Nutrition and tendon healing

NewsBot · Oct 24, 2015

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NUTRITION AFFECTS TENDON HEALING IN A RAT MODEL
S Korntner, N Kunkel, C Lehner, R Gehwolf, A Wagner, P Augat, H Resch, HC Bauer, A Traweger and H Tempfer
Bone Joint J 2015 vol. 97-B no. SUPP 11 1

Introduction Metabolic disorders are among known risk factors for tendinopathies or spontaneous tendon ruptures. However, the underlying cellular and molecular mechanisms remain unclear. We have previously shown that human and rat tendon cells produce and secrete insulin upon glucose stimulation. Therefore, we hypothesize that nutritional glucose uptake affects tendon healing in a rat model.

Materials and Methods Unilateral full-thickness Achilles tendon defects were created in 60 female rats. Animals were randomly assigned to three groups receiving different diets for 2 weeks (high glucose diet, low glucose/high fat diet, control diet). Gait analysis was performed at three time points (n=20/group). In addition, tendon thickness, biomechanical (n=14/group), and histological and immunohistochemical analysis was conducted. Subsequently, a subtractive-suppression-hybridization (SSH) screen comparing cDNA pools (n=5) prepared from repair tissues of the high glucose and the control diet group was conducted to identify differentially expressed genes.

Results Newly formed repair tissue of the high-glucose and high-fat group was significantly thicker compared to the control group (p<0.001). Gait analysis revealed a significantly increased Intermediate Toe Spread for animals receiving high glucose diet one week p.o. compared to the control and high fat diet group (p<0.01). Maximum tensile load was significantly reduced in the control diet and the fat diet group, compared to intact tendons (p<0.05). Interestingly, there was no reduction evident for the glucose diet group. A similar trend was observed for tendon stiffness, with glucose diet repair tissue being significantly stiffer compared to the control diet (p<0.05). The proportion of Ki67+ cells in the repair tissue was 3,3% in the control, 9,8% in the glucose and 8,4% in the fat diet group, indicating an increased cell proliferation rate for the glucose and fat diet groups (p<0.001). Finally, the SSH screen revealed 48 candidate genes to be differentially expressed among the diet groups.

Discussion Tendon repair tissue quality is moderately affected by nutritional glucose. The molecular mechanisms underlying these effects on cells and matrix are currently under investigation and may be helpful in developing a dietary intervention scheme to support tendon regeneration after trauma or tendon disease.
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NewsBot · Jan 12, 2016

Dietary Supplementation During Musculoskeletal Injury: Protein and Creatine.
Strength & Conditioning Journal: January 08, 2016
PDF can be downloaded

NewsBot · Jan 5, 2019

Oral Supplementation of Specific Collagen Peptides Combined with Calf-Strengthening Exercises Enhances Function and Reduces Pain in Achilles Tendinopathy Patients
Stephan F.E. Praet et al
Nutrients 2019, 11(1), 76

The current pilot study investigates whether oral supplementation of specific collagen peptides improves symptoms and tendon vascularisation in patients with chronic mid-portion Achilles tendinopathy in combination with structured exercise. Participants were given a placebo or specific collagen peptides (TENDOFORTE®) in combination with a bi-daily calf-strengthening program for 6 months. Group AB received specific collagen peptides for the first 3 months before crossing over to placebo. Group BA received placebo first before crossing over to specific collagen peptides. At baseline (T1), 3 (T2) and 6 (T3) months, Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaires and microvascularity measurements through contrast-enhanced ultrasound were obtained in 20 patients. Linear mixed modeling statistics showed that after 3 months, VISA-A increased significantly for group AB with 12.6 (9.7; 15.5), while in group BA VISA-A increased only by 5.3 (2.3; 8.3) points. After crossing over group AB and BA showed subsequently a significant increase in VISA-A of, respectively, 5.9 (2.8; 9.0) and 17.7 (14.6; 20.7). No adverse advents were reported. Microvascularity decreased in both groups to a similar extent and was moderately associated with VISA-A (Rc2:0.68). We conclude that oral supplementation of specific collagen peptides may accelerate the clinical benefits of a well-structured calf-strengthening and return-to-running program in Achilles tendinopathy patients
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