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Johnson D, Ridolfo A, Mueller R, Chermack M, Brockhouse J, Tadiwala J, Jain A, Bertram K, Garg K. Biosponge-Encased Placental Stem Cells for Volumetric Muscle Loss Repair. Adv Wound Care (New Rochelle) 2024. [PMID: 39171894 DOI: 10.1089/wound.2024.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024] Open
Abstract
Objective: Volumetric muscle loss (VML) leads to permanent muscle mass and functional impairments. While mesenchymal stromal cells (MSCs) and their secreted factors can aid muscle regeneration, MSCs exhibit limited persistence in injured tissue post-transplantation. Human placental-derived stem cells (hPDSCs), sharing surface markers with MSCs, demonstrate superior regenerative potential due to their fetal origin. Previously, a biosponge (BS) scaffold was shown to augment muscle regeneration post-VML. This study aims to coapply BS therapy and hPDSCs to further enhance muscle recovery following VML. Approach: A VML defect was created by removing ∼20% of the tibialis anterior muscle mass in male Lewis rats. Injured muscles were either left untreated or treated with BS or BS-encapsulated hPDSCs cultured under normoxic or hypoxic conditions. On day 28 postinjury, peak isometric torque was measured, and the muscle was harvested for analysis. Results: BS encapsulated hPDSCs subjected to hypoxic preconditioning persisted in larger quantities and enhanced muscle mass at day 28 postinjury. BS encapsulated hPDSCs cultured under normoxic or hypoxic conditions increased small myofibers (<500 µm2) percentage, MyoD protein expression, and both pro- and anti-inflammatory macrophage marker expression. BS encapsulated hPDSCs also reduced fibrosis and BS remodeling rate. Innovation: This study is the first to examine the therapeutic effects of hPDSCs in a rat VML model. A BS carrier and hypoxic preconditioning were investigated to mitigate low cell survival postimplantation. Conclusion: hPDSCs augment the regenerative effect of BS. Combining hPDSCs and BS emerges as a promising strategy worthy of further investigation.
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Affiliation(s)
- David Johnson
- Department of Biomedical Engineering, School of Sciences and Engineering, St. Louis, Saint Louis, Missouri, USA
| | - Amelia Ridolfo
- Department of Biomedical Engineering, School of Sciences and Engineering, St. Louis, Saint Louis, Missouri, USA
| | - Ryan Mueller
- Department of Biomedical Engineering, School of Sciences and Engineering, St. Louis, Saint Louis, Missouri, USA
| | - Megan Chermack
- Department of Biomedical Engineering, School of Sciences and Engineering, St. Louis, Saint Louis, Missouri, USA
| | - Julia Brockhouse
- Department of Biomedical Engineering, School of Sciences and Engineering, St. Louis, Saint Louis, Missouri, USA
| | - Jamshid Tadiwala
- Department of Biomedical Engineering, School of Sciences and Engineering, St. Louis, Saint Louis, Missouri, USA
| | - Avantika Jain
- Department of Pharmacology and Physiology, School of Medicine, St. Louis, Saint Louis, Missouri, USA
| | - Kenneth Bertram
- Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina, USA
| | - Koyal Garg
- Department of Biomedical Engineering, School of Sciences and Engineering, St. Louis, Saint Louis, Missouri, USA
- Department of Pharmacology and Physiology, School of Medicine, St. Louis, Saint Louis, Missouri, USA
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2
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Gahlawat S, Oruc D, Paul N, Ragheb M, Patel S, Fasasi O, Sharma P, Shreiber DI, Freeman JW. Tissue Engineered 3D Constructs for Volumetric Muscle Loss. Ann Biomed Eng 2024; 52:2325-2347. [PMID: 39085677 PMCID: PMC11329418 DOI: 10.1007/s10439-024-03541-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/08/2024] [Indexed: 08/02/2024]
Abstract
Severe injuries to skeletal muscles, including cases of volumetric muscle loss (VML), are linked to substantial tissue damage, resulting in functional impairment and lasting disability. While skeletal muscle can regenerate following minor damage, extensive tissue loss in VML disrupts the natural regenerative capacity of the affected muscle tissue. Existing clinical approaches for VML, such as soft-tissue reconstruction and advanced bracing methods, need to be revised to restore tissue function and are associated with limitations in tissue availability and donor-site complications. Advancements in tissue engineering (TE), particularly in scaffold design and the delivery of cells and growth factors, show promising potential for regenerating damaged skeletal muscle tissue and restoring function. This article provides a brief overview of the pathophysiology of VML and critiques the shortcomings of current treatments. The subsequent section focuses on the criteria for designing TE scaffolds, offering insights into various natural and synthetic biomaterials and cell types for effectively regenerating skeletal muscle. We also review multiple TE strategies involving both acellular and cellular scaffolds to encourage the development and maturation of muscle tissue and facilitate integration, vascularization, and innervation. Finally, the article explores technical challenges hindering successful translation into clinical applications.
