Hennion Ina, Philips Charlot, Jiang Chong, Van De Winkel Nele, Ceulemans Laurens J, Thorrez Lieven
Tissue Engineering Lab, Department of Development and Regeneration KU Leuven campus Kulak Kortrijk Belgium.
Department of Abdominal Surgery University Hospitals Leuven Leuven Belgium.
Bioeng Transl Med. 2025 Mar 4;10(4):e70009. doi: 10.1002/btm2.70009. eCollection 2025 Jul.
Volumetric muscle loss is the significant loss of skeletal muscle volume beyond the innate regenerative capacity, resulting in functional impairment. The current standard of care combines muscle autografting with physical therapy but is often insufficient to reach full recovery. Decellularized skeletal muscle (DSM) provides an interesting alternative to repair volumetric muscle loss. The native structure and composition of the extracellular matrix in these acellular implants provide a blueprint for muscle regeneration. Moreover, DSM can be combined with cells to facilitate the regeneration of the skeletal muscle defect. This systematic review provides a complete and thorough overview of the state-of-the-art applications and efficacy of DSM matrices in skeletal muscle repair in vivo, selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Technical information on the different methods to create DSM implants and the implantation studies is provided. Moreover, details on the evaluation of the structural and functional regeneration of the muscle defect after implantation of the DSM are described. Results reveal a large heterogeneity in the analysis of regeneration upon DSM implantation. This heterogeneity makes it difficult to fully assess the efficiency of DSM to regenerate skeletal muscle, hampering further translation of this technique. Therefore, we suggest a multi-level evaluation method to assess (i) muscle regeneration, (ii) vascularization, (iii) innervation of the regenerated muscle, and (iv) functional regeneration in a quantitative way.
容积性肌肉损失是指骨骼肌体积的显著减少，超过了其固有的再生能力，从而导致功能受损。当前的治疗标准是将肌肉自体移植与物理治疗相结合，但往往不足以实现完全恢复。去细胞骨骼肌（DSM）为修复容积性肌肉损失提供了一种有趣的替代方法。这些无细胞植入物中细胞外基质的天然结构和组成提供了肌肉再生的蓝图。此外，DSM可以与细胞结合，以促进骨骼肌缺损的再生。本系统评价根据系统评价和Meta分析的首选报告项目指南，全面、彻底地概述了DSM基质在体内骨骼肌修复中的最新应用和疗效。提供了关于创建DSM植入物的不同方法和植入研究的技术信息。此外，还描述了DSM植入后肌肉缺损的结构和功能再生评估的详细情况。结果显示，在DSM植入后的再生分析中存在很大的异质性。这种异质性使得难以全面评估DSM再生骨骼肌的效率，阻碍了该技术的进一步转化。因此，我们建议采用一种多层次评估方法，以定量方式评估（i）肌肉再生、（ii）血管生成、（iii）再生肌肉的神经支配以及（iv）功能再生。
