Exploring susceptibility factors in tendon and ligament injuries

Why some people are more likely than others to experience tendon and ligament injuries is the theme of recently published research jointly authored by Professor Minghao Zheng, Head of Brain and Bone Research at the Perron Institute and UWA.

The study has identified a protein that reacts to stresses on tendons and ligaments and plays a key role in how our body responds to them.

The protein, Secreted Protein Acidic and Rich in Cysteine (SPARC), is linked to a person’s genetic makeup and could explain why some people are more prone to injuries of this type.

Tendon and ligament injuries occur in the soft tissues that connect muscles and joints and are one of the most common musculoskeletal injuries, affecting millions of people every year. They can cause a great deal of pain and in some cases can even result in loss of limb functioning and inability to work.

Professor Zheng holds the position of Winthrop Professor of Orthopaedic Research at The University of Western Australia. Co-collaborators in the tendon and ligament study which was published in Science Translational Medicine are Professor Andreas Traweger from the Paracelsus Medical University (Austria) and Professor Jiang Qin at Nanjing University (China).

Professor Zheng’s career has centred on bone and joint research and regenerative medicine. He pioneered the development of collagen scaffolds and cell therapy to treat cartilage, tendon and ligament injury, and is a global leader in regeneration of tendon and cartilage using a patient’s own stem cells.

Professor Zheng said he and fellow scientists collaborating in the recent study were interested to see how a person’s biological make-up could contribute to the strength of their tendons and ligaments.

“We found that those who have less SPARC due to gene mutation, have less type I collagen in their tendons and ligaments. If these people play competitive sport or even engage in light exercise, their tendons or ligaments are much weaker and very susceptible to rupture,” Professor Zheng said.

“This can be observed in children’s injuries where we know that ageing is not a factor in injury, so it is interesting to see that the SPARC protein even contributes to injuries in the young.

“In recent years we have seen more ACL ruptures due to increasing sport activities. However, it is not known whether or not this is because of a predisposition to injuries due to genetic factors or because of an increase in competitive sports.”

Professor Zheng said the study offered new insights by highlighting genetic factors responsible for sports injuries.

“For the first time, we have identified a genetic factor that affects tendons and ligaments. This is very exciting because increased understanding will help our ability to improve patient care in the future,” Professor Zheng said.

“It will be important to expand this research to study those who play sport and how tendon and ligament injuries can be prevented.”