肌腱老化与肌腱损伤和/或慢性肌腱疾病的患病率增加有关。如肌腱病,这影响了大约25%的成年人口。衰老的肌腱通常以肌腱干/祖细胞(TSPCs)的数量和功能减少为特征。破碎或杂乱无章的胶原蛋白束,糖胺聚糖(GAGs)的沉积增加,导致疼痛,炎症,和行动不便。虽然确切的病理学是未知的,过度使用和老化引起的微创伤被认为是主要的致病因素。由于肌腱微环境的低血管和低细胞性质,使用当前的疼痛/炎症和外科治疗技术,难以治愈老年肌腱和相关损伤。因此,需要新疗法,特别是细胞疗法,如细胞再生,由于老化过程中的再生能力下降。为了加强治疗肌腱老化相关疾病和损伤的治疗策略,需要全面了解肌腱老化病理。这篇综述总结了与年龄相关的肌腱变化,包括细胞行为,细胞外基质(ECM)组成,生物力学特性和愈合能力。此外,常规治疗的影响(饮食,锻炼,和手术)进行了讨论,和最近的先进策略(细胞再生)被强调,以解决老年肌腱愈合。这篇综述强调了衰老肌腱生物力学特性与愈合反应之间的分子和细胞联系,并概述了目前治疗老年肌腱的新策略。了解未来肌腱老化的基础和转化研究的基本原理对于开发先进的肌腱再生疗法至关重要。
Tendon aging is associated with an increasing prevalence of tendon injuries and/or chronic tendon diseases, such as tendinopathy, which affects approximately 25% of the adult population. Aged tendons are often characterized by a reduction in the number and functionality of tendon stem/progenitor cells (TSPCs), fragmented or disorganized collagen bundles, and an increased deposition of glycosaminoglycans (GAGs), leading to pain, inflammation, and impaired mobility. Although the exact pathology is unknown, overuse and microtrauma from aging are thought to be major causative factors. Due to the hypovascular and hypocellular nature of the tendon microenvironment, healing of aged tendons and related injuries is difficult using current pain/inflammation and surgical management techniques. Therefore, there is a need for novel therapies, specifically cellular therapy such as cell rejuvenation, due to the decreased regenerative capacity during aging. To augment the therapeutic strategies for treating tendon-aging-associated diseases and injuries, a comprehensive understanding of tendon aging pathology is needed. This review summarizes age-related tendon changes, including cell behaviors, extracellular matrix (ECM) composition, biomechanical properties and healing capacity. Additionally, the impact of conventional treatments (diet, exercise, and surgery) is discussed, and recent advanced strategies (cell rejuvenation) are highlighted to address aged tendon healing. This review underscores the molecular and cellular linkages between aged tendon biomechanical properties and the healing response, and provides an overview of current and novel strategies for treating aged tendons. Understanding the underlying rationale for future basic and translational studies of tendon aging is crucial to the development of advanced therapeutics for tendon regeneration.