JSES - 2026-05-11 - Journal Article
An Icariin-Loaded PCL Electrospun Scaffold for Enhanced Tendon-Bone Healing in Rotator Cuff Repair.
Zhu Q, Zhai H, Cheng B, Huang J, Mao H, Bai Z
Topics
Key Takeaway
An icariin-loaded PCL electrospun scaffold promoted M2 macrophage polarization, increased CD31/EMCN angiogenic expression, and enhanced fibrocartilaginous interface regeneration with organized collagen I/II architecture at 8 weeks in a rat rotator cuff model.
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Summary
This study fabricated an icariin (ICA)-loaded PCL electrospun scaffold and tested its tendon-bone healing effects in a rat rotator cuff injury model, evaluating immunomodulatory, angiogenic, and fibrocartilaginous regeneration outcomes. In vitro, the scaffold reduced IL-1β, IL-6, and TNF-α in LPS-stimulated rBMSCs and promoted endothelial tube formation. In vivo, it shifted macrophage polarization toward M2 phenotype, upregulated CD31/EMCN expression, and produced organized collagen architecture with elevated collagen I/II at 8 weeks without systemic toxicity.
Key Limitation
The absence of biomechanical testing (ultimate load-to-failure, stiffness, cyclic loading) means the histological regeneration findings cannot be correlated with functional repair strength, which is the primary clinical endpoint in rotator cuff healing.
Original Abstract
OBJECTIVE
This study aimed to fabricate an icariin (ICA)-loaded polycaprolactone (PCL) electrospun scaffold and systematically evaluate its effects on tendon-bone healing in a rat rotator cuff injury model, with particular focus on its immunomodulatory, angiogenic, and fibrocartilaginous regeneration capabilities.
METHODS
ICA-PCL scaffolds were prepared using electrospinning technology and characterized for microstructure, drug release kinetics, and cytocompatibility. In vitro experiments involved LPS-induced rat bone marrow mesenchymal stem cells (rBMSCs) and brain microvascular endothelial cells to assess anti-inflammatory, antioxidant, and pro-angiogenic effects. In vivo evaluations were conducted in a rat rotator cuff injury model using histological staining, immunofluorescence, western blot, and ELISA to analyze tissue regeneration, macrophage polarization, and safety profiles at 4 and 8 weeks post-implantation.
RESULTS
The ICA-PCL scaffold displayed a biphasic release pattern with initial burst release followed by sustained ICA delivery. In vitro, it significantly enhanced rBMSC proliferation, reduced apoptosis and oxidative stress, downregulated pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), and promoted endothelial tube formation. In vivo results demonstrated that the scaffold modulated macrophage polarization toward M2 phenotype, enhanced angiogenesis (increased CD31/EMCN expression), and facilitated fibrocartilaginous interface regeneration with organized collagen architecture and elevated collagen I/II expression. No evident systemic toxicity or organ damage was observed.
CONCLUSION
The ICA-PCL electrospun scaffold effectively promotes tendon-bone healing through multi-mechanistic actions, including immunomodulation, angiogenesis promotion, and structured interface regeneration, demonstrating significant potential as a comprehensive therapeutic strategy for rotator cuff repair.