Evidence map›Paper›PMID 41828360›Full record

ReviewInternational journal of molecular sciences2026

The Role of Phagocytic Cells in the Achilles Tendon.

Yasir Majeed, Maria Kokozidou, Clemens Gögele, Andreas Traweger, Christine Lehner, Herbert Tempfer, Gundula Gesine Schulze-Tanzil

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yasir MajeedInstitute of Anatomy and Cell Biology, Paracelsus Medical Private University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany.
Maria KokozidouInstitute of Anatomy and Cell Biology, Paracelsus Medical Private University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany.
Clemens GögeleInstitute of Anatomy and Cell Biology, Paracelsus Medical Private University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany.ORCID 0000-0002-7086-9743
Andreas TrawegerSpinal Cord Injury & Tissue Regeneration Center Salzburg, Institute of Tendon and Bone Regeneration, Paracelsus Medical University, 5020 Salzburg, Austria.ORCID 0000-0002-0220-4766
Christine LehnerSpinal Cord Injury & Tissue Regeneration Center Salzburg, Institute of Tendon and Bone Regeneration, Paracelsus Medical University, 5020 Salzburg, Austria.
Herbert TempferSpinal Cord Injury & Tissue Regeneration Center Salzburg, Institute of Tendon and Bone Regeneration, Paracelsus Medical University, 5020 Salzburg, Austria.
Gundula Gesine Schulze-TanzilInstitute of Anatomy and Cell Biology, Paracelsus Medical Private University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany.ORCID 0000-0002-9807-9532

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Macrophages and other phagocytic cells are central regulators of tendon immunobiology, orchestrating inflammation, tissue repair, and extracellular matrix (ECM) remodeling in the tendons. They derive from circulating monocytes and resident tendon-specific populations, including tenophages. Macrophage polarization along the M1/M2 axis exerts a decisive influence on tendon healing trajectories. Activated M1 macrophages promote the early healing phase for debris clearance initiating the reparative cascade. However, their sustained activity leads to inflammation, ECM degradation, impaired healing, tendinopathy, and heterotopic ossification (HO). Conversely, a timed shift toward activated M2 macrophages promotes resolution of inflammation, angiogenesis, ECM deposition, and fibrocartilage formation, whereas excessive or prolonged M2 activity facilitates adhesion formation, fibrosis, scarring and HO. Recent single-cell and spatial profiling studies showed macrophage heterogeneity across tendon compartments, thereby extending the classical M1/M2 paradigm and underscoring the relevance of macrophages/resident tendon cell's interaction in tendon-specific local niches. Mechanobiological stimuli (depending on magnitude, frequency and duration) further modulate macrophage phenotypes and tendon healing. Emerging coculture models and human tendon-on-chip systems provide high-resolution platforms for dissecting these spatiotemporal interactions. Promising therapeutic approaches comprise the application of extracellular vesicles, controlled mechanoloading regimens, and immunomodulatory biomaterials demonstrating potential to induce regenerative macrophage signatures for improved healing outcomes. Notably, platelet-rich plasma (PRP) formulations shape macrophage responses: leukocyte-rich PRP preferentially promotes M1 activity whereas leukocyte-poor PRP supports M2 polarization. Thus, mechano- and immunomodulatory strategies can offer precise control over macrophage dynamics. Regarding the Achilles tendon pathologies, such approaches are helpful by directing macrophage-mediated inflammation towards effective tendon healing outcomes.

Indexed as

Achilles TendonMacrophagesPhagocytesAnimalsExtracellular MatrixHumansMacrophage ActivationTendinopathyTendon InjuriesWound HealingAchilles tendonhealingheterotopic ossificationM1 and M2 polarizationmacrophagestendinopathytenophages

Identifiers

PMID41828360
PMCPMC12985030

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.