Tendon healing in vivo: effect of mannose-6-phosphate on flexor tendon adhesion formation

The purpose of this study was to investigate the preventive effect of mannose-6-phosphate on flexor tendon adhesion formation. From a total of 84 adult New Zealand White rabbits, 36 were randomly divided into 2 groups, the normal saline group and the mannose-6-phosphate group, after anastomosis of the flexor tendons. Tendons were harvested at 4 weeks, and biomechanics testing was conducted. The other 48 rabbits were randomly divided into 2 groups, the normal saline group and the mannose-6-phosphate group, after anastomosis of the flexor tendons, and tendons were harvested at 7, 14, 28, and 56 days and analyzed by in situ hybridization to determine the mRNA expression of transforming growth factor (TGF)-β1 and collagen I. The results of biomechanics testing indicated that mannose-6-phosphate can effectively prevent flexor tendon adhesion formation after anastomonsis. The in situ hybridization examination revealed that TGF-β1 and collagen I mRNA expression in the mannose-6-phosphate group was lower than that in the normal saline group at each time point. Mannose-6-phosphate can effectively inhibit the function of TGF-β1 and prevent adhesion formation after flexor tendon injury.