Abstract
Skeletal myofibers naturally regenerate after damage; however, impaired muscle function can result in cases when a prominent portion of skeletal muscle mass is lost, for example, following traumatic muscle injury. Volumetric muscle loss can be modeled in mice using a surgical model of muscle ablation to study the pathology of volumetric muscle loss and to test experimental treatments, such as the implantation of acellular scaffolds, which promote de novo myogenesis and angiogenesis. Here we provide step-by-step instructions to perform full-thickness surgical ablation, using biopsy punches, and to remove a large volume of the tibialis anterior muscle of the lower limb in mice. This procedure results in a reduction in muscle mass and limited regeneration capacity; the approach is easy to reproduce and can also be applied to larger animal models. For therapeutic applications, we further explain how to implant bioscaffolds into the ablated muscle site. With adequate training and practice, the surgical procedure can be performed within 30 min.
Key points
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A surgical procedure for the full-thickness surgical ablation of ~20–60% of the mouse tibialis anterior using a commercial 2–3-mm biopsy punch allows the ablation size to be customized. The model is representative of skeletal muscle loss.
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The surgically ablated muscles’ uniform geometry does not fully reproduce the complexity of traumatic muscle injury, which includes other injuries associated with trauma to the bone, nerves or tendons.
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Data availability
All data generated or analyzed during this study are derived from our original research study or are included in this paper. Source data are provided with this paper.
References
Grogan, B. F., Hsu, J. R. & Skeletal Trauma Research Consortium. Volumetric muscle loss. J. Am. Acad. Orthop. Surg. 19, S35–S37 (2011).
Mauro, A. Satellite cell of skeletal muscle fibers. J. Biophys. Biochem. Cytol. 9, 493–495 (1961).
Caldwell, C. J., Mattey, D. L. & Weller, R. O. Role of the basement membrane in the regeneration of skeletal muscle. Neuropathol. Appl. Neurobiol. 16, 225–238 (1990).
Lefaucheur, J. P. & Sebille, A. The cellular events of injured muscle regeneration depend on the nature of the injury. Neuromuscul. Disord. 5, 501–509 (1995).
Aguilar, C. A. et al. Multiscale analysis of a regenerative therapy for treatment of volumetric muscle loss injury. Cell Death Discov. 4, 1–11 (2018).
Corona, B. T., Wenke, J. C. & Ward, C. L. Pathophysiology of volumetric muscle loss injury. Cells Tissues Organs 202, 180–188 (2016).
Greising, S. M., Dearth, C. L. & Corona, B. T. Regenerative and rehabilitative medicine: a necessary synergy for functional recovery from volumetric muscle loss injury. Cells Tissues Organs 202, 237–249 (2016).
Nakayama, K. H., Shayan, M. & Huang, N. F. Engineering biomimetic materials for skeletal muscle repair and regeneration. Adv. Healthc. Mater. 8, e1801168 (2019).
Shayan, M. & Huang, N. F. Pre-clinical cell therapeutic approaches for repair of volumetric muscle loss. Bioengineering https://doi.org/10.3390/bioengineering7030097 (2020).
Dziki, J. et al. An acellular biologic scaffold treatment for volumetric muscle loss: results of a 13-patient cohort study. NPJ Regen. Med. 1, 16008 (2016).
Nakayama, K. H. et al. Treatment of volumetric muscle loss in mice using nanofibrillar scaffolds enhances vascular organization and integration. Commun. Biol. 2, 170 (2019).
Anderson, S. E. et al. Determination of a critical size threshold for volumetric muscle loss in the mouse quadriceps. Tissue Eng. Part C. Methods 25, 59–70 (2019).
Garg, K. et al. Volumetric muscle loss: persistent functional deficits beyond frank loss of tissue. J. Orthop. Res. 33, 40–46 (2015).
Willett, N. J. et al. Attenuated human bone morphogenetic protein-2-mediated bone regeneration in a rat model of composite bone and muscle injury. Tissue Eng. C. 19, 316–325 (2013).
