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Abbreviations ROS: Reactive Oxygen Species NAC: N-acetyl-L-cysteine TSPCs: Tendon Stem/Progenitor Cells COL1A1: Collagen Type 1 Alpha 1 TNC: Tenascin C SCX: Scleraxis TNMD: Tenomodulin PI3K: Phosphoinositide 3-kinase ECM: Extracellular Matrix OS: Oxidative Stress ROS: Reactive Oxygen Species CCK-8: Cell Counting Kit-8 H 2 O 2 : Hydrogen Peroxide AMI: Arithmetic Means Intensity PBS: Phosphate-Buffered Saline MFI: Mean Fluorescence Intensity SDS: Sodium Dodecyl Sulfate HRP: Horseradish Peroxidase SD: Standard Deviation DEGs: Differentially expressed genes GO: Gene Ontology BP: Biological Process MF: Molecular Function CC: Cellular Component References Pillai DS, Dhinsa BS, Khan WS

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To meet the diagnostic criteria for cEDS, a person must meet: Major criterion 1 AND major criterion 2 OR Major criterion 1 AND three or more minor criteria Major Criteria Skin hyperextensibility and atrophic scarring Generalized joint hypermobility Minor Criteria Easy bruising Soft, doughy skin Skin fragility (or traumatic splitting) Molluscoid pseudotumors Subcutaneous spheroids Hernia (or history thereof) Epicanthal folds Complications of joint hypermobility (e.g., sprains, dislocations/subluxations, pain, flexible flatfoot) Family history of a first-degree relative who meets clinical criteria Hypermobility Spectrum Disorders (HSD) HSD in Adults Adults are diagnosed with HSD if they have symptomatic joint hypermobility that cannot be explained by other conditions