# Enhanced Tendon Healing Through Growth Factor and Cell Therapies

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $557,062

## Abstract

PROJECT SUMMARY
Musculoskeletal injuries in the United States result in significant disability and high costs. Almost half of these
injuries are to tendons and ligaments, including lacerations of the flexor tendons of the hand, tears of the
Achilles tendon of the ankle, and tears of the rotator cuff of the shoulder. Despite significant advances in suture
techniques and rehabilitation methods, outcomes after tendon repair remain unsatisfactory, with high rates of
rupture and lost joint range of motion. Therefore, our long-term goal is to develop cell- and growth factor-based
strategies to enhance tendon repair. Tendon healing progresses through well-defined stages of inflammation,
proliferation, extracellular matrix (ECM) formation, and ECM remodeling. In our prior work, we noted a dramatic
upregulation of inflammatory factors in the earliest stage of tendon healing and insufficient cell migration and
ECM synthesis in the later stages of tendon healing. Recent stem cell and growth factor studies have
demonstrated the potential for biologically augmenting tendon repair. In the current proposal, we will use non-
invasive delivery systems to deliver adipose derived stromal cells (ASCs) and the growth factor CTGF to
enhance tendon repair. Furthermore, we will elucidate the mechanisms by which ASCs and CTGF affect
healing. A cell sheet approach will be used to deliver cells to the tendon surface (suppressing adhesions) and
a porous suture approach will be used to deliver growth factors to tendon interior (promoting extracellular
matrix synthesis). These new approaches will be tested in a clinically relevant large animal flexor tendon
model (although, the approaches will be generally applicable to any tendon surgical repair). Our central
hypothesis is that cell therapy will modulate the early inflammatory response and growth factor therapy will
modulate the later remodeling response to improve tendon healing. The first specific aim will test the efficacy of
ASC cell sheets for enhancing the early inflammatory phase of tendon healing. Previously, we showed that
ASCs can modulate tendon responses to inflammation in vitro and in vivo. Despite these observations, the
mechanism behind the detrimental effects of inflammatory cytokines on tendon and the translational potential
for modulating inflammation via stem cell therapy to enhance healing, have not been fully determined. The
second specific aim will test the ability of CTGF to enhance tendon remodeling. In prior work, we demonstrated
the potential for tendon regeneration via endogenous stem cell recruitment through the growth factor CTGF.
The third aim will evaluate the efficacy of combining ASC cell sheets with suture-based CTGF delivery for
enhancing the tendon healing. Based on our in vitro and small animal studies, this aim seeks to enhance
tendon healing through simultaneous delivery of CTGF and ASCs to the repair site. If successful, the proposed
large animal studies can be directly translated to e...

## Key facts

- **NIH application ID:** 9970169
- **Project number:** 5R01AR062947-08
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** RICHARD H GELBERMAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $557,062
- **Award type:** 5
- **Project period:** 2012-09-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9970169

## Citation

> US National Institutes of Health, RePORTER application 9970169, Enhanced Tendon Healing Through Growth Factor and Cell Therapies (5R01AR062947-08). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9970169. Licensed CC0.

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