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J Orthop Translat. 2018 Apr 14;14:23-33. doi: 10.1016/ eCollection 2018 Jul.

The roles of inflammatory mediators and immunocytes in tendinopathy.

Tang C1,2,3,4,5, Chen Y1,2,3,4,5, Huang J1,2,3,4,5, Zhao K2,4,5, Chen X2,4,5, Yin Z2,4, Heng BC6, Chen W1,3, Shen W1,2,3,4,5.

Author information

Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China.
Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Zhejiang 310000, China.
Orthopaedics Research Institute, Zhejiang Univerisity, Zhejiang 310000, China.
Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China.
China Orthopaedic Regenerative Medicine (CORMed), Chinese Medical Association, Hangzhou, China.
Faculty of Dentistry, Department of Endodontology, The University of Hong Kong, Pokfulam, Hong Kong.


Tendinopathy is a common disease of the musculoskeletal system, particularly in athletes and sports amateurs. In this review, we will present evidence for the critical role of inflammatory mediators and immunocytes in the pathogenesis of tendinopathy and the efficacy of current antiinflammatory therapy and regenerative medicine in the clinic. We hereby propose a hypothesis that in addition to pulling force there may be compressive forces being exerted on the tendon during physical activities, which may initiate the onset of tendinopathy. We performed literature searches on MEDLINE from the inception of this review to February 2018. No language restrictions were imposed. The search terms were as follows: ("Tendinopathy"[Mesh] OR "Tendon Injuries"[Mesh] OR "Tendinitis"[Mesh] OR "Tendon"[Mesh]) AND (Inflammation OR "Inflammatory mediator*" OR Immunocyte*) OR ("anti inflammatory*" OR "regenerative medicine"). Inclusion criteria included articles that were original and reliable, with the main contents being highly relevant to our review. Exclusion criteria included articles that were not available online or have not been published. We scanned the abstract of these articles first. This was then followed by a careful screening of the articles which might be suitable for our review. Finally, 84 articles were selected as references. This review article is written in the narrative form. The translational potential of this article: Understanding the mechanisms of inflammation and existing antiinflammatory and regenerative therapies is key to the development of therapeutic strategies in tendinopathy.


Compression; Immunocytes; Inflammatory mediators; Pulling force; Tendinopathy

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