跟腱附着点病变。

IF 76.9 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Andreas Traweger, Alex Scott, Michael Kjaer, Evi Wezenbeek, Rodrigo Scattone Silva, John G Kennedy, James J Butler, Manuel Gomez-Florit, Manuela E Gomes, Jess G Snedeker, Stephanie G Dakin, Britt Wildemann
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引用次数: 0

摘要

跟腱病变很普遍,影响到6%的普通人群和高达50%的精英耐力跑者的一生。这些情况严重影响生活质量和工作效率,导致巨大的社会成本。跟腱病(AT)是一种以局部疼痛和与机械负荷相关的功能损伤为特征的疾病。AT会严重影响运动和日常活动的参与和表现。AT的病因是多因素的,卫生专业人员经常观察到肌腱的重复性超负荷是诱发因素。然而,AT也可能与某些药物的不良反应、衰老和各种合并症有关。特征性的肌腱改变包括蛋白多糖积聚、液体积聚伴肿胀和血管增生。由于细胞功能和组成的改变,导致基质结构的病理改变,组织解体的进展往往伴随着持续的炎症。治疗策略包括各种干预措施,尽管这些干预措施对患者和卫生保健提供者来说可能是长期的和具有挑战性的,往往失败率很高。目前的研究重点是在细胞和分子水平上了解病理过程,以区分疾病类别,并研究炎症、代谢失调和机械应力的作用。需要开发新的治疗方法来解决这些潜在的机制。这些方法侧重于优化康复方案和推进辅助疗法的发展,如先进的治疗药物产品,以及精准医学的整合,以改善治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Achilles tendinopathy.

Achilles tendon pathologies are prevalent, impacting ~6% of the general population and up to 50% of elite endurance runners over their lifetimes. These conditions substantially affect quality of life and work productivity, leading to substantial societal costs. Achilles tendinopathy (AT) is a condition marked by localized pain and functional impairment related to mechanical loading. AT can considerably impair participation and potentially also performance in sports and daily activities. The aetiology of AT is multifactorial and repetitive overloading of the tendon is often observed as the inciting factor by health professionals. However, AT can also be associated with adverse effects of certain medication, ageing and various comorbidities. Characteristic tendon changes include proteoglycan accumulation, fluid accumulation with swelling and hypervascularization. Tissue disorganization advances as pathological changes in matrix structure are driven by altered cellular function and makeup, often accompanied by persistent inflammation. Treatment strategies include various interventions, although these can be protracted and challenging for both patients and health-care providers, often with high failure rates. Current research focuses on understanding the pathological processes at the cellular and molecular levels to distinguish between disease categories and to investigate the role of inflammation, metabolic maladaptation and mechanical stress. Emerging therapeutic approaches need to be developed to address these underlying mechanisms. These approaches focus on optimizing rehabilitation protocols and advancing the development of adjunct therapies, such as advanced therapy medicinal products, alongside the integration of precision medicine to improve treatment outcomes.

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来源期刊
Nature Reviews Disease Primers
Nature Reviews Disease Primers Medicine-General Medicine
CiteScore
76.70
自引率
0.20%
发文量
75
期刊介绍: Nature Reviews Disease Primers, a part of the Nature Reviews journal portfolio, features sections on epidemiology, mechanisms, diagnosis, management, and patient quality of life. The editorial team commissions top researchers — comprising basic scientists and clinical researchers — to write the Primers, which are designed for use by early career researchers, medical students and principal investigators. Each Primer concludes with an Outlook section, highlighting future research directions. Covered medical specialties include Cardiology, Dermatology, Ear, Nose and Throat, Emergency Medicine, Endocrinology, Gastroenterology, Genetic Conditions, Gynaecology and Obstetrics, Hepatology, Haematology, Infectious Diseases, Maxillofacial and Oral Medicine, Nephrology, Neurology, Nutrition, Oncology, Ophthalmology, Orthopaedics, Psychiatry, Respiratory Medicine, Rheumatology, Sleep Medicine, and Urology.
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