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Updated: Sep 24, 2025

Author Spotlight: Advancements in Cell and Tissue Engineering for Tendon Repair
Published on: March 1, 2024
Tendon microstructural disruption promotes tendon-derived stem cells to express chondrogenic genes by activating
Chang Liu1,2, Tian-Yu Li1, Yong Chen1
1Shenzhen Key Laboratory of Musculoskeletal Tissue Reconstruction and Function Restoration, Division of Hand and Microvascular Surgery, Department of Orthopedic Surgery, Shenzhen People's Hospital (the First Affiliated Hospital, Southern University of Science and Technology the Second Clinical Medical College, Jinan University), Shenzhen, China.
Abstract:
The erroneous differentiation of tendon-derived stem cells (TDSCs) into adipocytes, chondrocytes, and osteoblasts is believed to play an important role in the development of tendinopathy. However, the regulatory mechanisms of TDSC differentiation remain unclear. The aim of this study is to investigate the contribution and mechanism of the tendon microstructural disruption to the differentiation of TDSCs. Bovine Achilles tendons were sliced. The tendon slices were stretched with different tensile strains to mimic the tendon structure alteration at various scales. The TDSCs were cultured on the tendon slices. The differentiation of TDSCs and endoplasmic reticulum (ER) stress in the TDSCs were investigated with quantitative reverse transcription polymerase chain reaction, immunostaining and western blot. The effect of ER stress inhibition on chondrogenic differentiation of the TDSCs was further investigated. The structural alteration did not affect the viability of TDSCs. However, the structural alteration of tendon slices with 6.4% strain promoted TDSCs to express the chondrogenic genes. ER stress-related markers, ATF-4 and PERK, were also upregulated. With the inhibition of ER stress, the expression of ATF-4 and the chondrogenic gene SOX9 of TDSCs were inhibited. The study indicated that tendon microdamage could induce the chondrogenic differentiation of TDSCs through triggering ER stress to activate ATF-4 and SOX9 subsequently.
Insights
Tendon microdamage can trigger endoplasmic reticulum (ER) stress, promoting tendon-derived stem cells (TDSCs) to differentiate into chondrocytes. Inhibiting ER stress reduces this chondrogenic differentiation, revealing a key mechanism in tendinopathy development.
Area of Science:
- Biomedical Engineering
- Stem Cell Biology
- Orthopedics
Background:
- Tendinopathy involves erroneous differentiation of tendon-derived stem cells (TDSCs).
- Regulatory mechanisms of TDSC differentiation in tendinopathy are not fully understood.
- Tendon microstructural disruption is a potential factor influencing TDSC differentiation.
Purpose of the Study:
- To investigate the role of tendon microstructural disruption in TDSC differentiation.
- To elucidate the underlying mechanisms, focusing on endoplasmic reticulum (ER) stress.
Main Methods:
- Bovine Achilles tendon slices were subjected to varying tensile strains.
- TDSCs were cultured on these altered tendon microstructures.
- Quantitative RT-PCR, immunostaining, and Western blot analyzed TDSC differentiation and ER stress markers (ATF-4, PERK).
- ER stress inhibition was used to assess its effect on chondrogenic differentiation.
Main Results:
- Structural alterations (6.4% strain) promoted TDSC chondrogenic gene expression without affecting viability.
- ER stress markers ATF-4 and PERK were upregulated following structural alteration.
- Inhibiting ER stress reduced ATF-4 and SOX9 (chondrogenic gene) expression in TDSCs.
Conclusions:
- Tendon microdamage induces chondrogenic differentiation of TDSCs.
- This process is mediated by ER stress activation.
- ER stress leads to the subsequent activation of ATF-4 and SOX9, contributing to tendinopathy development.
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