Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA.
Department of Biomedical Engineering, University of California, Davis, Davis, California, USA.
J Orthop Res. 2024 Feb;42(2):249-258. doi: 10.1002/jor.25746. Epub 2023 Nov 29.
Musculoskeletal trauma, specifically fractures, is a leading cause of patient morbidity and disability worldwide. In approximately 20% of cases with fracture and related traumatic muscle loss, bone healing is impaired leading to fracture nonunion. Over the past few years, several studies have demonstrated that bone and the surrounding muscle tissue interact not only anatomically and mechanically but also through biochemical pathways and mediators. Severe damage to the surrounding musculature at the fracture site causes an insufficiency in muscle-derived osteoprogenitor cells that are crucial for fracture healing. As an endocrine tissue, skeletal muscle produces many myokines that act on different bone cells, such as osteoblasts, osteoclasts, osteocytes, and mesenchymal stem cells. Investigating how muscle influences fracture healing at cellular, molecular, and hormonal levels provides translational therapeutic solutions to this clinical challenge. This review provides an overview about the contributions of surrounding muscle tissue in directing fracture healing. The focus of the review is on describing the interactions between bone and muscle in both healthy and fractured environments. We discuss current progress in identifying the bone-muscle molecular pathways and strategies to harness these pathways as cues for accelerating fracture healing. In addition, we review the existing challenges and research opportunities in the field.
肌肉骨骼创伤，特别是骨折，是全球患者发病率和残疾的主要原因。在大约 20%的骨折和相关外伤性肌肉丧失病例中，骨愈合受损导致骨折不愈合。在过去的几年中，有几项研究表明，骨骼和周围的肌肉组织不仅在解剖学和力学上相互作用，而且还通过生化途径和介质相互作用。骨折部位周围肌肉组织的严重损伤导致对骨折愈合至关重要的肌源性成骨前体细胞不足。作为内分泌组织，骨骼肌产生许多肌因子，作用于不同的骨细胞，如成骨细胞、破骨细胞、骨细胞和间充质干细胞。研究肌肉如何在细胞、分子和激素水平上影响骨折愈合，为这一临床挑战提供了转化治疗解决方案。这篇综述概述了周围肌肉组织在指导骨折愈合中的作用。综述的重点是描述健康和骨折环境中骨骼和肌肉之间的相互作用。我们讨论了确定骨-肌肉分子途径的当前进展，并探讨了利用这些途径作为加速骨折愈合的线索的策略。此外，我们还回顾了该领域现有的挑战和研究机会。
