Fukushima K, Badlani N, Usas A, Riano F, Fu F, Huard J
Department of Orthopaedic Surgery, Children's Hospital of Pittsburgh and University of Pittsburgh, Pennsylvania 15213, USA.
Am J Sports Med. 2001 Jul-Aug;29(4):394-402. doi: 10.1177/03635465010290040201.
Muscle injuries are challenging problems in traumatology and the most frequent injuries in sports medicine. Muscle injuries are capable of healing, although slowly and occasionally with incomplete functional recovery. We observed that lacerated muscle undergoes a rapid process of regeneration, which is hindered by the development of fibrosis. Biologic approaches to enhance muscle regeneration and prevent fibrosis are being investigated to improve muscle healing after injuries. We observed that growth factors can improve muscle regeneration but cannot prevent muscle fibrosis. We investigated the use of an antifibrosis substance, decorin, as an approach to prevent fibrosis and thereby improve muscle healing after injury in murine muscle. We observed that direct injection of human recombinant decorin can efficiently prevent fibrosis and enhance muscle regeneration in the lacerated muscle. More importantly, decorin can improve the recovery of strength in the injured muscle to a level similar to that observed in normal noninjured muscle. These results suggest that injection of decorin improves both the muscle structure and the function of the lacerated muscle to near complete recovery. This study will contribute significantly to the development of strategies to promote efficient muscle healing and complete functional recovery after muscle injuries.
肌肉损伤是创伤学中具有挑战性的问题,也是运动医学中最常见的损伤。肌肉损伤能够愈合,尽管愈合过程缓慢,且偶尔会伴有功能恢复不完全的情况。我们观察到,撕裂的肌肉会经历一个快速的再生过程,但这一过程会受到纤维化发展的阻碍。目前正在研究通过生物学方法来促进肌肉再生并预防纤维化,以改善损伤后的肌肉愈合情况。我们观察到生长因子可以促进肌肉再生,但无法预防肌肉纤维化。我们研究了使用一种抗纤维化物质——核心蛋白聚糖,作为预防纤维化的方法,从而改善小鼠肌肉损伤后的愈合情况。我们观察到直接注射重组人核心蛋白聚糖能够有效预防纤维化,并促进撕裂肌肉的再生。更重要的是,核心蛋白聚糖能够将受伤肌肉的力量恢复提高到与正常未受伤肌肉相近的水平。这些结果表明,注射核心蛋白聚糖可使撕裂肌肉的结构和功能都得到改善,接近完全恢复。本研究将为制定促进肌肉损伤后有效愈合及完全功能恢复的策略做出重大贡献。