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Affiliation(s)
- Sonal Gahlawat
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Doga Oruc
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Nikhil Paul
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Mark Ragheb
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Swati Patel
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Oyinkansola Fasasi
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Peeyush Sharma
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - David I Shreiber
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Joseph W Freeman
- Department of Biomedical Engineering, Rutgers University-New Brunswick, Piscataway, NJ, USA.
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3
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Habing KM, Alcazar CA, Duke VR, Tan YH, Willett NJ, Nakayama KH. Age-associated functional healing of musculoskeletal trauma through regenerative engineering and rehabilitation. Biomater Sci 2024. [PMID: 39172120 DOI: 10.1039/d4bm00616j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Traumatic musculoskeletal injuries that lead to volumetric muscle loss (VML) are challenged by irreparable soft tissue damage, impaired regenerative ability, and reduced muscle function. Regenerative rehabilitation strategies involving the pairing of engineered therapeutics with exercise have guided considerable advances in the functional repair of skeletal muscle following VML. However, few studies evaluate the efficacy of regenerative rehabilitation across the lifespan. In the current study, young and aged mice are treated with an engineered muscle, consisting of nanofibrillar-aligned collagen laden with myogenic cells, in combination with voluntary running activity following a VML injury. Overall, young mice perform at higher running volumes and intensities compared to aged mice but exhibit similar volumes relative to age-matched baselines. Additionally, young mice are highly responsive to the dual treatment showing enhanced force production (p < 0.001), muscle mass (p < 0.05), and vascular density (p < 0.01) compared to age-matched controls. Aged mice display upregulation of circulating inflammatory cytokines and show no significant regenerative response to treatment, suggesting a diminished efficacy of regenerative rehabilitation in aged populations. These findings highlight the restorative potential of regenerative engineering and rehabilitation for the treatment of traumatic musculoskeletal injuries in young populations and the complimentary need for age-specific interventions and studies to serve broader patient demographics.
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Affiliation(s)
- Krista M Habing
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA.
| | - Cynthia A Alcazar
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA.
| | - Victoria R Duke
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA.
| | - Yong How Tan
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA.
| | - Nick J Willett
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA.
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR, USA
- Department of Orthopaedics, Oregon Health & Science University, Portland, OR, USA
- The Veterans Affairs Portland Health Care System, Portland, OR, USA
| | - Karina H Nakayama
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA.
- Department of Orthopaedics, Oregon Health & Science University, Portland, OR, USA
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4
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Sicherer ST, Haque N, Parikh Y, Grasman J. Current methodologies for inducing aligned myofibers in tissue constructs for skeletal muscle tissue regeneration. Adv Wound Care (New Rochelle) 2024. [PMID: 39126403 DOI: 10.1089/wound.2024.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
SIGNIFICANCE 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. RECENT ADVANCES 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 in vitro 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. CRITICAL ISSUES 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 towards inducing myofiber alignment, the extent of myofiber alignment, tissue formation, and force production varies. This manuscript critically reviews the advantages and limitations of these methods, and specifically discusses their ability to impart mechanical and architectural cues to induce alignment within constructs. FUTURE DIRECTIONS 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.
