Abstract
Introduction: A new procedure using uniquely designed gold particles to stimulate the production of various protective and regenerative proteins in patients own blood (GOLDIC®) was investigated. This study was designed to evaluate the effect of four consecutive GOLDIC® injections in human patients with Achilles tendinopathy.
Methods: In this prospective case series study, 19 patients with chronic Achilles tendinopathy were treated with GOLDIC®. All patients received injections at the treated sides peritendinously. Pain score (VAS = visual analog scale) was evaluated at 4, 12, 24, and 52 months follow-up. Dunn-test analyses were performed using a multiple comparison procedure based on the failed normality test. MRI follow-up could be performed in five patients before and after 1 year follow-up. Adverse events were documented using medDRA.
Results: In all patient groups, a statistically significant improvement of VAS could be demonstrated at all time points compared to baseline (p < 0.05). This effect was maintained up to 52 months. All MRIs showed fatty degeneration on the side of the tendinopathy. One year after the treatment, all patients demonstrated a complete regeneration of original tendon tissue as seen on the MRI. No severe adverse events are reported.
Conclusion: The results indicate that the treatment with GOLDIC injections is safe and has the potential to reduce pain in patients suffering from chronic Achilles tendinopathy. An impressive regenerative capacity was demonstrated using MRI even in old patients. Future comparative clinical studies need to be performed to investigate the potential of this new approach in comparison to other regenerative therapies.
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References
Adams SB Jr et al (2014) Stem cell-bearing suture improves Achilles tendon healing in a rat model. Foot Ankle Int 35(3):293–299
Andersen MB et al (2011) Interleukin-6: a growth factor stimulating collagen synthesis in human tendon. J Appl Physiol 1985 110(6):1549–1554
Aspenberg P (2007) Stimulation of tendon repair: mechanical loading, GDFs and platelets. A mini-review. Int Orthop 31(6):783–789
Barber FA et al (2008) A biomechanical study of Achilles tendon repair augmentation using GraftJacket matrix. Foot Ankle Int 29(3):329–333
Beattie AJ et al (2009) Chemoattraction of progenitor cells by remodeling extracellular matrix scaffolds. Tissue Eng Part A 15(5):1119–1125
Bolt P et al (2007) BMP-14 gene therapy increases tendon tensile strength in a rat model of Achilles tendon injury. J Bone Joint Surg Am 89(6):1315–1320
Bruder SP, Fink DJ, Caplan AI (1994) Mesenchymal stem cells in bone development, bone repair, and skeletal regeneration therapy. J Cell Biochem 56:283–294
Chen JL et al (2010) Efficacy of hESC-MSCs in knitted silk-collagen scaffold for tendon tissue engineering and their roles. Biomaterials 31(36):9438–9451
Chong AK et al (2007) Bone marrow-derived mesenchymal stem cells influence early tendon-healing in a rabbit Achilles tendon model. J Bone Joint Surg Am 89(1):74–81
Cui Q et al (2011) HGF inhibits TGF-beta1-induced myofibroblast differentiation and ECM deposition via MMP-2 in Achilles tendon in rat. Eur J Appl Physiol 111(7):1457–1463
Cummings SH et al (2012) Effect of recombinant human platelet-derived growth factor-BB-coated sutures on Achilles tendon healing in a rat model: a histological and biomechanical study. J Tissue Eng 3(1):2041731412453577
Daher RJ et al (2011) Tendon repair augmented with a novel circulating stem cell population. Int J Clin Exp Med 4(3):214–219
Dines JS et al (2007) The effect of growth differentiation factor-5-coated sutures on tendon repair in a rat model. J Shoulder Elbow Surg 16(5 Suppl):S215–S221
Farnebo S et al (2014) Decellularized tendon-bone composite grafts for extremity reconstruction: an experimental study. Plast Reconstr Surg 133(1):79–89
Filardo G et al (2016) Platelet-rich plasma in tendon-related disorders: results and indications. Knee Surg Sports Traumatol Arthrosc
Gholami M et al (2016) A systematic review and meta-analysis of the application of platelet rich plasma in sports medicine. Electron Physician 8(5):2325–2332
Gilbert TW et al (2007) Degradation and remodeling of small intestinal submucosa in canine Achilles tendon repair. J Bone Joint Surg Am 89(3):621–630
Hou Y et al (2009) Effects of transforming growth factor-beta1 and vascular endothelial growth factor 165 gene transfer on Achilles tendon healing. Matrix Biol 28(6):324–335
Huang TF et al (2013) Mesenchymal stem cells from a hypoxic culture improve and engraft Achilles tendon repair. Am J Sports Med 41(5):1117–1125
Jelinsky SA et al (2011) Treatment with rhBMP12 or rhBMP13 increase the rate and the quality of rat Achilles tendon repair. J Orthop Res 29(10):1604–1612
de Jonge S et al (2011) One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: a double-blind randomized placebo-controlled trial. Am J Sports Med 39(8):1623–1629
Kashiwagi K et al (2004) Effects of transforming growth factor-beta 1 on the early stages of healing of the Achilles tendon in a rat model. Scand J Plast Reconstr Surg Hand Surg 38(4):193–197
Keller TC et al (2011) Growth/differentiation factor-5 modulates the synthesis and expression of extracellular matrix and cell-adhesion related molecules of rat Achilles tendon fibroblasts. Connect Tissue Res 52(4):353–364
