Expression of transforming growth factor-beta isoforms and their receptors in chronic tendinosis

Chronic tendon lesions are degenerative conditions and may represent a failure to repair or remodel the extracellular matrix after repeated micro-injury. Since TGF-ß is strongly associated with tissue repair, we investigated the expression of TGF-ß isoforms (ß1, ß2 and ß3) and their 2 signalling receptors (TGF-ßRI and TGF-ßRII) in normal and pathological Achilles tendons. In all tissues, all 3 TGF-ß isoforms and the 2 receptors were present at sites of blood vessels. Cells in the matrix showed no staining for TGF-ß1 or ß3, while TGF-ß2 was associated with cells throughout the normal cadaver tendon. Tissue from tendons with pathological lesions showed an increase in cell numbers and percentage TGF-ß2 expression. TGF-ßRII showed a wide distribution in cells throughout the tissue sections. As with TGF-ß2, there was an increase in the number of cells expressing TGF-ßRII in pathological tissue. TGF-ßRI was restricted to blood vessels and was absent from the fibrillar matrix. We conclude that despite the presence and upregulation of TGF-ß2, TGF-ß signalling is not propagated due to the lack of TGF-ßRI. This might explain why chronic tendon lesions fail to resolve and suggests that the addition of exogenous TGF-ß will have little effect on chronic tendinopathy.