Combined ascorbic acid and T3 produce better healing compared to bone marrow mesenchymal stem cells in an Achilles tendon injury rat model

[helvella]

Even orthopaedic specialists seem to be getting to understand and appreciate T3 better than endocrinologists!

Of course, the opposite might be just as important a lesson. Inadequate T3 (and, let us assume, ascorbic acid) is likely to impair healing of tendons.

J Orthop Surg Res. 2019; 14: 54.

Published online 2019 Feb 18. doi: 10.1186/s13018-019-1098-9

PMCID: PMC6380036

PMID: 30777116

Combined ascorbic acid and T3 produce better healing compared to bone marrow mesenchymal stem cells in an Achilles tendon injury rat model: a proof of concept study

Francesco Oliva,1 Nicola Maffulli,

1,2,3 Clarissa Gissi,4 Francesca Veronesi,5 Lucia Calciano,6 Milena Fini,5 Silvia Brogini,5 Marialucia Gallorini,7 Cristina Antonetti Lamorgese Passeri,4 Roberta Bernardini,8 Rosella Cicconi,8 Maurizio Mattei,8,9 and Anna Concetta Berardi4

Abstract

Background

This pilot study aimed to ascertain whether the local application of ascorbic acid (AA), of T3, and of rat (r) bone marrow mesenchymal stem cells (BMSCs), alone or in all possible combinations, promoted healing after an Achilles tendon injury in a rat model.

Methods

An Achilles tendon defect was produced in 24 6–8-week-old male inbred Lewis rats. The animals were then randomly divided into eight groups of three rats each. The tendon defect was filled with 50 μL of phosphate-buffered saline (PBS) containing (1) 50 μg/mL AA (AA group), (2) 10−7M T3 (T3 group), (3) 4 × 106 rBMSCs (rBMSC group), (4) 50 μg/mL AA + 10−7M T3 (AA + T3 group), (5) 4 × 106 rBMSCs + 50 μg/mL AA (rBMSC + AA group), (6) 4 × 106 rBMSCs + 10−7M T3 (rBMSC + T3 group), (7) 4 × 106 rBMSCS + 50 μg/mL AA + 10−7M T3 (rBMSC + AA + T3 group), and (8) PBS only (control group: CTRL). All treatments were administered by local injection immediately after the tendons had been damaged; additionally, AA was injected also on the second and fourth day from the first injection (for groups 1, 4, 5, and 7), and T3 was injected again every day for 4 days (for groups 2, 4, 6, and 7). At 30 days from initial treatment, tendon samples were harvested, and the quality of tendon repair was evaluated using histological and histomorphological analysis. The structure and morphology of the injured Achilles tendons were evaluated using the modified Svensson, Soslowsky, and Cook score, and the collagen type I and III ratio was calculated.

Results

The group treated with AA combined with T3 displayed the lowest Svensson, Soslowsky, and Cook total score value of all tissue sections at histopathological examination, with fiber structure close to regular orientation, normal-like tendon vasculature, and no cartilage formation. AA + T3 also showed the highest collagen I and the lowest collagen III values compared to all other treatments including the CTRL.

Conclusion

There are potential benefits using a combination of AA and T3 to accelerate tendon healing.

Keywords: Ascorbic acid, Thyroid hormones, T3, bone marrow mesenchymal stem cells, Tendon

Full paper freely available here:

ncbi.nlm.nih.gov/pmc/articl...

[LindaC]

Fascinating! Some heart issues also Thank you - one day they may get it! Or even need it themselves!

[SilverAvocado]

Very interesting paper... Given that other disciplines are interested in treating with T3, presumably to individuals who don't have thyroid illness, I wonder how this fits into the overall picture of what T3 is for.

It makes me wonder if lots of people (or rats) still don't have quite as much T3 as they need, and can benefit from a little top up even though their thyroid is working fine. This particularly seems to contradict the idea we see in the literature that older people or anyone else whose thyroid numbers slip out of the ideal will do just fine with lower levels. If most everyone benefits from a top up in times of injury or extra need it would be surprising if older people could do just fine on lower levels than usual.

[TSH110]

How did I miss this? Very interesting indeed, but the poor rats. I have often wondered if my hypothyroidism had a role in me developing chronic achilles tendinitis eventually requiring decompression. I was in agony all

the time and I walked with a serious limp. Luckily the decompression restored most of its function although it has never been quite as good or strong since but much better than the mess I was in. I presume my left tendon had some sort of inate weakness as the other one has held up despite my trials and tribulations with thyroid matters. The tendinitis occurred decades before I got a diagnosis of hypothyroidism. With diogenes saying T3 is maintained at all costs as the thyroid fails I wonder about any possible machinations. I did get bouts of hyper and hypo, perhaps in those roller coaster bits the T3 production was not stable.