Review Article

Macrophages Are Key Regulators of Stem Cells during Skeletal Muscle Regeneration and Diseases

Figure 1

Macrophages are central regulators in skeletal muscle regeneration and diseases. In acute muscle injury (a), the inflammatory process is characterized by early accumulation of proinflammatory macrophages, which play a key role in various biological processes involved in muscle regeneration, by regulating fibrosis (FAP apoptosis), myogenesis (satellite cell proliferation), angiogenesis (sprouting), and inflammation (phagocytosis). Thereafter, macrophages switch toward the anti-inflammatory phenotype, which dampens inflammation, stimulates satellite cell/myoblast differentiation, and promotes tissue remodelling. This temporal and coordinated process is essential for optimal muscle healing. In a chronic degenerative muscle (b), the concurrent pro- and anti-inflammatory signals lead to the adoption of an abnormal hybrid phenotype by macrophages, which promote chronic inflammatory cell infiltration, excessive fibrosis, impaired myogenesis, and disorganized blood vessel network.
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