During aging, tendons demonstrate substantial disruptions in homeostasis, leading to impairments in structure
and function. Given the central role of tendon in appropriate skeletal locomotion and ambulation, impaired
tendon function contributes to substantial declines in overall function and quality of life during aging. Moreover,
aged tendons are more likely to undergo spontaneous rupture, and the healing response following injury is
drastically impaired in aged tendons. Thus, there is a clear need to develop strategies to maintain tendon
homeostasis and healing capacity through the lifespan. Tendon cell density sharply declines by about 12
months of age in mice, and this low cell density is retained even in geriatric tendons. Our preliminary data
suggests that this decline in cellularity initiates a degenerative cascade due to insufficient production of the
extracellular matrix components needed to maintain tendon homeostasis. Thus, preventing this decline in
tendon cellularity has great potential for maintaining tendon health. In addition, the tenocytes that remain in
aged tendon demonstrate substantial alterations in their molecular programs, relative to young tendon cells.
Surprisingly, this programmatic skewing does not seem to drive additional homeostatic disruptions, but we
hypothesize that it is a key driver of age-related impairments in tendon healing. Thus, reversing this
programmatic skewing may restore physiological healing function to aged tendons. While the pathways that
drive aging-induced tendon cell death vs. programmatic skewing are likely distinct, epigenetic modifications
underly nearly every aspect of cell function. Indeed, partial epigenetic reprogramming has demonstrated
tremendous potential in addressing a range of age-related pathologies. In this proposal we will test the central
hypothesis that age-related tenocyte apoptosis driving tendon degeneration, and intrinsic programming shifts
leading to impaired healing capacity can be prevented via partial epigenetic reprogramming. In Aim 1 we will
define the multi-scale mechanisms of age-related tendon degeneration using a combination of genomics,
histological, and mechanical analyses. We will then determine the efficacy of partial reprogramming to maintain
tendon structure-function through the lifespan. In Aim 2 we will define how aging alters the cellular response to
tendon injury using a well-established model of healing in the flexor digitorum longus tendon. We will then
demonstrate that partial reprogramming can successfully restore the tenocyte functional plasticity that is
required for physiological healing. Successful completion of these studies will define the tendon aging
signature and establish partial reprogramming as a novel approach to maintain tendon health and healing
capacity through the lifespan.