Effects of transforming growth factor-β1 and vascular endothelial growth factor 165 gene transfer on Achilles tendon healing

Repaired Achilles tendons typically take weeks before they are strong enough to handle physiological loads. Gene therapy is a promising treatment for Achilles tendon defects. The aim of the present study was to evaluate the histological/biomechanical effects of Transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor 165 (VEGF₁₆₅) gene transfer on Achilles tendon healing in rabbits. Bone Marrow-Derived Mesenchymal Stem Cells (BMSCs) were transduced with adenovirus carrying human TGF-β1 cDNA (Ad-TGF-β1), human VEGF₁₆₅ cDNA (Ad-VEGF₁₆₅), or both (PIRES-TGF-β1/VEGF₁₆₅) Viruses, no cDNA (Ad-GFP), and the BMSCs without gene transfer and the intact tendon were used as control. BMSCs were surgically implanted into the experimentally injured Achilles tendons. TGF-β1 distribution, cellularity, nuclear aspect ratio, nuclear orientation angle, vascular number, collagen synthesis, and biomechanical features were measured at 1, 2, 4, and 8 weeks after surgery. The TGF-β1 and TGFβ1/VEGF₁₆₅ co-expression groups exhibited improved parameters compared with other groups, while the VEGF₁₆₅ expression group had a negative impact. In the co-expression group, the angiogenesis effects of VEGF₁₆₅ were diminished by TGF-β1, while the collagen synthesis effects of TGF-β1 were unaltered by VEGF₁₆₅. Thus treatment with TGF-β1 cDNA-transduced BMSCs grafts is a promising therapy for acceleration and improvement of tendon healing, leading to quicker recovery and improved biomechanical properties of Achilles tendons.