https://doi.org/10.4081/ejtm.2022.10768
Treatment of Achilles tendon partial injuries with injection of peripheral blood mononuclear cells (PB-MNCs): a case series
Submitted: 2 August 2022
Accepted: 21 October 2022
Published: 2 November 2022
Accepted: 21 October 2022
Abstract Views: 836
PDF: 336
HTML: 7
HTML: 7
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Three patients with Achilles tendon partial injury were treated with local injection of peripheral blood mononuclear cells (PB-MNCs). All subjects were evaluated both clinically (American Orthopedic Foot and Ankle Society - AOFAS scale) and radiologically (MRI examination) at 2 months, and a clinical reassessment with the AOFAS scale was performed at 6 months. Functional and radiological signs of tendon healing processes were detected as early as 2 months after the procedure and the AOFAS scale rose from an initial average value of 37.0 to 82.7. Even though this study only involved a limited number of participants, our preliminary results indicate that regenerative therapies with PB-MNCs may be a valid alternative to surgical options for Achilles tendon partial injuries, especially in patients with contraindications to surgery, when other conservative approaches (exercises, physical therapies, sclerosing treatment) have failed. Further investigations on the subject seem rationally supported and advisable.
Ames PRJ, Longo UG, Denaro V, Maffulli N. Achilles tendon problems: Not just an orthopaedic issue. Disability and Rehabilitation. 2008;30(20-22):1646-1650.
DOI: https://doi.org/10.1080/09638280701785882
van der Vlist AC, Breda SJ, Oei EHG, Verhaar JAN, de Vos RJ. Clinical risk factors for Achilles tendinopathy: a systematic review. Br J Sports Med. 2019;53(21):1352-1361.
DOI: https://doi.org/10.1136/bjsports-2018-099991
Hess GW. Achilles tendon rupture: a review of etiology, population, anatomy, risk factors, and injury prevention. Foot Ankle Spec. 2010;3(1):29-32.
DOI: https://doi.org/10.1177/1938640009355191
Järvinen TAH, Kannus P, Maffulli N, Khan KM. Achilles tendon disorders: etiology and epidemiology. Foot Ankle Clin. 2005;10(2):255-266.
DOI: https://doi.org/10.1016/j.fcl.2005.01.013
Llanos Alcázar LF, Martín López C. Biomecánica del calcáneo. Rev Ortop Traumatol Ed Lat Am. 2005;49:61-68.
DOI: https://doi.org/10.1016/S0482-5985(05)74466-7
Ogle ME, Segar CE, Sridhar S, Botchwey EA. Monocytes and macrophages in tissue repair: Implications for immunoregenerative biomaterial design. Exp Biol Med. 2016;241(10):1084-1097.
DOI: https://doi.org/10.1177/1535370216650293
Buono AD, Del Buono A, Battery L, Denaro V, Maccauro G, Maffulli N. Tendinopathy and Inflammation: Some Truths. International Journal of Immunopathology and Pharmacology. 2011;24(1_suppl2):45-50.
DOI: https://doi.org/10.1177/03946320110241S209
Hoofnagle CJ, van der Sloot B, Borgesius FZ. The European Union general data protection regulation: what it is and what it means. Information & Communications Technology Law. 2019;28(1):65-98.
DOI: https://doi.org/10.1080/13600834.2019.1573501
General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014;81(3):14-18.
Cöster MC, Rosengren BE, Bremander A, Brudin L, Karlsson MK. Comparison of the Self-reported Foot and Ankle Score (SEFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS). Foot Ankle Int. 2014;35(10):1031-1036.
DOI: https://doi.org/10.1177/1071100714543647
Nunes Ferreira LE, Hasan D, Muniz BV, Sanchez JB, Volpato MC, Groppo FC. Effects of local anesthetics on cellular necrosis, apoptosis and inflammatory modulation: Short review. J Anesth Clin Res. 2018;09(05).
DOI: https://doi.org/10.4172/2155-6148.1000826
Fenwick SA, Hazleman BL, Riley GP. The vasculature and its role in the damaged and healing tendon. Arthritis Res. 2002;4(4):252-260.
DOI: https://doi.org/10.1186/ar416
Mauro A, Russo V, Di Marcantonio L, Berardinelli P, Martelli A, Muttini A, Mattioli M, Barboni B. M1 and M2 macrophage recruitment during tendon regeneration induced by amniotic epithelial cell allotransplantation in ovine. Res Vet Sci. 2016 Apr;105:92-102. Epub 2016 Jan 21.
DOI: https://doi.org/10.1016/j.rvsc.2016.01.014
Julier Z, Park AJ, Briquez PS, Martino MM. Promoting tissue regeneration by modulating the immune system. Acta Biomaterialia. 2017;53:13-28.
DOI: https://doi.org/10.1016/j.actbio.2017.01.056
Sugg KB, Lubardic J, Gumucio JP, Mendias CL. Changes in macrophage phenotype and induction of epithelial-to-mesenchymal transition genes following acute Achilles tenotomy and repair. J Orthop Res. 2014;32(7):944-951.
