In last July 13 issue of EVJ, an interesting article questions the use of aniinflamatory drugs in tendon pathology. A lipoxin A4 receptor, FPR2/ALX and also resolvins, protectins and maresins have been studied as “resolving pathways” for inflamation.
“Studies suggest that whilst the endogenous resolution response of tendons to inflammation is initiated, it is insufficient or dysregulated such that inflammation is not adequately ‘switched off,’ perpetuating chronic inflammation and favouring fibrogenic repair”
Age can be another factor reducing the ability to the tissue to cope with inflamation due to inmunosenescence. We all know how older horse´s tendinopathies are more difficult to manage.
The paper says that while it is considered appropiate the use of antinflamatory drugs to relieve the clinical symptoms of the excessive early acute inflamation, the long term use of these drugs may be associated with adverse effects on tendon mechanical properties and propensity for rupture.
Future therapeutic goal would be modulating rather than suppresing the inflamatory process.