Hu, C. et al. Comparative effects of basic fibroblast growth factor delivery or voluntary exercise on muscle regeneration after volumetric muscle loss. Bioengineering 9, 37 (2022).
Larouche, J. A., Wallace, E. C., Spence, B. D., Buras, E. & Aguilar, C. A. Spatiotemporal mapping of immune and stem cell dysregulation after volumetric muscle loss. JCI Insight https://doi.org/10.1172/jci.insight.162835 (2023).
Corona, B. T., Henderson, B. E., Ward, C. L. & Greising, S. M. Contribution of minced muscle graft progenitor cells to muscle fiber formation after volumetric muscle loss injury in wild-type and immune deficient mice. Physiol. Rep. 5, e13249 (2017).
Pollot, B. E. & Corona, B. T. Volumetric muscle loss. Methods Mol. Biol. 1460, 19–31 (2016).
Quarta, M. et al. Bioengineered constructs combined with exercise enhance stem cell-mediated treatment of volumetric muscle loss. Nat. Commun. 8, 15613 (2017).
Nakayama, K. H. et al. Rehabilitative exercise and spatially patterned nanofibrillar scaffolds enhance vascularization and innervation following volumetric muscle loss. NPJ Regen. Med. 3, 16 (2018).
Quarta, M. et al. Biomechanics show stem cell necessity for effective treatment of volumetric muscle loss using bioengineered constructs. NPJ Regen. Med. 3, 18 (2018).
Corona, B. T. et al. Further development of a tissue engineered muscle repair construct in vitro for enhanced functional recovery following implantation in vivo in a murine model of volumetric muscle loss injury. Tissue Eng. Part A 18, 1213–1228 (2012).
Sicari, B. M. et al. An acellular biologic scaffold promotes skeletal muscle formation in mice and humans with volumetric muscle loss. Sci. Transl. Med. 6, 234ra258 (2014).
Zaitseva, T. S. et al. Aligned nanofibrillar scaffolds for controlled delivery of modified mRNA. Tissue Eng. Part A 25, 121–130 (2019).
Alcazar, C. A., Hu, C., Rando, T. A., Huang, N. F. & Nakayama, K. H. Transplantation of insulin-like growth factor-1 laden scaffolds combined with exercise promotes neuroregeneration and angiogenesis in a preclinical muscle injury model. Biomater. Sci. 8, 5376–5389 (2020).
Corona, B. T. et al. Autologous minced muscle grafts: a tissue engineering therapy for the volumetric loss of skeletal muscle. Am. J. Physiol. Cell Physiol. 305, C761–775 (2013).
Sirabella, D., De Angelis, L. & Berghella, L. Sources for skeletal muscle repair: from satellite cells to reprogramming. J. Cachexia Sarcopenia Muscle 4, 125–136 (2013).
Wu, X., Corona, B. T., Chen, X. & Walters, T. J. A standardized rat model of volumetric muscle loss injury for the development of tissue engineering therapies. Biores. Open Access 1, 280–290 (2012).
Sicherer, S. T., Venkatarama, R. S. & Grasman, J. M. Recent trends in injury models to study skeletal muscle regeneration and repair. Bioengineering https://doi.org/10.3390/bioengineering7030076 (2020).
Owens, B. D. et al. Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. J. Trauma 64, 295–299 (2008).
Merritt, E. K. et al. Repair of traumatic skeletal muscle injury with bone-marrow-derived mesenchymal stem cells seeded on extracellular matrix. Tissue Eng. A 16, 2871–2881 (2010).
Gamba, P. G. et al. Experimental abdominal wall defect repaired with acellular matrix. Pediatr. Surg. Int. 18, 327–331 (2002).
