The Journal of Bone and Joint Surgery (American). 2007;89:1315-1320.
doi:10.2106/JBJS.F.00257
© 2007 The Journal of Bone and Joint Surgery, Inc.
BMP-14 Gene Therapy Increases Tendon Tensile Strength in a Rat Model of Achilles Tendon Injury
Patrick Bolt, MD1,
Avnish Neil Clerk, MD1,
Hue H. Luu, MD1,
Quan Kang, MD1,
Jennifer L. Kummer, MD1,
Zhong-Liang Deng, MD, PhD1,
Kirstina Olson, MD1,
Frank Primus, BS1,
Anthony G. Montag, MD1,
Tong-Chuan He, MD, PhD1,
Rex C. Haydon, MD, PhD1 and
Brian C. Toolan, MD1
1 Section of Orthopaedic Surgery and Rehabilitation Medicine, Department of
Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC
3079, Chicago, IL 60637. E-mail address for B.C. Toolan:
btoolan{at}surgery.bsd.uchicago.edu
Investigation performed at the Section of Orthopaedic Surgery and
Rehabilitation Medicine, Department of Surgery, University of Chicago Medical
Center, Chicago, Illinois
Disclosure: In support of their research for or preparation of this
work, one or more of the authors received, in any one year, outside funding or
grants of less than $10,000 from the Orthopaedic Research and Education
Foundation, the American Orthopaedic Foot and Ankle Society, and the National
Institutes of Health/National Institute of Arthritis and Musculoskeletal and
Skin Diseases. Neither they nor a member of their immediate families received
payments or other benefits or a commitment or agreement to provide such
benefits from a commercial entity. No commercial entity paid or directed, or
agreed to pay or direct, any benefits to any research fund, foundation,
division, center, clinical practice, or other charitable or nonprofit
organization with which the authors, or a member of their immediate families,
are affiliated or associated.
NOTE: The authors thank Dezheng Huo of the Department of Health
Studies for his expert assistance with the statistical analysis of the
samples.
Background: Molecular and cellular-based enhancements of healing
combined with conventional methods may yield better outcomes after the
surgical management of tendon injury. We examined the histological and
biomechanical effects of adenovirus-mediated transgene expression of bone
morphogenetic protein-14 (BMP-14) on healing in a rat Achilles tendon
laceration model. Specifically, we hypothesized that this delivery system for
gene therapy would hasten the restoration of the normal histological
appearance and tensile strength of a surgically repaired tendon.
Methods: The right Achilles tendon of ninety male Sprague-Dawley
rats was transected, repaired, and immediately infected with adenovirus
expressing either the gene for green fluorescent protein (AdGFP) or the gene
for human BMP-14 and green fluorescent protein (AdBMP-14). A sham control
group received no viral-mediated infection after repair. Animals from each of
the three groups were killed at one, two, and three weeks after surgery. The
retrieved tendons were inspected, examined under light and fluorescent
microscopy, and tested to determine their tensile strength.
Results: Tendons transduced with BMP-14 exhibited less visible
gapping, a greater number of neotenocytes at the site of healing, and 70%
greater tensile strength than did either those transduced with GFP or the sham
controls at two weeks after repair. Histological examination revealed no
inflammatory response to the adenovirus in tendons transduced with BMP-14 or
GFP. No ectopic bone or cartilage formed in the tendons transduced with
BMP-14.
Conclusions: Adenovirus-mediated gene therapy with BMP-14 expedites
tendon-healing in this animal model. No adverse immunological response to the
adenoviral vector was detected in the host tissue, and the local production of
BMP-14 did not induce unwelcome bone or cartilage formation within the healing
tendon.
Clinical Relevance: The results of this animal study suggest that
gene therapy with BMPs may improve the capacity of injured musculoskeletal
tissue to heal.

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Letters to the Editor:
Read all Letters to the Editor
- BMP-14 gene transfer into rat Achilles tendon
- Markus Rickert, M.D., Ph.D
- JBJS Online, 31 Jul 2007
[Full text]
- Dr. Toolan et al. respond to Dr. Rickert.
- Brian C. Toolan, M.D., et al.
- JBJS Online, 31 Jul 2007
[Full text]
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