Kessler MW et al (2014) Enhancement of Achilles tendon repair mediated by matrix metalloproteinase inhibition via systemic administration of doxycycline. J Orthop Res 32(4):500–506
Kim HJ et al (2007) The role of transforming growth factor-beta and bone morphogenetic protein with fibrin glue in healing of bone-tendon junction injury. Connect Tissue Res 48(6):309–315
Lee DK (2007) Achilles tendon repair with acellular tissue graft augmentation in neglected ruptures. J Foot Ankle Surg 46(6):451–455
Lee DK (2008) A preliminary study on the effects of acellular tissue graft augmentation in acute Achilles tendon ruptures. J Foot Ankle Surg 47(1):8–12
Li GH et al (2012) Multifunctional roles of gelsolin in health and diseases. Med Res Rev 32:999–1025
Lohan A et al (2013) Human hamstring tenocytes survive when seeded into a decellularized porcine Achilles tendon extracellular matrix. Connect Tissue Res 54(4–5):305–312
Majewski M et al (2008) Ex vivo adenoviral transfer of bone morphogenetic protein 12 (BMP-12) cDNA improves Achilles tendon healing in a rat model. Gene Ther 15(16):1139–1146
Majewski M et al (2012) Improvement of tendon repair using muscle graft transduced with TGF-beta1 cDNA. Eur Cell Mater 23:94–101. discussion 101–102
Marycz K et al (2014) The autologous gelsolin combined with exogenous nucleotides enhance chondrogenic differentiation in equine adipose derived mesenchymal stromal cells—an in vitro research. J Cell Sci Ther 5:174
Mlynarek RA et al (2016) Platelet-Rich Plasma (PRP) in orthopedic sports medicine. Am J Orthop (Belle Mead NJ) 45(5):290–326
Ning LJ et al (2012) Preparation and characterization of decellularized tendon slices for tendon tissue engineering. J Biomed Mater Res A 100(6):1448–1456
Nirmalanandhan VS et al (2008) Effect of scaffold material, construct length and mechanical stimulation on the in vitro stiffness of the engineered tendon construct. J Biomech 41(4):822–828
Philpott NJ et al (1997) G-CSF-mobilized CD34 peripheral blood stem cells are significantly less apoptotic than unstimulated peripheral blood CD34 cells: role of G-CSF as survival factor. Br J Haematol 97(1):146–152
Pietschmann MF et al (2013) Comparison of tenocytes and mesenchymal stem cells seeded on biodegradable scaffolds in a full-size tendon defect model. J Mater Sci Mater Med 24(1):211–220
Prockop DJ (1997) Marrow stromal cells as stem cells for nonhematopoietic tissues. Science 276:71–74
Rickert M et al (2005) Adenovirus-mediated gene transfer of growth and differentiation factor-5 into tenocytes and the healing rat Achilles tendon. Connect Tissue Res 46(4–5):175–183
Schneider U, Veith G (2013) First results on the outcome of gold induced, autologous-conditioned serum (GOLDIC) in the treatment of different lameness-associated equine diseases. J Cell Sci Ther 5:151
Shah V et al (2013) Dose-response effect of an intra-tendon application of recombinant human platelet-derived growth factor-BB (rhPDGFBB) in a rat Achilles tendinopathy model. J Orthop Res 31(3):413–420
Spinardi L, Witke W (2007) Gelsolin and diseases. Subcell Biochem 45:55–69
Tang SW et al (2014) Stringent requirement for spatial arrangement of extracellular matrix in supporting cell morphogenesis and differentiation. BMC Cell Biol 15:10
Tetta C et al (2012) The role of microvesicles derived from mesenchymal stem cells in tissue regeneration; a dream for tendon repair? Muscles Ligaments Tendons J 2:212–221
Webb WR et al (2013) The application of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) scaffolds for tendon repair in the rat model. Biomaterials 34(28):6683–6694
Wen D et al (1996) The plasma and cytoplasmic forms of human gelsolin differ in disulfide structure. Biochemistry 35:9700–9709
Widmer A et al (2017) A prospective comparison of the Goldic® technique and corticosteroid plus hyaluronic acid injections for arthrogenic lamness in horses. Vet Comp Orthop Traumatol in review
Wisbeck JM et al (2012) Xenograft scaffold full-wrap reinforcement of Krackow Achilles tendon repair. Orthopedics 35(3):e331–e334
Yao J et al (2011) Viability and proliferation of pluripotential cells delivered to tendon repair sites using bioactive sutures-an in vitro study. J Hand Surg Am 36(2):252–258
Yin Z et al (2013) The effect of decellularized matrices on human tendon stem/progenitor cell differentiation and tendon repair. Acta Biomater 9(12):9317–9329
Zantop T et al (2006) Extracellular matrix scaffolds are repopulated by bone marrow-derived cells in a mouse model of Achilles tendon reconstruction. J Orthop Res 24(6):1299–1309
Zhang QH et al (2011) Treatment with gelsolin reduces brain inflammation and apoptotic signaling in mice following thermal injury. J Neuroinflammation 8:118
Zhou Y, Wang JH (2016) PRP treatment efficacy for tendinopathy: a review of basic science studies. Biomed Res Int 2016:9103792
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Schneider, U., Wallich, R., Felmet, G., Murrell, W.D. (2017). Gold-Induced Autologous Cytokine Treatment in Achilles Tendinopathy. In: Canata, G., d'Hooghe, P., Hunt, K. (eds) Muscle and Tendon Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54184-5_39
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DOI: https://doi.org/10.1007/978-3-662-54184-5_39
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