VanDusen, K. W., Syverud, B. C., Williams, M. L., Lee, J. D. & Larkin, L. M. Engineered skeletal muscle units for repair of volumetric muscle loss in the tibialis anterior muscle of a rat. Tissue Eng. A 20, 2920–2930 (2014).
Carleton, M. M., Locke, M. & Sefton, M. V. Methacrylic acid-based hydrogels enhance skeletal muscle regeneration after volumetric muscle loss in mice. Biomaterials 275, 120909 (2021).
Dolan, C. P. et al. The impact of bilateral injuries on the pathophysiology and functional outcomes of volumetric muscle loss. NPJ Regen. Med. 7, 59 (2022).
Corona, B. T., Rivera, J. C., Dalske, K. A., Wenke, J. C. & Greising, S. M. Pharmacological mitigation of fibrosis in a porcine model of volumetric muscle loss injury. Tissue Eng. A 26, 636–646 (2020).
Greising, S. M. et al. Unwavering pathobiology of volumetric muscle loss injury. Sci. Rep. 7, 13179 (2017).
Novakova, S. S. et al. Repairing volumetric muscle loss in the ovine peroneus tertius following a 3-month recovery. Tissue Eng. A 26, 837–851 (2020).
Ibrahim, M. M. et al. Modifying hernia mesh design to improve device mechanical performance and promote tension-free repair. J. Biomech. 71, 43–51 (2018).
Langford, D. J. et al. Coding of facial expressions of pain in the laboratory mouse. Nat. Methods 7, 447–449 (2010).
Clark, A. et al. Myogenic tissue nanotransfection improves muscle torque recovery following volumetric muscle loss. NPJ Regen. Med. 7, 63 (2022).
Nakayama, K. H. et al. Aligned-braided nanofibrillar scaffold with endothelial cells enhances arteriogenesis. ACS Nano 9, 6900–6908 (2015).
Acknowledgements
This research received funding from the Alliance for Regenerative Rehabilitation Research and Training (AR3T), which is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Neurological Disorders and Stroke (NINDS) and National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health under Award Number P2CHD086843. This study was supported by grants to N.F.H. from the US National Institutes of Health (R01 HL142718, R41HL170875 and R21 HL172096-01), the National Science Foundation (1829534 and 2227614) and the Department of Veterans Affairs (RX001222 and 1I01BX004259). N.F.H is a recipient of a Research Career Scientist award (IK6BX006309) from the Department of Veterans Affairs. K.H.N. was supported by grants from the National Institutes of Health (R01AR080150, R00HL136701) and AR3T (CNVA00048860).
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C.A., C.H., M.Q. and K.H.N. optimized the muscle ablation model and scaffold implantation procedure. G.C. and A.H.-P.C provided technical assistance with tissue histology. N.F.H. and T.A.R. interpreted the data. C.A., C.H. and N.F.H. planned and wrote the manuscript, with input from all authors. All authors gave approval for the final version to be published.
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Nature Protocols thanks Kimberley Huey, Pablo Fernandez-Marcos and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
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Key references using this protocol
Hu, C. et al. Bioengineering 9, 37 (2022): https://doi.org/10.3390/bioengineering9010037
Alcazar, C. A. et al. Biomat. Sci. 8, 5376–5389 (2020): https://doi.org/10.1039/d0bm00990c
Quarta, M. et al. NPJ Regen. Med. 3, 18 (2018): https://doi.org/10.1038/s41536-018-0057-0
Quarta, M. et al. Nat. Commun. 8, 15613 (2017): https://doi.org/10.1038/ncomms15613
Supplementary information
Supplementary Video 1
Video showing the surgical procedure of collecting the TA muscle at 3 weeks after induction of VML.
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Source Data Table 1
Statistical source data.
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Hu, C., Chiang, G., Chan, A.HP. et al. A mouse model of volumetric muscle loss and therapeutic scaffold implantation. Nat Protoc (2024). https://doi.org/10.1038/s41596-024-01059-y
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DOI: https://doi.org/10.1038/s41596-024-01059-y