Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2019) 18, 155 - 159

Research article
Epigenetic Status of The Human MMP11 Gene Promoter is Altered in Patellar Tendinopathy
Rebecca Rickaby1,2, Louis Y El Khoury3, Tom Samiric4, Stuart M Raleigh5, 
Author Information
1 Faculty of Health and Society, University of Northampton, UK
2 Faculty of Science, School of Pharmacy, University of Nottingham, UK
3 Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA
4 School of Life Sciences, La Trobe University, Melbourne, Victoria, Australia
5 Centre for Sport, Exercise and Life Sciences, Coventry University, UK

Stuart M Raleigh
‚úČ School of Life Sciences, Centre for Sport, Exercise and Life Sciences,Coventry University, Coventry, CV1 5FB, UK
Publish Date
Received: 20-12-2018
Accepted: 23-01-2019
Published (online): 11-02-2019
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Patellar tendinopathy (PT) is a debilitating condition that often affects those who are physically active. Gene variation is known to contribute to human tendinopathy but the role of DNA methylation, as an epigenetic factor, has only recently been discovered. Using a case-control approach, we sought to determine whether differences existed between the methylation status of the MMP11 gene promoter in patellar tendinopathy compared to healthy tendon. We used PCR and pyrosequencing to interrogate the methylation profiles of 4 CpG sites (areas of the genome rich in C/G nucleotides) upstream of the MMP11 gene in DNA from males with PT (n = 10) and those with healthy tendon (n = 10). We also conducted a correlation analysis to establish whether age influenced methylation in the PT patients and controls. We found a significant (p = 0.045) difference in the methylation status of a single CpG site 65 base pairs (bp) upstream of the MMP11 promoter between the PT group and controls. There were no other differences in the extent of MMP11 promoter methylation between the two groups. Interestingly, we also found that in controls the degree of methylation at a second CpG site, 55 bp upstream of the first exon, tentatively correlated (r = 0.77, p = 0.009) with age. However, the correlation did not reach significance when a potential outlier was removed. This is the first study to show an epigenetic alteration to a member of the MMP gene family in human patellar tendinopathy. The data add to our understanding of how epigenetics should be considered when developing appropriate risk models.

Key words: Tendon, genetics, epigenetics, sports injury, tendinopathy

           Key Points
  • An understanding of the epigenetics of tendinopathy leads the way to possible future preventative strategies, as epigenetic factors can be modified by the environment. Hence, we speculate that specific changes to training, diet and possibly training surface and climate, informed by epigenetics, could reduce incidence of these injuries.
  • DNA methylation changes, including those reported here in the MMP11 gene promoter, may partially explain the different patterns of genetic risk factors that are sometimes observed between different population cohorts.
  • DNA methylation patterns coupled with genomic factors and other epigenetic markers, such as miRNA expression profiles, will improve current risk models for tendinopathy.
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