口颌肌再生纤维化的特异性机制与药物治疗的研究进展

Research progress on mechanism and drug treatment of orofacial muscle regeneration and fibrosis

唇腭裂等先天性颌面畸形的患者多伴有口颌肌结构和功能的异常,颌面整复术后,口颌肌通常表现出成肌能力不足和过度纤维化的特点,这极大地限制了患者颌面功能的恢复。口颌肌是具有独特进化及发育特征的骨骼肌亚群,其纤维化的发生与其独特的胚胎发育来源和固有的再生特性有关,其中卫星细胞和成纤维脂肪前体细胞主导的成肌-成纤维失衡是纤维化发生的重要因素。药物治疗或可成为改善口颌肌纤维化的有效途径。本文就口颌肌发育和再生的独特性、肌纤维化发生的细胞学基础,以及美国食品药品监督管理局批准的或正在进行临床试验的对抗骨骼肌纤维化的药物治疗展开综述,为阐明口颌肌再生纤维化的特异性机制和制定更有效的促进口颌肌再生的策略提供思路。

Patients with congenital maxillofacial deformities such as cleft lip and palate are often characterized by the abnormal structure and function of the orofacial muscles.After facial plastic surgeries,orofacial muscles usually exhibit the characteristics of impaired myogenesis and excessive fibrosis,which greatly limits the recovery of orofacial function.Orofacial muscles are skeletal muscle subsets with unique evolutionary and developmental characteristics.The occurrence of orofacial muscle fibrosis is related to its unique embryonic development source and inherent regeneration characteristics.Muscle satellite cell and fibroadipogenic progenitors are the two main cell types in the skeletal muscle tissue that are responsible for the myogenic process and fibrogenic process,respectively.Myogenesis-fibrogenesis imbalance is an important factor in orofacial muscle fibrosis.A variety of antifibrosis drugs are expected to improve skeletal muscle fibrosis effectively.This review focuses on the specificity of orofacial muscle development and regeneration,the cytological basis of orofacial muscle fibrosis,and the treatment of orofacial muscle fibrosis to clarify the unique mechanism of orofacial muscle regeneration and to develop the precise treatment for orofacial muscle regeneration.