Achilles Tendinopathy is a Troublesome Sports-related Condition Involving Blood Vessel Ingrowth into the Tendon Tissue Studies on the Adjacent Plantaris Tendon and the Peritendinous Connective Tissue Suggest that TNF-alpha can be Highly Involved in the Vascular and Tissue Changes

摘要

Achilles tendinopathy/tendinosis is a troublesome condition which is frequently occurring in response to sports related activities. It can lead to an ending of the sport activity. There is evidence which shows that ingrowth of blood vessels occurs from the peritendinous tissue. In well-established treatments the areas of these vessels are targeted. In Achilles tendinosis there is frequently a coalescing of the plantaris tendon with the Achilles tendon. TNF-alpha is known to be involved in blood vessel remodelling events and angiogenesis. With these facts as background, the peritendinous connective tissue located inbetween the plantaris and Achilles tendons and the plantaris tendon itself in cases with Achilles tendinosis were evaluated concerning expression of TNF-alpha and TNF receptor II (TNFRII). It was found that there were expressions of TNF-alpha in the numerous cells located in the peritendinous connective tissue and that the very frequently occurring blood vessels located in this tissue as well as in the tendon tissue exhibited marked TNFRII reactions. The tenocytes were shown to exhibit moderate TNF-alpha reactions and very strong TNFRII reactions. The observations suggest that TNF-alpha is highly involved in the blood vessel remodelling in tendinosis and that TNF-alpha also is involved in tenocyte function.