Venetian Institute of Molecular Medicine, Via Orus 2, 35129 Padova, Italy.
Curr Pharm Des. 2010;16(8):906-14. doi: 10.2174/138161210790883453.
Mammalian skeletal muscles can regenerate following injury and this response is mediated by a specific type of stem cell, the satellite cell. We review here the three main phases of muscle regeneration, including i) the initial inflammatory response and the dual role of macrophages as both scavengers involved in the phagocytosis of necrotic debris and promoters of myogenic differentiation, ii) the activation and differentiation of satellite cells and iii) the growth and remodeling of the regenerated muscle tissue. Nerve activity is required to support the growth of regenerated myofibers and the specification of muscle fiber types, in particular the activation of the slow gene program. We discuss the regeneration process in two different settings. Chronic degenerative diseases, such as muscular dystrophies, are characterized by repeated cycles of segmental necrosis and regeneration involving scattered myofibers. In these conditions the regenerative capacity of satellite cells becomes exhausted with time and fibrosis prevails. Acute traumatic injuries, such as strain injuries common in sport medicine, cause the rupture of large myofiber bundles leading to muscle regeneration and formation of scar tissue and new myotendinous junctions at the level of the rupture. Mechanical loading is essential for muscle regeneration, therefore, following initial immobilization to avoid the risk of reruptures, early remobilization is required to induce correct growth and orientation of regenerated myofibers. Finally, we discuss the causes of age-dependent decline in muscle regeneration potential and the possibility of boosting regeneration in aging muscle and in muscular dystrophies.
哺乳动物的骨骼肌在受伤后可以再生,这种反应是由一种特定类型的干细胞——卫星细胞介导的。我们在这里回顾了肌肉再生的三个主要阶段,包括:i)最初的炎症反应和巨噬细胞的双重作用,巨噬细胞既是参与坏死碎片吞噬的清道夫,也是促进成肌分化的促进剂;ii)卫星细胞的激活和分化;iii)再生肌肉组织的生长和重塑。神经活动对于支持再生肌纤维的生长和肌肉纤维类型的特化是必需的,特别是慢肌基因程序的激活。我们在两种不同的情况下讨论了再生过程。慢性退行性疾病,如肌肉营养不良症,其特征是反复发生节段性坏死和再生,涉及散在的肌纤维。在这些情况下,卫星细胞的再生能力随着时间的推移而耗尽,纤维化占主导地位。急性创伤性损伤,如运动医学中常见的拉伤,会导致大肌纤维束断裂,导致肌肉再生、瘢痕组织形成和断裂处新的肌肌腱连接。机械负荷对于肌肉再生是必不可少的,因此,在最初的固定以避免再次断裂的风险后,需要早期重新活动,以诱导再生肌纤维的正确生长和定向。最后,我们讨论了与年龄相关的肌肉再生能力下降的原因,以及在衰老肌肉和肌肉营养不良中增强再生的可能性。
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