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Affiliation(s)
- Sydnee T Sicherer
- New Jersey Institute of Technology, Biomedical Engineering, Newark, New Jersey, United States;
| | - Noor Haque
- New Jersey Institute of Technology, Biomedical Engineering, Newark, New Jersey, United States;
| | - Yash Parikh
- New Jersey Institute of Technology, Biomedical Engineering, Newark, New Jersey, United States;
| | - Jonathan Grasman
- New Jersey Institute of Technology, Biomedical Engineering, 323 Dr Martin Luther King Jr Blvd, Newark, New Jersey, United States, 07102;
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5
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Cai CW, Grey JA, Hubmacher D, Han WM. Biomaterial-Based Regenerative Strategies for Volumetric Muscle Loss: Challenges and Solutions. Adv Wound Care (New Rochelle) 2024. [PMID: 38775429 DOI: 10.1089/wound.2024.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
Significance: Volumetric muscle loss (VML) is caused by the loss of significant amounts of skeletal muscle tissue. VML cannot be repaired by intrinsic regenerative processes, resulting in permanent loss of muscle function and disability. Current rehabilitative-focused treatment strategies lack efficacy and do not restore muscle function, indicating the need for the development of effective regenerative strategies. Recent Advances: Recent developments implicate biomaterial-based approaches for promoting muscle repair and functional restoration post-VML. Specifically, bioscaffolds transplanted in the injury site have been utilized to mimic endogenous cues of the ablated tissue to promote myogenic pathways, increase neo-myofiber synthesis, and ultimately restore contractile function to the injured unit. Critical Issues: Despite the development and preclinical testing of various biomaterial-based regenerative strategies, effective therapies for patients are not available. The unique challenges posed for biomaterial-based treatments of VML injuries, including its scalability and clinical applicability beyond small-animal models, impede progress. Furthermore, production of tissue-engineered constructs is technically demanding, with reproducibility issues at scale and complexities in achieving vascularization and innervation of large constructs. Future Directions: Biomaterial-based regenerative strategies designed to comprehensively address the pathophysiology of VML are needed. Considerations for clinical translation, including scalability and regulatory compliance, should also be considered when developing such strategies. In addition, an integrated approach that combines regenerative and rehabilitative strategies is essential for ensuring functional improvement.
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Affiliation(s)
- Charlene W Cai
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Biology, The College of New Jersey, Ewing, New Jersey, USA
| | - Josh A Grey
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Cell, Developmental, and Regenerative Biology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute of Regenerative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dirk Hubmacher
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Woojin M Han
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Cell, Developmental, and Regenerative Biology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute of Regenerative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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6
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Luo W, Zhang H, Wan R, Cai Y, Liu Y, Wu Y, Yang Y, Chen J, Zhang D, Luo Z, Shang X. Biomaterials-Based Technologies in Skeletal Muscle Tissue Engineering. Adv Healthc Mater 2024; 13:e2304196. [PMID: 38712598 DOI: 10.1002/adhm.202304196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/26/2024] [Indexed: 05/08/2024]
Abstract
For many clinically prevalent severe injuries, the inherent regenerative capacity of skeletal muscle remains inadequate. Skeletal muscle tissue engineering (SMTE) seeks to meet this clinical demand. With continuous progress in biomedicine and related technologies including micro/nanotechnology and 3D printing, numerous studies have uncovered various intrinsic mechanisms regulating skeletal muscle regeneration and developed tailored biomaterial systems based on these understandings. Here, the skeletal muscle structure and regeneration process are discussed and the diverse biomaterial systems derived from various technologies are explored in detail. Biomaterials serve not merely as local niches for cell growth, but also as scaffolds endowed with structural or physicochemical properties that provide tissue regenerative cues such as topographical, electrical, and mechanical signals. They can also act as delivery systems for stem cells and bioactive molecules that have been shown as key participants in endogenous repair cascades. To achieve bench-to-bedside translation, the typical effect enabled by biomaterial systems and the potential underlying molecular mechanisms are also summarized. Insights into the roles of biomaterials in SMTE from cellular and molecular perspectives are provided. Finally, perspectives on the advancement of SMTE are provided, for which gene therapy, exosomes, and hybrid biomaterials may hold promise to make important contributions.
