Skeletal muscle has a remarkable regenerative capacity; however, after volumetric muscle loss (VML) due to traumatic injury or surgery this regenerative response is significantly diminished, causing chronic functional deficits. The critical defect size at which the muscle will not functionally recover has not yet been established and subsequently, the relative contribution of crucial muscle components, including muscle stem cells and the muscle stem cell niche, are unknown. In this study, we created VML injuries of 2, 3, or 4 mm diameter, full-thickness defects in the mouse quadriceps. The 2, 3, and 4 mm injuries resulted in a defect of 5, 15, or 30% of the quadriceps mass, respectively. At 14 and 28 days after injury, histological analyses revealed injury size-dependent differences in myofiber morphology and fibrosis; the number of small myofibers increased with increasing injury size. The results showed that the 3 mm injury was at a threshold point, as myofibers were unable to bridge the defect, there was persistent fibrosis and inflammation, and significantly increased number of myofibers with centrally located nuclei. We then further investigated the 3 mm VML for nerve and vascular regeneration. These injured muscles were accompanied by a drastic increase in denervated neuromuscular junctions (NMJ), while assessment of angiogenesis via micro-CT analysis revealed a significant increase in vascular volume primarily from small diameter vessels after VML injury. Collectively, these data indicate that the spatial and temporal control of the fibrotic and neuromotor response are critical to regeneration and could be potential therapeutic targets, as they are the most dysregulated components of the muscle stem cell niche after VML.

Muscle Stem Cell Niche Dysregulation in Volumetric Muscle Loss Injury