The overall goal of this proposal is to define the regulatory roles of collagen V in the injury response in normal and classic Ehlers-Danlos syndrome (EDS) tendons. Collagen V is a quantitatively minor component of collagen fibrils, yet modulation of its expression has dramatic phenotypic effects, indicating critical regulatory roles. EDS is a heritable connective tissue disorder with generalized connective tissue fragility and the classic form is characterized by hyperextensible skin, joint laxity and instability, as well as abnormal wound healing. Classic EDS is defined by collagen V mutations with haploinsufficiency for COL5A1 present in ~67% of affected individuals. Collagen V also has been linked to: Achilles tendinopathy, ACL rupture, as well as injury and performance deficiencies. In addition, upregulation of collagen V is observed in the injury response in tendons and ligaments. Our established haploinsufficent collagen V EDS mouse model will be used for the proposed studies. However, this model has limitations due to chronic effects resulting from lack of collagen V throughout development and maturation that are then superimposed on the changes associated with the injury response. Therefore, this proposal incorporates our inducible collagen V-null and heterozygous models that allow for temporal targeting of the modulation of collagen V expression. For the first time, directly studying the critical regulatory roles of collagen V during specific phases of the injury response will be possible. Using the haploinsufficient collagen V EDS model, we have demonstrated reduced fibril number, abnormal fibril structure, decreased cross sectional area, and a reduction in the stiffness of the flexor digitorum longus tendon consistent with the hypermobile EDS phenotype. Our recent work using a conditional null model demonstrated severe structural alterations at the fibril, fiber and tendon level associated with severely compromised mechanical function, joint dislocations and gait abnormalities. The general hypothesis tested in this proposal is that the tendon response to injury is modulated by collagen V mediated mechanism(s).
The aims are to:
(Aim 1) Define the altered regulatory function(s) of collagen V in the abnormal tendon injury response in classic EDS~ (Aim 2) Elucidate the mechanistic regulatory role(s) of collagen V in the repair response to tendon injury in a normal matrix~ and (Aim 3) Compare the effect of modulation of collagen V expression on the injury response in normal and in diseased/abnormal tendons. Our innovative approach with both conventional and inducible mouse models will systematically analyze the regulatory roles of collagen V on repair of tendon injuries. This approach will be coupled with sophisticated and innovative measures of mechanical and organizational properties, together with compositional profiles, to derive a mechanistic understanding of the injury responses. These studies will define the specific temporal regulatory roles of collagen V in the re- establishment of tendon structure and function in response to injury. In addition, the data will provide a critical foundation for developing therapeutic interventions to enhance the abnormal wound healing in EDS.

Public Health Relevance

Collagen V is upregulated in the tendon injury response and mutations in collagen V are the molecular basis underlying classic Ehlers-Danlos Syndrome (EDS), a heritable connective tissue disorder with generalized connective tissue defects including abnormal wound healing and joint laxity. The overall goal of this proposal is to define the regulatory roles of collagen V in the injury response in normal and classic EDS tendons. These studies will define the specific temporal regulatory roles of collagen V in the re-establishment of tendon structure and function in response to injury. In addition, the data will provide a critical foundation for developing therapeutic interventions to enhance the injury response in tendons and ligaments as well as the clinically important problem of abnormal wound healing in EDS.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR065995-02
Application #
8823733
Study Section
Skeletal Biology Structure and Regeneration Study Section (SBSR)
Program Officer
Tyree, Bernadette
Project Start
2014-07-01
Project End
2019-06-30
Budget Start
2015-07-01
Budget End
2016-06-30
Support Year
2
Fiscal Year
2015
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Orthopedics
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Johnston, Jessica M; Connizzo, Brianne K; Shetye, Snehal S et al. (2017) Collagen V haploinsufficiency in a murine model of classic Ehlers-Danlos syndrome is associated with deficient structural and mechanical healing in tendons. J Orthop Res 35:2707-2715
Connizzo, Brianne K; Adams, Sheila M; Adams, Thomas H et al. (2016) Collagen V expression is crucial in regional development of the supraspinatus tendon. J Orthop Res 34:2154-2161
Connizzo, Brianne K; Adams, Sheila M; Adams, Thomas H et al. (2016) Multiscale regression modeling in mouse supraspinatus tendons reveals that dynamic processes act as mediators in structure-function relationships. J Biomech 49:1649-1657
Screen, Hazel R C; Berk, David E; Kadler, Karl E et al. (2015) Tendon functional extracellular matrix. J Orthop Res 33:793-9
Sun, Mei; Connizzo, Brianne K; Adams, Sheila M et al. (2015) Targeted deletion of collagen V in tendons and ligaments results in a classic Ehlers-Danlos syndrome joint phenotype. Am J Pathol 185:1436-47
Connizzo, Brianne K; Freedman, Benjamin R; Fried, Joanna H et al. (2015) Regulatory role of collagen V in establishing mechanical properties of tendons and ligaments is tissue dependent. J Orthop Res 33:882-8