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Affiliation(s)
- Wei Luo
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Hanli Zhang
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Renwen Wan
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Yuxi Cai
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Yinuo Liu
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, P. R. China
| | - Yang Wu
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Yimeng Yang
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Jiani Chen
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Deju Zhang
- Food and Nutritional Sciences, School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong, 999077, Hong Kong
| | - Zhiwen Luo
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
| | - Xiliang Shang
- Department of Sports Medicine Huashan Hospital, Fudan University, Shanghai, 200040, P. R. China
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7
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Johnson D, Tobo C, Au J, Nagarapu A, Ziemkiewicz N, Chauvin H, Robinson J, Shringarpure S, Tadiwala J, Brockhouse J, Flaveny CA, Garg K. Combined regenerative rehabilitation improves recovery following volumetric muscle loss injury in a rat model. J Biomed Mater Res B Appl Biomater 2024; 112:e35438. [PMID: 38923755 PMCID: PMC11210688 DOI: 10.1002/jbm.b.35438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/27/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
Volumetric muscle loss (VML) injury causes irreversible deficits in muscle mass and function, often resulting in permanent disability. The current standard of care is physical therapy, but it is limited in mitigating functional deficits. We have previously optimized a rehabilitation technique using electrically stimulated eccentric contraction training (EST) that improved muscle mass, strength, and size in VML-injured rats. A biosponge scaffold composed of extracellular matrix proteins has previously enhanced muscle function postVML. This study aimed to determine whether combining a regenerative therapy (i.e., biosponge) with a novel rehabilitation technique (i.e., EST) could enhance recovery in a rat model of VML. A VML defect was created by removing ~20% of muscle mass from the tibialis anterior muscle in adult male Lewis rats. Experimental groups included VML-injured rats treated with biosponge with EST or biosponge alone (n = 6/group). EST was implemented 2 weeks postinjury at 150 Hz and was continued for 4 weeks. A linear increase in eccentric torque over 4 weeks showed the adaptability of the VML-injured muscle to EST. Combining biosponge with EST improved peak isometric torque by ~52% compared with biosponge treatment alone at 6 weeks postinjury. Application of EST increased MyoD gene expression and the percentage of large (>2000 μm2) type 2B myofibers but reduced fibrotic tissue deposition in VML-injured muscles. Together, these changes may provide the basis for improved torque production. This study demonstrates the potential for combined regenerative and rehabilitative therapy to improve muscle recovery following VML.
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Affiliation(s)
- David Johnson
- Department of Biomedical Engineering, School of Sciences and Engineering
| | - Connor Tobo
- Department of Biomedical Engineering, School of Sciences and Engineering
| | - Jeffrey Au
- Department of Biomedical Engineering, School of Sciences and Engineering
| | - Aakash Nagarapu
- Department of Biomedical Engineering, School of Sciences and Engineering
| | | | - Hannah Chauvin
- Department of Biomedical Engineering, School of Sciences and Engineering
| | - Jessica Robinson
- Department of Biomedical Engineering, School of Sciences and Engineering
| | | | - Jamshid Tadiwala
- Department of Biomedical Engineering, School of Sciences and Engineering
| | - Julia Brockhouse
- Department of Biomedical Engineering, School of Sciences and Engineering
| | | | - Koyal Garg
- Department of Biomedical Engineering, School of Sciences and Engineering
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8
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Ziemkiewicz N, Au J, Chauvin HM, Garg K. Electrically stimulated eccentric contraction training enhances muscle mass, function, and size following volumetric muscle loss. J Orthop Res 2023; 41:2588-2598. [PMID: 37132367 DOI: 10.1002/jor.25591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/14/2023] [Accepted: 05/01/2023] [Indexed: 05/04/2023]
Abstract
Volumetric muscle loss (VML) overwhelms muscle's innate capacity for repair and can lead to permanent disability. The standard of care for VML injuries includes physical therapy, which can improve muscle function. The objective of this study was to develop and evaluate a rehabilitative therapy using electrically stimulated eccentric contraction training (EST) and determine the structural, biomolecular, and functional response of the VML-injured muscle. This study implemented EST using three different frequencies (50, 100, and 150 Hz) in VML-injured rats starting at 2 weeks postinjury. Four weeks of EST at 150 Hz showed a progressive increase in eccentric torque with an improvement in muscle mass (~39%), myofiber cross-sectional area, and peak isometric torque (~37.5%) relative to the untrained VML-injured sham group. EST at 150 Hz group also increased the number of large type 2B fibers (>5000 µm2 ). Elevated gene expression of markers associated with angiogenesis, myogenesis, neurogenesis, and an anti-inflammatory response was also observed. These results suggest that VML-injured muscles can respond and adapt to eccentric loading. The results of this study may aid in developing physical therapy regimens for traumatized muscles.
