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Rotator cuff tears (RCTs) within tendons of these muscles are common musculoskeletal injuries, often resulting in intramuscular fat, fibrosis, and muscle atrophy. Fatty infiltration specifically correlates with high rates of retear following repair. The cellular sources and molecular cues that cause these pathologies are unknown and therefore non-surgical cell\/drug therapies for RCTs do not exist. Thus, we first sought to determine the cellular source(s) and molecular underpinnings of fatty atrophy and fibrosis associated with massive RCTs. Using a murine model of massive RCTs combined with lineage tracing, we demonstrate that muscle resident\n                  <jats:italic>Pdgfra+<\/jats:italic>\n                  non-myogenic mesenchymal cells (NMMCs) are responsible for the fatty and fibrotic RCT pathologies. Utilizing sorted\n                  <jats:italic>Pdgfra+<\/jats:italic>\n                  cells from rotator cuff muscles and \u201cdeep\u201d single cell RNA-sequencing, we identified a specific\n                  <jats:italic>Dpp4+<\/jats:italic>\n                  cell population associated with RCT-induced fibrosis, while\n                  <jats:italic>Gfra1+<\/jats:italic>\n                  nerve-associated NMMCs are drivers of the RCT-induced intramuscular fat pathology. Finally, we demonstrate that RCT-induced fatty infiltration occurs at least partially via the loss of GDNF-GFRA1-RET signaling, since local treatment of murine RCTs with a small molecule RET agonist reduces development of the RCT-induced intramuscular fat.\n                <\/jats:p>","DOI":"10.64898\/2026.02.11.705391","type":"posted-content","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T09:30:16Z","timestamp":1771061416000},"source":"Crossref","is-referenced-by-count":1,"title":["Specific non-myogenic mesenchymal cells contribute to rotator cuff tear myosteatosis and fibrosis revealing novel therapeutic options"],"prefix":"10.64898","author":[{"given":"Helen","family":"Rueckert","sequence":"first","affiliation":[{"name":"Department of Cell Biology, Duke University School of Medicine, Durham, NC 27708"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Mirando","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27708"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail P.","family":"Leinroth","sequence":"additional","affiliation":[{"name":"Department of Cell Biology, Duke University School of Medicine, Durham, NC 27708"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Ibarra","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27708"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe V.","family":"Chakkalakal","sequence":"additional","affiliation":[{"name":"Department of Cell Biology, Duke University School of Medicine, Durham, NC 27708"},{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27708"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3165-267X","authenticated-orcid":false,"given":"Matthew J.","family":"Hilton","sequence":"additional","affiliation":[{"name":"Department of Cell Biology, Duke University School of Medicine, Durham, NC 27708"},{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27708"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026021704250440000_2026.02.11.705391v1.1","first-page":"78","article-title":"Fatty muscle degeneration in cuff ruptures. 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