Growth factor delivery strategies for rotator cuff repair and regeneration

[Display omitted] The high incidence of degenerative tears and prevalence of retears (20–95%) after surgical repair makes rotator cuff injuries a significant health problem. This high retear rate is attributed to the failure of the repaired tissue to regenerate the native tendon-to-bone insertion (e...

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Published inInternational journal of pharmaceutics Vol. 544; no. 2; pp. 358 - 371
Main Authors Prabhath, Anupama, Vernekar, Varadraj N., Sanchez, Enid, Laurencin, Cato T.
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 15.06.2018
Subjects
Delivery
Enthesis
Growth factor
Rotator cuff
Scaffold
Tendon
b-FGF
Gli
GDF
IHH
SCX
Scaffold
CTGF
PRP
COMP
α-SMA
TGF-β
SOX-9
PlGF
HSPG
BMP
VEGF
IGF
PRFM
GAG
Enthesis
MMP
PDGF
Delivery
Rotator cuff
Tendon
Growth factor
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Abstract [Display omitted] The high incidence of degenerative tears and prevalence of retears (20–95%) after surgical repair makes rotator cuff injuries a significant health problem. This high retear rate is attributed to the failure of the repaired tissue to regenerate the native tendon-to-bone insertion (enthesis). Biological augmentation of surgical repair such as autografts, allografts, and xenografts are confounded by donor site morbidity, immunogenicity, and disease transmission, respectively. In contrast, these risks may be alleviated via growth factor therapy, which can actively influence the healing environment to promote functional repair. Several challenges have to be overcome before growth factor delivery can translate into clinical practice such as the selection of optimal growth factor(s) or combination, identification of the most efficient stage and duration of delivery, and the design considerations for the delivery device. Emerging insight into the injury-repair microenvironment and our understanding of growth factor mechanisms in healing are informing the design of advanced delivery scaffolds to effectively treat rotator cuff tears. Here, we review potential growth factor candidates, design parameters and material selection for growth factor delivery, innovative and dynamic delivery scaffolds, and novel therapeutic targets from tendon and developmental biology for the structural and functional healing of rotator cuff repair.
AbstractList [Display omitted] The high incidence of degenerative tears and prevalence of retears (20–95%) after surgical repair makes rotator cuff injuries a significant health problem. This high retear rate is attributed to the failure of the repaired tissue to regenerate the native tendon-to-bone insertion (enthesis). Biological augmentation of surgical repair such as autografts, allografts, and xenografts are confounded by donor site morbidity, immunogenicity, and disease transmission, respectively. In contrast, these risks may be alleviated via growth factor therapy, which can actively influence the healing environment to promote functional repair. Several challenges have to be overcome before growth factor delivery can translate into clinical practice such as the selection of optimal growth factor(s) or combination, identification of the most efficient stage and duration of delivery, and the design considerations for the delivery device. Emerging insight into the injury-repair microenvironment and our understanding of growth factor mechanisms in healing are informing the design of advanced delivery scaffolds to effectively treat rotator cuff tears. Here, we review potential growth factor candidates, design parameters and material selection for growth factor delivery, innovative and dynamic delivery scaffolds, and novel therapeutic targets from tendon and developmental biology for the structural and functional healing of rotator cuff repair.
The high incidence of degenerative tears and prevalence of retears (20-95%) after surgical repair makes rotator cuff injuries a significant health problem. This high retear rate is attributed to the failure of the repaired tissue to regenerate the native tendon-to-bone insertion (enthesis). Biological augmentation of surgical repair such as autografts, allografts, and xenografts are confounded by donor site morbidity, immunogenicity, and disease transmission, respectively. In contrast, these risks may be alleviated via growth factor therapy, which can actively influence the healing environment to promote functional repair. Several challenges have to be overcome before growth factor delivery can translate into clinical practice such as the selection of optimal growth factor(s) or combination, identification of the most efficient stage and duration of delivery, and the design considerations for the delivery device. Emerging insight into the injury-repair microenvironment and our understanding of growth factor mechanisms in healing are informing the design of advanced delivery scaffolds to effectively treat rotator cuff tears. Here, we review potential growth factor candidates, design parameters and material selection for growth factor delivery, innovative and dynamic delivery scaffolds, and novel therapeutic targets from tendon and developmental biology for the structural and functional healing of rotator cuff repair.
Author Sanchez, Enid
Vernekar, Varadraj N.
Prabhath, Anupama
Laurencin, Cato T.
AuthorAffiliation e Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT, 06269, USA
f Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, 06269, USA
b Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
c Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USA
a Institute for Regenerative Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
d Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
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  fullname: Prabhath, Anupama
  organization: Institute for Regenerative Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
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  surname: Vernekar
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  surname: Sanchez
  fullname: Sanchez, Enid
  organization: Institute for Regenerative Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
– sequence: 4
  givenname: Cato T.
  surname: Laurencin
  fullname: Laurencin, Cato T.
  email: laurencin@uchc.edu
  organization: Institute for Regenerative Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29317260$$D View this record in MEDLINE/PubMed
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Issue 2
Keywords b-FGF
Gli
GDF
IHH
SCX
Scaffold
CTGF
PRP
COMP
α-SMA
TGF-β
SOX-9
PlGF
HSPG
BMP
VEGF
IGF
PRFM
GAG
Enthesis
MMP
PDGF
Delivery
Rotator cuff
Tendon
Growth factor
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References_xml – volume: 473
  start-page: 1644
  year: 2015
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Snippet [Display omitted] The high incidence of degenerative tears and prevalence of retears (20–95%) after surgical repair makes rotator cuff injuries a significant...
The high incidence of degenerative tears and prevalence of retears (20-95%) after surgical repair makes rotator cuff injuries a significant health problem....
The high incidence of degenerative tears and prevalence of retears (20–95%) after surgical repair makes rotator cuff injuries a significant health problem....
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SubjectTerms Delivery
Enthesis
Growth factor
Rotator cuff
Scaffold
Tendon
Title Growth factor delivery strategies for rotator cuff repair and regeneration
URI https://dx.doi.org/10.1016/j.ijpharm.2018.01.006
https://www.ncbi.nlm.nih.gov/pubmed/29317260
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