Growth Factor Roles in Soft Tissue Physiology and Pathophysiology.
Abstract: Repair and healing of injured and diseased tendons has been traditionally fraught with apprehension and difficulties, and often led to rather unsatisfactory results. The burgeoning research field of growth factors has opened new venues for treatment of tendon disorders and injuries, and possibly for treatment of disorders of the aorta and major arteries as well. Several chapters in this volume elucidate the role of transforming growth factor β (TGFß) in pathogenesis of several heritable disorders affecting soft tissues, such as aorta, cardiac valves, and tendons and ligaments. Several members of the bone morphogenetic group either have been approved by the FDA for treatment of non-healing fractures or have been undergoing intensive clinical and experimental testing for use of healing bone fractures and tendon injuries. Because fibroblast growth factors (FGFs) are involved in embryonic development of tendons and muscles among other tissues and organs, the hope is that applied research on FGF biological effects will lead to the development of some new treatment strategies providing that we can control angiogenicity of these growth factors. The problem, or rather question, regarding practical use of imsulin-like growth factor I (IGF-I) in tendon repair is whether IGF-I acts independently or under the guidance of growth hormone. FGF2 or platelet-derived growth factor (PDGF) alone or in combination with IGF-I stimulates regeneration of periodontal ligament: a matter of importance in Marfan patients with periodontitis. In contrast, vascular endothelial growth factor (VEGF) appears to have rather deleterious effects on experimental tendon healing, perhaps because of its angiogenic activity and stimulation of matrix metalloproteinases-proteases whose increased expression has been documented in a variety of ruptured tendons. Other modalities, such as local administration of platelet-rich plasma (PRP) and/or of mesenchymal stem cells have been explored extensively in tendon healing. Though treatment with PRP and mesenchymal stem cells has met with some success in horses (who experience a lot of tendon injuries and other tendon problems), the use of PRP and mesenchymal stem cells in people has been more problematic and requires more studies before PRP and mesenchymal stem cells can become reliable tools in management of soft tissue injuries and disorders.
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Publication Date: 2021-11-23 PubMed ID: 34807418PubMed Central: 6128323DOI: 10.1007/978-3-030-80614-9_6Google Scholar: Lookup
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Summary
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This research explores the role of growth factors in the treatment of soft tissue injuries and disorders, focusing particularly on tendons, cardiac valves, and aorta. It reviews how growth factors can potentially develop fresh treatment strategies for injuries and diseases affecting these soft tissues.
Growth Factors and Tendon Disorders
- The paper highlights the revolutionary potential growth factors have in the treatment of tendon disorders and injuries. Traditionally challenging, the treatment of tendons has shown promising results thanks to research advancements in growth factors.
- Notable mentions are the Transforming Growth Factor β (TGFß) responsible for the pathogenesis of several heritable disorders affecting soft tissues such as aorta, cardiac valves, and tendons and ligaments.
- Also discussed is the Fibroblast Growth Factor (FGFs) known for its part in embryonic development of tendons and muscles among other organs. The potentiality of developing new treatment strategies lies in our ability to control the angiogenicity of these growth factors.
Insulin-like Growth Factor I and Tendon Repair
- The use of Insulin-like Growth Factor I (IGF-I) in tendon repair shows promise, but more research is needed to determine if it acts independently or needs the guidance of growth hormones.
- This paper indicates that FGF2 or Platelet-Derived Growth Factor (PDGF) alone or combined with IGF-I can stimulate the regeneration of periodontal ligaments, crucial treatment for Marfan patients diagnosed with periodontitis.
Effects of Vascular Endothelial Growth Factor & Other Modalities
- In contrast, Vascular Endothelial Growth Factor (VEGF) is seen to potentially have harmful effects on experimental tendon healing. This may be attributed to its angiogenic activity and stimulation of matrix metalloproteinases-proteases, the increased expression of which has been observed in a variety of ruptured tendons.
- Other treatment modalities like the local administration of Platelet-Rich Plasma (PRP) and mesenchymal stem cells are also being extensively explores for their potential in tendon healing.
- Though successful use of PRP and mesenchymal stem cells have been recorded in horses prone to tendon injuries and other tendon problems, the use in humans requires more study before becoming reliable treatment methods for soft tissue injuries and disorders.
Cite This Article
APA
Roberts JH, Halper J.
(2021).
Growth Factor Roles in Soft Tissue Physiology and Pathophysiology.
Adv Exp Med Biol, 1348, 139-159.
https://doi.org/10.1007/978-3-030-80614-9_6 Publication
Researcher Affiliations
- Department of Pathology, College of Veterinary Medicine, The University of Georgia, Athens, GA, USA.
- Department of Pathology, College of Veterinary Medicine, and Department of Basic Sciences, AU/UGA Medical Partnership, The University of Georgia, Athens, GA, USA. jhalper@uga.edu.
MeSH Terms
- Animals
- Horses
- Humans
- Platelet-Derived Growth Factor
- Platelet-Rich Plasma
- Tendon Injuries / therapy
- Tendons
- Vascular Endothelial Growth Factor A
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