"While the body has a capacity to repair small defects in skeletal muscle, the only option for larger defects is to surgically move muscle from one part of the body to another. This is like robbing Peter to pay Paul," said George Christ, Ph.D., a professor at Wake Forest Baptist Medical Center's Institute for Regenerative Medicine. "Rather than moving existing muscle, our aim is to help the body grow new muscle."
In the current issue of Tissue Engineering Part A, Christ and team build on their prior work and report their second round of experiments showing that placing cells derived from muscle tissue on a strip of biocompatible material - and then "exercising" the strip in the lab - results in a muscle-like implant that can prompt muscle regeneration and significant functional recovery. The researchers hope the treatment can one day help patients with muscle defects ranging from cleft lip and palate to those caused by traumatic injuries or surgery.
For the study, small samples of muscle tissue from rats and mice were processed to extract cells, which were then multiplied in the lab. The cells, at a rate of 1 million per square centimeter, were placed onto strips of a natural biological material. The material, derived from pig bladder with all cells removed, is known to be compatible with the body.
Next, the strips were placed in a computer-controlled device that slowly expands and contracts - essentially "educating" the implants on how to perform in the body. This cyclic stretching and relaxation occurred three times per minute for the first five minutes of each hour for about a week. In the current study, the scientists tried several different protocols, such as adding more cells to the strips during the exercise process.
The next step was implanting the strips in mice with about half of a large muscle in the back (latissimus dorsi) removed to create functional impairment. While the strips are "muscle-like" at the time of implantation, they are not yet functional. Implantation in the body - sometimes referred to as "nature's incubator" - prompts further development.
The goal of the project was to speed up the body's natural recovery process as well as prompt the development of new muscle tissue. The scientists compared four groups of mice. One group received no surgical repair. The other groups received implants prepared in one of three ways: one was not exercised before implantation, one was exercised for five to seven days, and one had extra cells added midway through the exercise process. The results showed that exercising the implants made a significant difference in both muscle development and function.
"The implant that wasn't exercised, or pre-conditioned, was able to accelerate the repair process, but recovery then stopped," said Christ. "On the other hand, when you exercise the implant, there is a more prolonged and extensive functional recovery. Through exercising the implant, you can increase both the rate and the magnitude of the recovery."
A variety of laboratory tests were used to measure results. A test of muscle force at two months, for example, showed that animals who received the implants with extra cells added had a threefold increase in absolute force compared to animals whose muscle damage was not repaired. The force-producing capacity of muscle is what determines the ability to perform everyday tasks.
"If these same results were repeated in humans, the recovery in function would clearly be considered significant," said Christ. "Within two months after implantation, the force generated by the repaired muscle is 70 percent that of native tissue, compared to 30 percent in animals that didn't receive repair."
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