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Affiliation(s)
- Natalia Ziemkiewicz
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Jeffrey Au
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Hannah M Chauvin
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Koyal Garg
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
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9
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Kozan NG, Caswell S, Patel M, Grasman JM. Aligned Collagen Sponges with Tunable Pore Size for Skeletal Muscle Tissue Regeneration. J Funct Biomater 2023; 14:533. [PMID: 37998102 PMCID: PMC10672557 DOI: 10.3390/jfb14110533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/25/2023] Open
Abstract
Volumetric muscle loss (VML) is a traumatic injury where at least 20% of the mass of a skeletal muscle has been destroyed and functionality is lost. The standard treatment for VML, autologous tissue transfer, is limited as approximately 1 in 10 grafts fail because of necrosis or infection. Tissue engineering strategies seek to develop scaffolds that can regenerate injured muscles and restore functionality. Many of these scaffolds, however, are limited in their ability to restore muscle functionality because of an inability to promote the alignment of regenerating myofibers. For aligned myofibers to form on a scaffold, myoblasts infiltrate the scaffold and receive topographical cues to direct targeted myofiber growth. We seek to determine the optimal pore size for myoblast infiltration and differentiation. We developed a method of tuning the pore size within collagen scaffolds while inducing longitudinal alignment of these pores. Significantly different pore sizes were generated by adjusting the freezing rate of the scaffolds. Scaffolds frozen at -20 °C contained the largest pores. These scaffolds promoted the greatest level of cell infiltration and orientation in the direction of pore alignment. Further research will be conducted to induce higher levels of myofiber formation, to ultimately create an off-the-shelf treatment for VML injuries.
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Affiliation(s)
| | | | | | - Jonathan M. Grasman
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
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10
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Retrospective characterization of a rat model of volumetric muscle loss. BMC Musculoskelet Disord 2022; 23:814. [PMID: 36008828 PMCID: PMC9414143 DOI: 10.1186/s12891-022-05760-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Volumetric muscle loss (VML) is a pervasive injury within contemporary combat and a primary driver of disability among injured Service members. As such, VML has been a topic of investigation over the past decade as the field has sought to understand the pathology of these injuries and to develop treatment strategies which restore the form and function of the involved musculature. To date, much of this work has been performed in disparate animal models that vary significantly in terms of the species utilized, the muscle (or muscle group) affected, and the volume of muscle lost. Moreover, variation exists in the reporting of anatomical and functional outcomes within these models. When taken together, the ability to successfully assess comparative efficacy of promising therapies is currently limited. As such, greater scrutiny on the characterization of these VML models is needed to better assess the quality of evidence supporting further translation of putative therapies. Thus, the objective of this study was to retrospectively characterize anatomical and functional outcomes associated with one such VML model – the 6 mm biopsy punch model of the rat tibialis anterior muscle. Through these efforts, it was shown that this model is highly reproducible and consistent across a large number of experiments. As such, the data presented herein represent a reasonable benchmark for the expected performance of this model with utility for drawing inferences across studies and identifying therapies which have shown promise within the preclinical domain, and thus are ready for further translation towards the clinic.
