis in patellar tendinopathy in athletes. Am J Sports Med. 2007;35:605–611.
Lian OB, Engebretsen L, Bahr R. Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med. 2005;33:561–567.
Maffulli N, Testa V, Capasso G, Ewen SW, Sullo A, Benazzo F, King JB. Similar histopathological picture in males with Achilles and patellar tendinopathy. Med Sci Sports Exerc. 2004;36:1470–1475.
McConkey DJ, Orrenius S. Signal transduction pathways in apoptosis. Stem Cells. 1996;14:619–631.
Murakami H, Shinomiya N, Kikuchi T, Fujikawa K, Nemoto K. Differential sensitivity to NO-induced apoptosis between anterior cruciate and medial collateral ligament cells. J Orthop Sci. 2005;10:84–90.
Murakami H, Shinomiya N, Kikuchi T, Yoshihara Y, Nemoto K. Upregulated expression of inducible nitric oxide synthase plays a key role in early apoptosis after anterior cruciate ligament injury. J Orthop Res. 2006;24:1521–1534.
Renstrom P. Sports traumatology today. A review of common current sports injury problems. Ann Chir Gynaecol. 1991;80:81–93.
Schwartzman RA, Cidlowski JA. Apoptosis: the biochemistry and molecular biology of programmed cell death. Endocr Rev. 1993;14:133–151.
Scott A, Khan KM, Heer J, Cook JL, Lian O, Duronio V. High strain mechanical loading rapidly induces tendon apoptosis: an ex vivo rat tibialis anterior model. Br J Sports Med. 2005;39:e25.
Screen HR, Lee DA, Bader DL, Shelton JC. An investigation into the effects of the hierarchical structure of tendon fascicles on micromechanical properties. Proc Inst Mech Eng [H]. 2004;218:109–119.
Skutek M, van Griensven M, Zeichen J, Brauer N, Bosch U. Cyclic mechanical stretching of human patellar tendon fibroblasts: activation of JNK and modulation of apoptosis. Knee Surg Sports Traumatol Arthrosc. 2003;11:122–129.
Szomor ZL, Appleyard RC, Murrell GA. Overexpression of nitric oxide synthases in tendon overuse. J Orthop Res. 2006;24:80–86.
Tidball J, Albrecht D. Regulation of apoptosis by cellular interactions with the extracellular matrix. In: Lockshin RA, Zakeri Z, Tilly JL, eds. When Cells Die. Wilmington, DE: Wiley-Liss, Inc; 1998:411–427.
Tuoheti Y, Itoi E, Pradhan RL, Wakabayashi I, Takahashi S, Minagawa H, Kobayashi M, Okada K, Shimada Y. Apoptosis in the supraspinatus tendon with stage II subacromial impingement. J Shoulder Elbow Surg. 2005;14:535–541.
Van Cruchten S, Van Den Broeck W. Morphological and biochemical aspects of apoptosis, oncosis and necrosis. Anat Histol Embryol. 2002;31:214–223.
Wang MX, Wei A, Yuan J, Clippe A, Bernard A, Knoops B, Murrell GA. Antioxidant enzyme peroxiredoxin 5 is upregulated in degenerative human tendon. Biochem Biophys Res Commun. 2001;284:667–673.
Wilson AM, Goodship AE. Exercise-induced hyperthermia as a possible mechanism for tendon degeneration. J Biomech. 1994;27:899–905.
Woo SL-Y, Renstrom PAFH, Arnoczky SP, eds. Tendinopathy in Athletes. Ames, IA: Blackwell Publishing; 2007, p. XI.
Wu JZ, Brumfield A, Miller GR, Metheny R, Cutlip RG. Comparison of mechanical properties of rat tibialis anterior tendon evaluated using two different approaches. Biomed Mater Eng. 2004;14:13–22.
Yuan J, Murrell GA, Trickett A, Wang MX. Involvement of cytochrome c release and caspase-3 activation in the oxidative stress-induced apoptosis in human tendon fibroblasts. Biochim Biophys Acta. 2003;1641:35–41.
Yuan J, Murrell GA, Wei AQ, Wang MX. Apoptosis in rotator cuff tendonopathy. J Orthop Res. 2002;20:1372–1379.
Yuan J, Wang MX, Murrell GA. Cell death and tendinopathy. Clin Sports Med. 2003;22:693–701.
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Egerbacher, M., Arnoczky, S.P., Caballero, O. et al. Loss of Homeostatic Tension Induces Apoptosis in Tendon Cells: An In Vitro Study. Clin Orthop Relat Res 466, 1562–1568 (2008). https://doi.org/10.1007/s11999-008-0274-8
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DOI: https://doi.org/10.1007/s11999-008-0274-8