PATHOPHYSIOLOGY OF TENDON AND LIGAMENT INJURY AND HEALING

摘要

Immune cells and inflammatory mechanisms are now believed to play key roles in the pathophysiology of tendon and ligament injury and healing throughout the disease process, despite continued controversy over terminology.Millar et al. have recently described three distinct compartments involved in the inflammation network that influences tendon homeostasis:1) Immune-sensing compartment: resident mast cells and macrophages that produce cytokines and chemokines in response to initial tendon damage2) Infiltrating compartment: immune cells that exit the blood stream and invade the tendon in response to the cytokines and chemokines produced by the resident cells.3) Stromal compartment: mainly tenocytes, which are responsible for extracellular matrix (ECM) regulation and are subject to the effects of both resident and invading immune cells. Tenocytes also have the ability to produce cytokines and chemokines, andmay be responsible for lack of homeostasis and resolution of inflammation in chronic cases.