Engineering skeletal muscle: Building complexity to achieve functionality.
Engineering skeletal muscle: Building complexity to achieve functionality.
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DOI：
10.1016/j.semcdb.2021.04.016
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发表时间：
2021-11
影响因子：
7.3
通讯作者：
Grayson W
中科院分区：
文献类型：
--
作者：
Mihaly E;Altamirano DE;Tuffaha S;Grayson W
容积性肌肉丧失(VML)被定义为骨骼肌的临界质量的丧失，使肌肉的自然愈合机制不堪重负，导致患者永久的功能缺陷和畸形。这些缺陷的治疗是复杂的，因为骨骼肌是一种复合结构，密切依赖于肌腱、血管、神经和骨骼等支持组织的作用。治疗VML损伤的黄金标准是一种自体肌瓣移植，尽管存在许多缺点，但仍是临床上恢复功能的最佳途径。这篇综述将考虑使用复合组织工程化结构，由多个组件共同作用来复制完整肌肉的功能，作为自体肌瓣的替代方案。我们将讨论组织工程领域的最新进展，这些进展使骨骼肌构建物能够通过结合血管系统、促进神经支配和重建肌肉-肌腱边界来更接近地再现自体肌瓣的功能。此外，我们对骨骼肌细胞组成的了解已经发展到认识到各种类型的细胞在肌肉再生中的重要性，包括纤维/成脂前体细胞和免疫细胞，如巨噬细胞和调节性T细胞。我们将介绍我们在理解这些细胞类型如何与植入的组织工程结构相互作用以及如何将其结合到植入的组织工程结构中的最新进展。
Volumetric muscle loss (VML) is defined as the loss of a critical mass of skeletal muscle that overwhelms the muscle’s natural healing mechanisms, leaving patients with permanent functional deficits and deformity. The treatment of these defects is complex, as skeletal muscle is a composite structure that relies closely on the action of supporting tissues such as tendons, vasculature, nerves, and bone. The gold standard of treatment for VML injuries, an autologous muscle flap transfer, suffers from many shortcomings but nevertheless remains the best clinically available avenue to restore function. This review will consider the use of composite tissue engineered constructs, with multiple components that act together to replicate the function of an intact muscle, as an alternative to autologous muscle flaps. We will discuss recent advances in the field of tissue engineering that enable skeletal muscle constructs to more closely reproduce the functionality of an autologous muscle flap by incorporating vasculature, promoting innervation, and reconstructing the muscle-tendon boundary. Additionally, our understanding of the cellular composition of skeletal muscle has evolved to recognize the importance of a diverse variety of cell types in muscle regeneration, including fibro/adipogenic progenitors and immune cells like macrophages and regulatory T cells. We will address recent advances in our understanding of how these cell types interact with, and can be incorporated into, implanted tissue engineered constructs.
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通讯作者：
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