Sicherer Sydnee T, Haque Noor, Parikh Yash, Grasman Jonathan M
Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA.
Adv Wound Care (New Rochelle). 2025 Feb;14(2):114-131. doi: 10.1089/wound.2024.0111. Epub 2024 Aug 30.
Volumetric muscle loss (VML) results in the loss of large amounts of tissue that inhibits muscle regeneration. Existing therapies, such as autologous muscle transfer and physical therapy, are incapable of returning full function and force production to injured muscle. Skeletal muscle tissue constructs may provide an alternative to existing therapies currently used to treat VML. Unlike autologous muscle transplants, muscle constructs can be cultured and are not reliant on intact muscle tissue. Skeletal muscle constructs can be generated from small muscle biopsies and could be used to generate skeletal muscle tissue constructs to replace injured tissues. To serve as effective therapies, muscle constructs must be capable of generating contractile forces that can assist the function of host skeletal muscle. The contractile force of native muscle arises in part as a consequence of the highly aligned, bundled architecture of myofibers. Attempts to induce similar alignment include applications of tension/strain across hydrogels, inducing aligned architectures within scaffolds, casting tissues in straited molds, and 3D printing. While all these methods have demonstrated efficacy toward inducing myofiber alignment, the extent of myofiber alignment, tissue formation, and force production varies. This manusript critically reviews the advantages and limitations of these methods and specifically discusses their ability to impart mechanical and architectural cues to induce alignment within tissue constructs. As tissue-synthesizing techniques continue to improve, muscle constructs must include more cell types than simply myoblasts, such as the addition of neuronal and endothelial cells. Higher-level tissue organization is critical to the success of these constructs. Many of these technologies have yet to be implanted into host tissue to understand engraftment and how they can contribute to traumatic injury, and as such continued collaboration between surgeons and tissue engineers is necessary to ultimately result in clinical translation.
容积性肌肉损失（VML）会导致大量组织丧失，从而抑制肌肉再生。现有的治疗方法，如自体肌肉移植和物理治疗，无法使受伤肌肉恢复全部功能和力量产生能力。骨骼肌组织构建物可能为目前用于治疗VML的现有疗法提供一种替代方案。与自体肌肉移植不同，肌肉构建物可以进行培养，并且不依赖完整的肌肉组织。骨骼肌构建物可以从小的肌肉活检样本中生成，并可用于生成骨骼肌组织构建物以替代受损组织。为了成为有效的治疗方法，肌肉构建物必须能够产生收缩力，以协助宿主骨骼肌的功能。天然肌肉的收缩力部分源于肌纤维高度排列、成束的结构。诱导类似排列的尝试包括在水凝胶上施加张力/应变、在支架内诱导排列结构、在有条纹的模具中铸造组织以及3D打印。虽然所有这些方法都已证明在诱导肌纤维排列方面有效，但肌纤维排列的程度、组织形成和力量产生各不相同。本手稿批判性地回顾了这些方法的优点和局限性，并特别讨论了它们赋予机械和结构线索以诱导组织构建物内排列的能力。随着组织合成技术不断改进，肌肉构建物必须包含比单纯成肌细胞更多的细胞类型，例如添加神经元和内皮细胞。更高层次的组织构建对于这些构建物的成功至关重要。这些技术中的许多尚未植入宿主组织以了解植入情况以及它们如何有助于创伤性损伤，因此外科医生和组织工程师之间持续的合作对于最终实现临床转化是必要的。
