The Potential Role of Pro-resolving Mediators for the Treatment of Tendon Inflammation

Research vision and objectives

Musculoskeletal diseases such as tendinopathy (tendon injury) affecting the shoulder and ankle are a significant cause of chronic disability and reduction in quality of life, which are exacerbated with ageing.

Tendinopathy presents an immense global health burden and significant cost to the NHS. The causes of tendinopathy are not fully understood, although repetitive wear and tear, ageing and genetic factors are known contributors. A growing body of recent evidence supports the importance of inflammation in the pathogenesis of tendinopathy.

This project investigates how cells present in injured tendons can contribute to the development of chronic inflammation and fibrosis (scarring), causing tendon pain and loss of function in patients with these injuries. The aims of this work are to:

• Determine how inflammation changes in the early and advanced stages of tendon disease and how chronic inflammation develops; 
• Understand how tendons respond to injury with particular focus on a physiological process termed resolution, which is activated in response to inflammation;
• Investigate the inter-relationships between inflammation and pain to understand why some patient's symptoms resolve after treatment but others remain persistently painful.

Clinical Benefits

This research will generate new insights into the biological processes that underpin tendon health and disease. Findings from this study will enhance understanding of how tendon injuries develop, explore the mechanisms by which pain is perceived during injury and improve understanding of how injured tendons heal. This research will facilitate identification of new therapeutic targets and help people with tendinopathy keep fit for improved future health.

^{Image Top panel: Staining of healthy and diseased shoulder tendons showing disruption to the tendon tissue structure and increased cellularity and vascularity with disease. Bottom panel: Confocal images showing markers for inflammatory cells (macrophages) in a diseased shoulder tendon. Macrophage markers are in green, red and purple, blue shows nuclear counterstain.}