Triggers of tendon complaints uncovered
Researchers at ETH Zurich have identified the protein HIF1 as the central trigger for tendinopathies. Overuse of tendons, for example due to intensive sports, leads to painful changes such as Achilles tendon pain or tennis elbow. HIF1 causes a pathological reorganization of tissue with more cross-connections between collagen fibers, which makes tendons more brittle and impairs mechanical functions. In addition, blood vessels and nerves grow in, which could explain pain.
In mouse experiments, permanent HIF1 activation triggered complaints without overload, while deactivation offered protection even under stress. Similar effects were seen in human tendon cells from surgery. Early treatment is crucial because damage can become irreversible and then only surgical procedures will help.
HIF1 detects oxygen deficiency and regulates gene activity, and a system-wide blockade carries risks of side effects. The findings could lead to targeted therapies, for example through research into downstream molecules.
Original Paper:
Moschini G et al.: HIF1α gates tendon response to overload and drives tendinopathy independently of vascular recruitment. Science Translational Medicine, January 7, 2026, DOI: 10.1126/scitranslmed.adt1228
Editor: X-Press Journalistenbüro GbR
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