DOI: https://doi.org/10.1002/jor.22624
Tsai SL, Nödl MT, Galloway JL. Bringing tendon biology to heel: Leveraging mechanisms of tendon development, healing, and regeneration to advance therapeutic strategies. Dev Dyn. 2021;250(3):393-413.
DOI: https://doi.org/10.1002/dvdy.269
Kokubu S, Inaki R, Hoshi K, Hikita A. Adipose-derived stem cells improve tendon repair and prevent ectopic ossification in tendinopathy by inhibiting inflammation and inducing neovascularization in the early stage of tendon healing. Regen Ther. 2020;14:103-110.
DOI: https://doi.org/10.1016/j.reth.2019.12.003
Spaltro G, Straino S, Gambini E, Bassetti B, Persico L, Zoli S, Zanobini M, Capogrossi MC, Spirito R, Quarti C, Pompilio G. Characterization of the Pall Celeris system as a point-of-care device for therapeutic angiogenesis. Cytotherapy. 2015 Sep;17(9):1302-13. Epub 2015 May 30.
DOI: https://doi.org/10.1016/j.jcyt.2015.04.006
Scatena A, Petruzzi P, Maioli F, Lucaroni F, Ambrosone C, Ventoruzzo G, Liistro F, Tacconi D, Di Filippi M, Attempati N, Palombi L, Ercolini L, Bolognese L. Autologous Peripheral Blood Mononuclear Cells for Limb Salvage in Diabetic Foot Patients with No-Option Critical Limb Ischemia. J Clin Med. 2021 May 20;10(10):2213.
DOI: https://doi.org/10.3390/jcm10102213
Misharin AV, Cuda CM, Saber R, Turner JD, Gierut AK, Haines GK 3rd, Berdnikovs S, Filer A, Clark AR, Buckley CD, Mutlu GM, Budinger GR, Perlman H. Nonclassical Ly6C(-) monocytes drive the development of inflammatory arthritis in mice. Cell Rep. 2014 Oct 23;9(2):591-604. Epub 2014 Oct 16.
DOI: https://doi.org/10.1016/j.celrep.2014.09.032
Cantini M, Massimino ML, Bruson A, Catani C, Dalla Libera L, Carraro U. Macrophages regulate proliferation and differentiation of satellite cells. Biochem Biophys Res Commun. 1994 Aug 15;202(3):1688-96.
DOI: https://doi.org/10.1006/bbrc.1994.2129
Cantini M, Carraro U. Macrophage-released factor stimulates selectively myogenic cells in primary muscle culture. J Neuropathol Exp Neurol. 1995 Jan;54(1):121-8.
DOI: https://doi.org/10.1097/00005072-199501000-00014
Cantini M, Massimino ML, Rapizzi E, Rossini K, Catani C, Dalla Libera L, Carraro U. Human satellite cell proliferation in vitro is regulated by autocrine secretion of IL-6 stimulated by a soluble factor(s) released by activated monocytes. Biochem Biophys Res Commun. 1995 Nov 2;216(1):49-53.
DOI: https://doi.org/10.1006/bbrc.1995.2590
Massimino ML, Rapizzi E, Cantini M, Libera LD, Mazzoleni F, Arslan P, Carraro U. ED2+ macrophages increase selectively myoblast proliferation in muscle cultures. Biochem Biophys Res Commun. 1997 Jun 27;235(3):754-9.
DOI: https://doi.org/10.1006/bbrc.1997.6823
Nauwelaers AK, Van Oost L, Peers K. Evidence for the use of PRP in chronic midsubstance Achilles tendinopathy: A systematic review with meta-analysis. Foot Ankle Surg. 2021;27(5):486-495.
DOI: https://doi.org/10.1016/j.fas.2020.07.009
Caravaggio F, Antonelli M, Depalmi F. Regenerative medicine: potential applications for foot and ankle disorders. Lo Scalpello - Otodi Educational. 2021;35(2):117-128.
DOI: https://doi.org/10.36149/0390-5276-208
How to Cite
Caravaggio, F., Depalmi, F., & Antonelli, M. (2022). Treatment of Achilles tendon partial injuries with injection of peripheral blood mononuclear cells (PB-MNCs): a case series. European Journal of Translational Myology, 32(4). https://doi.org/10.4081/ejtm.2022.10768
Copyright (c) 2022 The Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Sandra Zampieri, Ines Bersch, Piera Smeriglio, Elena Barbieri, Simona Boncompagni, Maria Chiara Maccarone, Ugo Carraro, Program with last minute abstracts of the Padua Days on Muscle and Mobility Medicine, 27 February – 2 March, 2024 (2024Pdm3) , European Journal of Translational Myology: Vol. 34 No. 1 (2024)
- Sandra Zampieri, Ines Bersch, Piera Smeriglio, Elena Barbieri, Massimo Ganassi, Christiaan Leeuwenburg, Riccardo Rosati, Paolo Gargiulo, Amber Pond, H. Lee Sweeney, Ugo Carraro, Five Padua days on muscle and mobility medicine (2024Pdm3) 27 February - 2 March, 2024 at Hotel Petrarca, Thermae of Euganean Hills, Padua, and San Luca Hall, Prato della Valle, Padua, Italy , European Journal of Translational Myology: Vol. 33 No. 4 (2023)
You may also start an advanced similarity search for this article.