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11
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Ziemkiewicz N, Hilliard GM, Dunn AJ, Madsen J, Haas G, Au J, Genovese PC, Chauvin HM, West C, Paoli A, Garg K. Laminin-111-Enriched Fibrin Hydrogels Enhance Functional Muscle Regeneration Following Trauma. Tissue Eng Part A 2022; 28:297-311. [PMID: 34409846 DOI: 10.1089/ten.tea.2021.0096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Volumetric muscle loss (VML) is the surgical or traumatic loss of skeletal muscle, which can cause loss of limb function or permanent disability. VML injuries overwhelms the endogenous regenerative capacity of skeletal muscle and results in poor functional healing outcomes. Currently, there are no approved tissue engineering treatments for VML injuries. In this study, fibrin hydrogels enriched with laminin-111 (LM-111; 50-450 μg/mL) were used for the treatment of VML of the tibialis anterior in a rat model. Treatment with fibrin hydrogel containing 450 μg/mL of LM-111 (FBN450) improved muscle regeneration following VML injury. FBN450 hydrogel treatment increased the relative proportion of contractile to fibrotic tissue as indicated by the myosin: collagen ratio on day 28 post-VML injury. FBN450 hydrogels also enhanced myogenic protein expression and increased the quantity of small to medium size myofibers (500-2000 μm2) as well as innervated myofibers. Improved contractile tissue deposition due to FBN450 hydrogel treatment resulted in a significant improvement (∼60%) in torque production at day 28 postinjury. Taken together, these results suggest that the acellular FBN450 hydrogels provide a promising therapeutic strategy for VML that is worthy of further investigation.
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Affiliation(s)
- Natalia Ziemkiewicz
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Genevieve M Hilliard
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Andrew J Dunn
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Josh Madsen
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Gabriel Haas
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Jeffrey Au
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Peter C Genovese
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Hannah M Chauvin
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Charles West
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Allison Paoli
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
| | - Koyal Garg
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, St. Louis, Missouri, USA
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12
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Kiran S, Dwivedi P, Kumar V, Price RL, Singh UP. Immunomodulation and Biomaterials: Key Players to Repair Volumetric Muscle Loss. Cells 2021; 10:cells10082016. [PMID: 34440785 PMCID: PMC8394423 DOI: 10.3390/cells10082016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/27/2021] [Accepted: 08/03/2021] [Indexed: 11/21/2022] Open
Abstract
Volumetric muscle loss (VML) is defined as a condition in which a large volume of skeletal muscle is lost due to physical insult. VML often results in a heightened immune response, resulting in significant long-term functional impairment. Estimates indicate that ~250,000 fractures occur in the US alone that involve VML. Currently, there is no active treatment to fully recover or repair muscle loss in VML patients. The health economics burden due to VML is rapidly increasing around the world. Immunologists, developmental biologists, and muscle pathophysiologists are exploring both immune responses and biomaterials to meet this challenging situation. The inflammatory response in muscle injury involves a non-specific inflammatory response at the injured site that is coordination between the immune system, especially macrophages and muscle. The potential role of biomaterials in the regenerative process of skeletal muscle injury is currently an important topic. To this end, cell therapy holds great promise for the regeneration of damaged muscle following VML. However, the delivery of cells into the injured muscle site poses a major challenge as it might cause an adverse immune response or inflammation. To overcome this obstacle, in recent years various biomaterials with diverse physical and chemical nature have been developed and verified for the treatment of various muscle injuries. These biomaterials, with desired tunable physicochemical properties, can be used in combination with stem cells and growth factors to repair VML. In the current review, we focus on how various immune cells, in conjunction with biomaterials, can be used to promote muscle regeneration and, most importantly, suppress VML pathology.
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Affiliation(s)
- Sonia Kiran
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN 38163, USA; (S.K.); (V.K.)
| | - Pankaj Dwivedi
- Department of Pharmaceutical and Administrative Sciences, University of Health Science and Pharmacy, St. Louis, MO 63110, USA;
| | - Vijay Kumar
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN 38163, USA; (S.K.); (V.K.)
| | - Robert L. Price
- Department of Cell and Developmental Biology, University of South Carolina, Columbia, SC 29208, USA;
| | - Udai P. Singh
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN 38163, USA; (S.K.); (V.K.)
- Correspondence:
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