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J Tissue Eng Regen Med. 2018 Apr;12(4):1039-1048. doi: 10.1002/term.2605. Epub 2017 Dec 6.

Cell-laden composite suture threads for repairing damaged tendons.

Costa-Almeida R1,2,3,4, Domingues RMA1,2, Fallahi A3,4,5, Avci H3,4,6, Yazdi IK3,4,5, Akbari M3,4,5, Reis RL1,2,7, Tamayol A3,4,5, Gomes ME1,2,7, Khademhosseini A3,4,5.

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3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, GuimarĂ£es, Portugal.
ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal.
Department of Biomedical Engineering, Biomaterials Innovation Research Center, Cambridge, MA, USA.
Harvard-MIT Division of Health Sciences and Technologies, Massachusetts Institute of Technology, Cambridge, MA, USA.
Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, USA.
Eskisehir Osmangazi University, Metallurgical and Materials Engineering, Eskisehir, Turkey.
The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, GuimarĂ£es, Portugal.


Tendons have limited regenerative capacity due to their low cellularity and hypovascular nature, which results in poor clinical outcomes of presently used therapies. As tendon injuries are often observed in active adults, it poses an increasing socio-economic burden on healthcare systems. Currently, suture threads are used during surgical repair to anchor the tissue graft or to connect injured ends. Here, we created composite suture threads coated with a layer of cell-laden hydrogel that can be used for bridging the injured tissue aiming at tendon regeneration. In addition, the fibres can be used to engineer 3-dimensional constructs through textile processes mimicking the architecture and mechanical properties of soft tissues, including tendons and ligaments. Encapsulated human tendon-derived cells migrated within the hydrogel and aligned at the surface of the core thread. An up-regulation of tendon-related genes (scleraxis and tenascin C) and genes involved in matrix remodelling (matrix metalloproteinases 1, matrix metalloproteinases 2) was observed. Cells were able to produce a collagen-rich matrix, remodelling their micro-environment, which is structurally comparable to native tendon tissue.


biotextiles; braiding; cell-laden fibres; composite sutures; tendon tissue engineering; tissue regeneration


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