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Pathogenesis of tendinopathies: inflammation or degeneration? |
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| Authors: | Michele Abate Karin Gravare Silbernagel Carl Siljeholm Angelo Di Iorio Daniele De Amicis Vincenzo Salini Suzanne Werner Roberto Paganelli |
| Institution: | 1. Postgraduate School of Physical Medicine and Rehabilitation, University G d'Annunzio, Chieti-Pescara, Chieti Scalo, CH, 66013, Italy 2. Lundberg Laboratory of Orthopaedic Research, Department of Orthopaedics, G?teborg University, Sahlgrenska University Hospital, 41345, G?teborg, Sweden 3. Stockholm Sports Trauma Research Center, Karolinska Institutet, 11486, Stockholm, Sweden 4. Section of Clinical Epidemiology and Geriatrics, Department of Medicine and Sciences of Aging, University G d'Annunzio, Chieti-Pescara, Chieti Scalo, CH, 66013, Italy 5. Postgraduate School of Orthopaedic and Traumatology, Department of Human Movement Science, University G d'Annunzio, Chieti-Pescara, Chieti Scalo, CH, 66013, Italy 6. Section of Clinical Immunology, Department of Medicine and Sciences of Aging, University G d'Annunzio, Chieti-Pescara, Chieti Scalo, CH, 66013, Italy |
| Abstract: | The intrinsic pathogenetic mechanisms of tendinopathies are largely unknown and whether inflammation or degeneration has the prominent role is still a matter of debate. Assuming that there is a continuum from physiology to pathology, overuse may be considered as the initial disease factor; in this context, microruptures of tendon fibers occur and several molecules are expressed, some of which promote the healing process, while others, including inflammatory cytokines, act as disease mediators. Neural in-growth that accompanies the neovessels explains the occurrence of pain and triggers neurogenic-mediated inflammation. It is conceivable that inflammation and degeneration are not mutually exclusive, but work together in the pathogenesis of tendinopathies. |
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