"One Health" in tendinopathy research: Current concepts

Area of Science:

• Musculoskeletal disorders
• Veterinary medicine
• Human medicine

Background:

• Tendinopathy is a prevalent musculoskeletal disorder in human and equine athletes.
• It poses significant challenges in diagnosis and treatment.
• The third Dorothy Havemeyer Symposium focused on tendinopathy in both species.

Purpose of the Study:

• To provide an overview of current understanding in tendinopathy basic science and clinical challenges.
• To explore underlying mechanisms of tendon failure, regeneration, and inflammation resolution.
• To foster collaboration between human and veterinary medicine using analogous disease models.

Main Methods:

• Review of current knowledge on tendinopathy pathology (cellular, molecular, structural, biomechanical).
• Comparison of human Achilles tendinopathy and equine superficial digital flexor tendon pathology.
• Discussion on clinical trial design, conduct, and impact, informed by human medicine experience.
• Consideration of observational studies and registries for equine medicine.

Main Results:

• Tendon pathology involves complex cellular, molecular, structural, and biomechanical alterations.
• Equine tendons offer naturally occurring models analogous to human tendinopathies.
• Human clinical trial experience can inform equine clinical trial design and execution.

Conclusions:

• Understanding tendon failure and regeneration mechanisms is vital for novel intervention development.
• Collaborative efforts between human and veterinary fields can advance tendinopathy research.
• Careful consideration of study design, enrollment, and economic factors is crucial for effective clinical trials in equine medicine.