Endogenous stem cells promote regeneration of muscle in rotator cuff repair

内源干细胞促进肩袖修复中的肌肉再生

• 批准号: 10595521
• 负责人: Brian Feeley
• 金额: --
• 依托单位: VETERANS AFFAIRS MED CTR SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595521
• 关键词: Achievement; Activities of Daily Living; Address; Adipose tissue; Affect; Age; Aging; Agonist; American; Anterior; Atrophic; Cells; Chronic; Clinical; Clinical Research; Disease; Economic Burden; Fatty acid glycerol esters; Fibrosis; Future; Gene Expression; Gene Expression Profile; Health; Health Care Costs; Human; Impairment; In Vitro; Infiltration; Injury; Magnetic Resonance Imaging; Modeling; Mus; Muscle; Muscle Development; Muscle satellite cell; Muscular Atrophy; Natural regeneration; Operative Surgical Procedures; Pathologic; Patient-Focused Outcomes; Patients; Phenotype; Population; Process; Productivity; Property; Quality of life; Recovery; Role; Rotator Cuff; Source; Tendon structure; Time; Tissue Differentiation; Tissues; Translating; Upper Extremity; Wages; age related; aging population; arm; cell motility; clinically relevant; effective therapy; human data; improved; in vitro regeneration; in vivo; in vivo Model; limb injury; medical attention; military veteran; muscle degeneration; muscle regeneration; novel therapeutic intervention; older patient; patient population; physically handicapped; progenitor; regeneration potential; regenerative; repaired; response; rotator cuff tear; stem cell proliferation; stem cells; supraspinatus muscle; surgery outcome; targeted treatment; tissue regeneration; treatment strategy

Rotator cuff (RC) tears are the most common upper extremity injury, with over two million Americans seeking medical attention annually. With the increased age of our veterans' population, RC tears are becoming a vital health issue for the VA patients. Secondary muscle degradation following tears, including atrophy and fatty infiltration (FI) are critical factors that directly determine the clinical outcome of patients with this injury. Muscle residential fibro/adipogenic progenitor (FAP) cells have been found to be the major cellular source of fat in RC muscle after massive tendon tears. We recently discovered that these cells represent a heterogeneous cell population capable of both regenerative and pathologic responses to muscle injury. Importantly, FAPs can differentiate into a beige adipose tissue (BAT) phenotype that may have a role in promoting muscle recovery and regeneration in chronic injury states. However, at this time, no studies have evaluated factors that influence the fate of FAPs in human cuff tears, nor what FAP regenerative capabilities could be in clinical scenarios such as rotator cuff repair. Clinically, both patient age and size of the rotator cuff tear have been found to be independent factors that associate with poorer muscle quality and worse patient outcomes. However, the interplay between patient and rotator cuff tear size and their influence on muscle stem cell proliferation, differentiation, and regenerative capabilities is not known at this time. To address this problem, we will perform the first large-scale clinical study evaluating FAP phenotypic properties in patients with rotator cuff tears. Expanding on our promising mouse studies that show FAPs are capable of stimulating muscle regeneration, we will perform a rigorous set of studies that will determine the regenerative capabilities of human FAPs in this clinically relevant scenario to confirm our hypothesis that the ability of FAPs to promote healthy muscle regeneration is dependent on the size of the tear and age of the patient due to changes in FAP gene expression. By the end of this study, we will understand how clinically important factors (age, tear size) affect the degeneration and regeneration potential of human FAPs, which should provide critical information on how these endogenous stem cells can be leveraged to improve precision guided patient outcomes with targeted therapeutic strategies in the near future.

肩袖 (RC) 撕裂是最常见的上肢损伤，超过 200 万美国人 每年寻求医疗救助。随着退伍军人年龄的增长，RC 的眼泪越来越多 成为退伍军人管理局患者的一个重要健康问题。眼泪后继发性肌肉退化， 包括萎缩和脂肪浸润（FI）是直接决定临床的关键因素 受此伤害的患者的结果。肌肉驻留纤维/脂肪祖细胞 (FAP) 具有 被发现是大量肌腱撕裂后 RC 肌肉中脂肪的主要细胞来源。我们最近 发现这些细胞代表了能够再生和再生的异质细胞群 对肌肉损伤的病理反应。重要的是，FAP 可以分化成米色脂肪组织 (BAT) 表型可能在促进慢性损伤的肌肉恢复和再生中发挥作用 州。然而，目前还没有研究评估影响 FAPs 命运的因素。 人类袖带撕裂，以及 FAP 再生能力在临床场景（例如旋转器）中的表现 袖口修复。临床上发现，患者年龄和肩袖撕裂的大小都与 与较差的肌肉质量和较差的患者预后相关的独立因素。然而， 患者和肩袖撕裂大小之间的相互作用及其对肌肉干细胞的影响 增殖、分化和再生能力目前尚不清楚。为了解决这个问题 为了解决这个问题，我们将进行第一个大规模临床研究，评估 FAP 表型特性 肩袖撕裂的患者。扩展我们有前途的小鼠研究，这些研究表明 FAP 具有能力 为了刺激肌肉再生，我们将进行一系列严格的研究来确定 人类 FAP 在这种临床相关场景中的再生能力证实了我们的假设 FAP 促进健康肌肉再生的能力取决于撕裂的大小和 由于 FAP 基因表达的变化而导致的患者年龄。在本研究结束时，我们将了解 临床重要因素（年龄、泪液大小）如何影响退化和再生潜力 人类 FAP，它应该提供有关如何这些内源干细胞的关键信息 利用近期有针对性的治疗策略来改善精确指导的患者结果 未来。