Advances in Muscle Regeneration
Q: Can you start us off by explaining what volumetric muscle loss is and how it impacts trauma patients?
A: Volumetric muscle loss injuries are injuries in which the muscle itself is damaged and may even be sheared from the body. Most often, these injuries occur after traumatic events such as motor vehicle accidents or bomb blasts. In the case of the Boston Marathon bombings, many patients lost or injured their muscles as a result of projectile shrapnel, which penetrated the skin and damaged underlying muscle. As a patient heals, their connective tissues become thickened and scarred-a process known as fibrosis-causing impaired muscle function.
Q: Your project seeks to restore a patient’s muscle mass and function by using stem cells and 3D-printed bio-scaffolds. Can you break down how this process works?
A: For the body to heal a muscle injury properly, there are a few critical requirements: 1) There has to be enough resident stem cells present, 2) there has to be an area of the stem cells to grow into and form new muscle, and 3) the environment has to be supportive of skeletal muscle regeneration. When these conditions are not met, the body instead creates a large area of scarring and fibrosis.
Our approach to addressing this issue is twofold: First, scaffolds can provide an area for the muscle stem cells to grow into, and second, they can be embedded with growth factors to stimulate muscle regeneration.
Q: What are the next steps for your project?
A: We are still refining and optimizing specific features of both the scaffold and stem cells. The next step would be trials in large animal studies to test the efficacy of scaffolds, with subsequent clinical trials. We are probably two years away from large animal studies. Intriguingly, there are some clinically approved scaffolds that may improve regeneration, however. In that case, if the large animal trials are effective, clinical trials could follow very soon after.
Q: Finally, tell us about your collaboration, and why two heads are perhaps better than one.
A: We have very different backgrounds, representing the fields of plastic surgery and bioengineering [Indranil Sinha, MD, and Su-Ryon Shin, PhD, respectively]. Our skill sets complement each other, and both are necessary to properly address volumetric muscle loss. Through listening to other research presentations through the Stepping Strong Innovator Awards series, we quickly realized that our ideas were much better combined, allowing us to address the full spectrum of necessary facets in treating volumetric muscle loss.