Advances in tendinopathy

Previously I have touched on my summer research project on tendinopathy but today I thought I would share a bit of what I have done with you all, enjoy!

The driving force behind my research was due to the fact that soft tissue disorders represent the third most common musculoskeletal condition in the UK with 18 cases per 1000. These primarily affect tendons, accounting for 30% of all rheumatological consultations with a general practitioner. Causes are multifactorial but with an ever increasing number of professional athletes and also an ageing population whose tendons decrease in elasticity; there is an annual estimated cost to the NHS of £250 million. Though molecular pathophysiology of tendinopathy remains incompletely understood key inflammatory mediators such as proinflammatory cytokines are found to play a vital role.

This little fella is tenascin-C

The extracellular matrix molecule tenascin-C is highly expressed during embryonic development, in pathological situations such as chronic inflammation, cancer. By this report it is found to be at significantly higher levels during diseased tendon tissue repair as compared to healthy tendons to carry out its role as an inflammatory mediator and induce inflammation in attempts to repair the diseased tendon. Tenascin-C prolongs inflammation at site of trauma and leads to further tendon damage. These results provide useful insight into the complex cross-regulation of inflammation and tissue remodelling mediated by tenascin-C.

Some background information

Tendons are a band of flexible fibrous connective tissue which connects muscle to bone. They are present in joints and largely inelastic to conserve energy whilst transmitting the contractile movement of muscle to move bone. Despite the frequent mention of tendinopathy, tendons are in fact extremely tough it is found that collagen fibrillogenesis begins as an assembly of collagen molecules in a series of extracellular compartments, progressing through post-depositional maturation leading to thicker and longer fibrils and ending in their coalescence in the final stages of fibre production.

 

Figure 1Various tendons on the body which are affected by tendinopathy especially the Achilles tendon and rotator cuff

Short Rant about Entropy and the Universe

One of the most important laws of Physics is perhaps one we have all heard once in a while – the second law of thermodynamics.

This law states that the entropy – in a closed system – in which we can infer as the Universe, will always increase.

A common misconception with the term entropy is that it is a measure of disorder. A “disordered” state does not necessarily mean that it has high entropy and vice versa. Entropy is rather the number of ways particles can be arranged. We can take tea and milk as an example, as many people do. Looking at the tea and milk system, at the instantaneous moment when you pour milk into tea, it is perceived to have low entropy, this is because the milk molecules are virtually sitting on top of the tea molecules. When you wait for a second or two until the milk starts to blend and dissolve into the tea, the system begins to increase in entropy, because there are so many more ways for the milk and tea molecules to arrange themselves in this sense, rather than being stacked on top of each other.

My mind-changing Science Summer School experience

From Monday 24th to Friday 28th July 2017 I had attended a residential Sciences Summer School which made me even more set on a future career in STEM (which I didn’t think was possible, haha) and especially medicine. Moreover, I made an abundance of fellow nerd friends who didn’t make me feel as lonely. There were a total of 58 fifth year pupils from all different backgrounds, Scottish, English, Welsh and 1 lone Northern Irish guy but somehow we all connected in a way which prior to the summer school, I believe to be impossible in the span of only a week.

Sunday

To give myself enough time to travel to the college, I had packed up my bags a day before and arrived to explore the city. Like the tourist I was, I stocked up on a plethora of various fridge magnets depicting medieval buildings and misleadingly sunny postcards which did not accurately depict the British weather. We (10 other people who also travelled down on Sunday) met and were instantly friends. I tried my hand at the out of tune piano and out problems just melted away for a while under the diminishing sunlight.

Monday

After everyone else arrived and the different procedural introductions we got stuck in problem solving. (Note: the icebreaker we had to go through did not in fact break-the-ice for it was a bingo involving facts of students. An absurd example being to find someone with blue socks which I was only one of a precious few.) The director of studies did not treat us like kids, as a brilliant mathematician he questioned our intuition. After explaining Claude Shannon’s Information theory, he asked an array of mind-bending questions, but even the simplest one caused commotion amongst budding mathematicians:

“I have a bottle and a cap, together costing £1.10. The bottle costs exactly £1 more than the cap so my questions to you is: How much does the cap cost?”