Sonaye Surendrasingh Y, Sikder Prabaha
Department of Mechanical Engineering, Cleveland State University, Cleveland, Ohio, USA.
Tissue Eng Part B Rev. 2025 Apr 23. doi: 10.1089/ten.teb.2025.0017.
Severe skeletal muscle injuries involving substantial tissue loss can significantly impair muscle strength and functionality, reducing the quality of life for affected individuals. Such injuries, termed volumetric muscle loss, require extensive clinical intervention, as the body's innate healing mechanisms are insufficient to regenerate functional muscle. The current standard of care primarily involves autologous muscle tissue transfer, with some consideration of acellular synthetic constructs. However, both approaches have limited therapeutic efficacy, presenting challenges such as donor-site morbidity, infection risks, and suboptimal functional recovery. Over the past decade, skeletal muscle tissue engineering (SMTE) has emerged as a promising strategy for regenerating functional muscle through bioengineered constructs. Advanced biofabrication techniques, including bioprinting, have further enabled the development of synthetic constructs that closely mimic native muscle architecture. Given these advancements, a critical review of recent therapeutic strategies, their achievements, and limitations is necessary. This review examines the spectrum of bioengineered constructs developed from various biomaterials and evaluates their therapeutic potential. Special emphasis is placed on 3D bioprinting strategies and their role in creating physiologically relevant constructs for functional muscle restoration. In addition, the integration of machine learning in optimizing construct design, predicting cellular behavior, and enhancing tissue integration is discussed. The review indicates that despite significant progress in SMTE, key challenges remain, including replicating the complex structural organization of muscle tissue, minimizing fibrosis, and achieving vascularization and innervation to regenerate functional, strengthened muscle. Future research should address these barriers while prioritizing the development of translational, clinically relevant regenerative constructs. In addition, efforts should focus on advancing scalable, construct-based regenerative treatments that are readily available at the point of care and easily managed in surgical settings.
严重的骨骼肌损伤伴有大量组织损失，会显著削弱肌肉力量和功能，降低受影响个体的生活质量。这种损伤被称为大面积肌肉损失，由于人体自身的愈合机制不足以再生功能性肌肉，因此需要广泛的临床干预。目前的护理标准主要包括自体肌肉组织移植，也会考虑一些无细胞合成支架。然而，这两种方法的治疗效果都有限，存在供体部位发病、感染风险和功能恢复不理想等挑战。在过去十年中，骨骼肌组织工程（SMTE）已成为一种有前景的策略，通过生物工程构建体来再生功能性肌肉。先进的生物制造技术，包括生物打印，进一步推动了能够紧密模仿天然肌肉结构的合成支架的发展。鉴于这些进展，有必要对近期的治疗策略、其成就和局限性进行批判性综述。本综述考察了由各种生物材料开发的生物工程构建体的范围，并评估了它们的治疗潜力。特别强调了3D生物打印策略及其在创建用于功能性肌肉修复的生理相关构建体中的作用。此外，还讨论了机器学习在优化构建体设计、预测细胞行为和增强组织整合方面的整合。该综述表明，尽管SMTE取得了重大进展，但关键挑战仍然存在，包括复制肌肉组织的复杂结构组织、最小化纤维化以及实现血管化和神经支配以再生功能性、强化的肌肉。未来的研究应在优先发展可转化的、临床相关的再生构建体的同时，解决这些障碍。此外，努力应集中在推进基于构建体的可扩展再生治疗，使其在护理点易于获得并在手术环境中易于管理。
