Rheumatology Advance Access originally published online on July 16, 2003
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Rheumatology 2004; 43: 131-142
© British Society for Rheumatology 2003; all rights reserved
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The pathogenesis of tendinopathy. A molecular perspective
Rheumatology Research Unit, Box 194, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2NH, UK.
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Introduction |
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There are many publications that discuss the aetiology, diagnosis and treatment of the various forms of tendinopathy, but few are based on conclusive scientific evidence. The pathogenesis of tendinopathy is difficult to study because tendon biopsies are rarely obtained before a tendon has ruptured. There are interesting comparisons with animal tendinopathy, particularly in the equine athlete, although many animal models do not accurately reflect the human condition—the tendon lesions usually heal. However, the application of biochemical and molecular techniques to the study of both animal and human tendinopathy has led to a greater understanding of these common and disabling conditions. This article summarizes current knowledge of the pathogenesis of tendinopathy, with particular emphasis on the molecular pathology of the tendon matrix.
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Classification and terminology |
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Tendons may be affected by a variety of different pathological conditions. Many systemic diseases are associated with general defects in matrix metabolism and structure that compromise tendon strength and
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Aetiology of tendinopathy |
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Structure of tendon |
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Collagens in tendon |
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Proteoglycans in tendon |
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Ageing of the tendon matrix |
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Matrix turnover in tendon |
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Collagen degradation in tendon |
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Proteoglycan degradation in tendon |
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The matrix in chronic tendinopathy |
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Matrix turnover in tendinopathy |
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Regulation of matrix turnover in tendinopathy |
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Animal models, gene knockouts and tendon pathology |
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Summary |
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