Sarrafian Tiffany L, Bodine Sue C, Murphy Brian, Grayson J Kevin, Stover Susan M
J. D. Wheat Veterinary Orthopedic Research Laboratory, University of California, Davis, Davis, California.
Clinical Investigation Facility, David Grant US Air Force Medical Center, Travis Air Force Base, Fairfield, California.
Vet Surg. 2018 May;47(4):524-535. doi: 10.1111/vsu.12787. Epub 2018 Mar 30.
Large muscular or musculotendinous defects present a dilemma because of the inadequacies of current treatment strategies. Extracellular matrices (ECM) are potential clinically applicable regenerative biomaterials. This review summarizes information from the preclinical literature evaluating the use of ECM for muscle regeneration in animal models of volumetric muscle loss (VML).
Literature review.
Animal models of VML in which surgical repair was performed with an ECM product, with or without added cell populations.
PubMed, Google Scholar, CAB abstracts, and Scopus were searched for preclinical studies using ECM in animal models of VML. The search terms "extracellular matrix," "VML," "muscle regeneration," "cell seeded," and "scaffold" identified 40 articles that met inclusion criteria of an animal model of VML in which surgical repair was performed with an ECM product, with or without added cell populations. Key skeletal muscle repair mechanisms and experimental findings on scaffold type, VML location, and experimental animal species were summarized.
Satellite cells and basal lamina are key endogenous contributors to skeletal muscle regeneration. ECM as a dynamic tissue component may provide structural integrity, signaling molecules, and a 3-dimensional topography conducive to muscle regeneration. Preclinical models of muscle repair most commonly used mice and rats (88%). Most experimental lesions were created in abdominal wall (33%), anterior tibialis (33%), latissimus dorsi (10%), or quadriceps (10%) muscles. Matrices varied markedly in source and preparation. Experimental outcomes of ECM and cell-seeded ECM implantation for muscle regeneration in VML were highly variable and dependent on matrix tissue source, preparation method, and anatomic site of injury. Scar tissue formation likely contributes to load transfer. Nonappendicular lesions had better regenerative results compared with appendicular VML.
The preponderance of current evidence supports the use of ECM for muscle defect repair only in specific instances, such as nonappendicular and/or partial-thickness defects. Consequently, clinical use of ECM in veterinary patients requires careful consideration of the specific ECM product, lesion size and location, and loading circumstances.
由于当前治疗策略存在不足，大型肌肉或肌腱缺损带来了一个难题。细胞外基质（ECM）是具有临床应用潜力的再生生物材料。本综述总结了临床前文献中的信息，这些文献评估了ECM在容积性肌肉损失（VML）动物模型中用于肌肉再生的情况。
文献综述。
VML动物模型，其中使用ECM产品进行手术修复，添加或未添加细胞群体。
在PubMed、谷歌学术、CAB文摘和Scopus中搜索在VML动物模型中使用ECM的临床前研究。搜索词“细胞外基质”“VML”“肌肉再生”“细胞接种”和“支架”确定了40篇符合VML动物模型纳入标准的文章，其中使用ECM产品进行手术修复，添加或未添加细胞群体。总结了关键的骨骼肌修复机制以及关于支架类型、VML位置和实验动物物种的实验结果。
卫星细胞和基膜是骨骼肌再生的关键内源性因素。ECM作为一种动态组织成分，可能提供结构完整性、信号分子和有利于肌肉再生的三维地形。肌肉修复的临床前模型最常用小鼠和大鼠（88%）。大多数实验性损伤位于腹壁（33%）、胫前肌（33%）、背阔肌（10%）或股四头肌（10%）。基质在来源和制备方面差异显著。ECM和细胞接种的ECM植入用于VML肌肉再生的实验结果高度可变，且取决于基质组织来源、制备方法和损伤的解剖部位。瘢痕组织形成可能有助于负荷传递。与肢体VML相比，非肢体损伤的再生结果更好。
目前的大量证据仅支持在特定情况下使用ECM修复肌肉缺损，如非肢体和/或部分厚度缺损。因此，在兽医患者中临床使用ECM需要仔细考虑特定的ECM产品、损伤大小和位置以及负荷情况。
