HIF1 Identified as the Molecular Trigger in Common Tendon Injuries

ETH Zurich researchers identify the protein HIF1 as an active driver of tendinopathy, showing in mice and human tendon cells that high HIF1 remodels tendon tissue with more collagen crosslinks, brittleness, and ingrowth of blood vessels and nerves—causing pain in common overuse injuries like Achilles tendinopathy and tennis elbow. Activating HIF1 caused disease even without extra strain, while silencing it protected tendons under heavy loading, underscoring the need for early treatment and raising the possibility of tendon-specific therapies that target the HIF1 pathway rather than the whole body.