Tendon-Derived Progenitor Cells With Multilineage Potential Are Present Within Human Patellar Tendon

Erika A Leonardi; Michelle Xiao; Iain R Murray; William H Robinson; Geoffrey D Abrams

doi:10.1177/23259671211023452

Tendon-Derived Progenitor Cells With Multilineage Potential Are Present Within Human Patellar Tendon

Orthop J Sports Med. 2021 Aug 20;9(8):23259671211023452. doi: 10.1177/23259671211023452. eCollection 2021 Aug.

Authors

Erika A Leonardi¹, Michelle Xiao¹, Iain R Murray¹, William H Robinson^{2

3}, Geoffrey D Abrams¹

Affiliations

¹ Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, California, USA.
² Division of Rheumatology and Immunology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
³ Palo Alto Division, VA Palo Alto Health Care System, Palo Alto, California, USA.

Abstract

Background: Progenitor cells serve as a promising source of regenerative potential in a variety of tissue types yet remain underutilized in tendinopathy. Tendon-derived progenitor cells (TDPCs) have previously been isolated from hamstring tendon but only as part of a concomitant medical procedure. Determining the presence of TDPCs in patellar tendon may facilitate clinical utilization of these cells because of the relative accessibility of this location for tissue harvest.

Purpose: To characterize TDPCs in human patellar tendon samples.

Study design: Descriptive laboratory study.

Methods: Human patellar tendon samples were obtained during elective knee surgery. TDPCs were isolated and seeded at an optimal low cell density and subcultured to confluence for up to 2 passages. Flow cytometry was used to analyze for the expression of CD90+, CD105+, CD44+, and CD31-, CD34-, and CD45- markers. The multilineage differentiation potential of TDPCs was tested in vitro via adipogenic, osteogenic, and chondrogenic culture with subsequent cytochemical staining for Oil Red O, Alizarin Red, and Alcian Blue, respectively. Enzyme-linked immunosorbent assay was used to quantify the amount of adiponectin, alkaline phosphatase, and SRY-box transcription factor 9 secreted into cell culture supernatant for further confirmation of lineage differentiation. Results were analyzed statistically using the 2-tailed Student t test.

Results: TDPCs demonstrated near-uniform expression of CD90, CD105, and CD44 with minimal expression of CD34, CD31, and CD45. Adipogenic, osteogenic, and chondrogenic differentiation of TDPCs was confirmed using qualitative analysis. The expression of adiponectin, alkaline phosphatase, and SRY-box transcription factor 9 were significantly increased in differentiated cells versus undifferentiated TDPCs (P < .05).

Conclusion: TDPCs can be successfully isolated from human patellar tendon samples, and they exhibit characteristics of multipotent progenitor cells.

Clinical relevance: These data demonstrate the promise of patellar tendon tissue as a source of progenitor cells for use in biologic therapies for the treatment of tendinopathy.

Keywords: patellar tendon; progenitor cell; regeneration; stem cell; tendinopathy; tendon.