Injectable Therapy May Avert Rotator Cuff Injuries

An injectable compound under development could inhibit the breakdown of the supraspinatus tendon, a rotator cuff tendon that is commonly torn in sports.

Researchers at Georgia Tech (Atlanta, USA) and Emory University (Atlanta, GA, USA) are conducting a study to develop improved regenerative medicine strategies to aid repair of tendinopathic tissues. Since one of the hallmarks of tendinopathy is disruption of extracellular matrix (ECM), and particularly collagen, the researcher set out to test which classes of ECM proteases are involved in the tissue degeneration, and develop treatments to deliver inhibitory agents for these enzymes to reduce pathology progression and improve healing.

The central hypothesis of the researchers is that long-term regulation of protease activity in tendinopathy using a protease inhibitor will result in greater tendon tissue structure and mechanical properties. To do so, proteases and inhibitors related to ECM degradation will be tested in vivo in a rat supraspinatus tendon overuse model. The researchers hope to develop a controlled, injectable carrier to achieve local, sustained release of protease inhibitors. The researchers will also study the histology and mechanics of the tendons after healing.

“Normally people focus on treating tendon injuries after the tear has occurred, but we’re focusing on a much earlier stage in the disease,” said lead researcher associate professor Johnna Temenoff, PhD, of the department of Biomedical Engineering. “This is the first time that an injectable therapy specifically designed to interact with tissue at an early disease state has been attempted for this particular tendon injury.”

“We’re studying enzymes that are known to chew up the collagen, and we’re looking at then delivering inhibitors to those enzymes in a local injection in the tendon to try to stop the degradation,” added Dr. Temenoff. “We’re studying the disease in the shoulder, but it’s the same disease that causes tennis elbow, Achilles injuries, and jumper’s knee. It’s the same process, just in different tendons in the body.”

Tendinopathy is a common disorder resulting from repetitive motion in the workplace or during athletic activity that can cause severe pain and long-term disability due to tendon damage in the rotator cuff, a collation of four tendons made of collagen.

Related Links:
Georgia Tech
Emory University