Leveraging mechanobiology: Identifying mechanotransducers with potential applications for tendon repair

Tendons are collagen-rich tissues that are necessary for movement and, as such, are exposed to mechanical forces. Mechanical loading impacts tendon formation, homeostasis and injury. Frequent injury and poor healing of tendon is a major clinical issue. An improved understanding of how tendon cells respond to mechanical forces is needed to advance new therapies to treat tendon injuries and limit degeneration caused by aberrant mechanical loading. In this review, we highlight recent discoveries in how mechanical stimulation impacts tendon and enthesis formation during development, as well as tendon maintenance and degradation during adulthood. We focus on understanding the cell-level mechanotransduction mechanisms, which include calcium signalling, activation of specific cell receptors and ion channels, and the effect on primary cilia and other downstream cell signalling pathways. These recently identified mechanotransducers in tendon cells show promise as future therapeutic targets, which can be leveraged for tendon healing.