The Roles of Growth Factors in Tendon and Ligament Healing - PRP가 효과적인 이유!!

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건과 인대의 치유에서 5가지 성장촉진인자의 역할

tendon과 ligament 재생과정을 이해하고, 재생을 촉진하는 약물 찾기에 중요한 논문이 될듯

PRP가 왜 효과적인가를 설명하고 있음

panic bird.....

건과 인대를 재생하는 5가지 성장촉진 인자

1) insulin-like growth factor-I (IGF-I)

 IGF-I has been shown to be highly expressed during the early inflammatory phase in a number of animal tendon

healing models, and appears to aid in the proliferation and migration of fibroblasts and to subsequently increase collagen production

2) transforming growth factor β (TGFβ)

TGFβ is also active during inflammation, and has a variety of effects including the regulation of cellular migration and proliferation, and fibronectin binding interactions

3) vascular endothelial growth factor (VEGF)

VEGF is produced at its highest levels only after the inflammatory phase, at which time it is a powerful stimulator of angiogenesis. 

4) platelet-derived growth factor (PDGF)

PDGF is produced shortly after tendon damage and helps to stimulate the production of other growth factors, including IGF-I, and has roles in tissue remodelling.

5) basic fibroblast growth factor (bFGF)

In vitro and in vivo studies have shown that bFGF is both a powerful stimulator of angiogenesis and a regulator of cellular migration and proliferation

The Roles of Growth Factors in tendon and ligament healing.pdf

Tendon healing is a complex and highly-regulated process that is initiated, sustained and eventually terminated by a large number and variety of molecules. Growth factors represent one of the most important of the molecular families involved in healing, and a considerable number of studies have been undertaken in an effort to elucidate their many functions. This review covers some of the recent investigations into the roles of five growth factors whose activities have been best

characterised during tendon healing: insulin-like growth factor-I (IGF-I), transforming growth factor β (TGFβ), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and basic fibroblast growth factor (bFGF).

All five are markedly up-regulated following tendon injury and are active at multiple stages of the healing process. IGF-I has been shown to be highly expressed during the early inflammatory phase in a number of animal tendon healing models, and appears to aid in the proliferation and migration of fibroblasts and to subsequently increase collagen production. TGFβ is also active during inflammation, and has a variety of effects including the regulation of cellular

migration and proliferation, and fibronectin binding interactions. VEGF is produced at its highest levels only after the inflammatory phase, at which time it is a powerful stimulator of angiogenesis. PDGF is produced shortly after tendon damage and helps to stimulate the production of other growth factors, including IGF-I, and has roles in tissue remodelling.

In vitro and in vivo studies have shown that bFGF is both a powerful stimulator of angiogenesis and a regulator of cellular migration and proliferation. 

This review also covers some of the most recent studies into the use of these molecules as therapeutic agents to increase the efficacy and efficiency of tendon and ligament healing. Studies into the effects of the exogenous application of TGFβ, IGF-I, PDGF and bFGF into the wound site singly and in combination have shown promise, significantly decreasing a number of parameters used to define the functional deficit of a healing tendon. Application of IGF-I has been shown to increase in the Achilles Functional Index and the breaking energy of injured rat tendon. TGFβ and PDGF have been shown separately to increase the breaking energy of healing tendon. Finally, application of bFGF has been shown to promote cellular proliferation and collagen synthesis in vivo.

건과 인대의 치유 과정

Summary of the roles of five growth factors during tendon and ligament healing

analysis of transforming growth factor β (TGFβ-1)

vascular endothelial growth factor(VEGF) mRNA expression‎ in the canine flexor tendon post injury