Skeletal muscle regeneration is a coordinate process in which several factors are sequentially activated to maintain and preserve muscle structure and function. The major role in the growth, remodeling and regeneration is played by satellite cells, a quiescent population of myogenic cells that reside between the basal lamina and plasmalemma and are rapidly activated in response to appropriate stimuli. However, in several muscle conditions, including aging, the capacity of skeletal muscle to sustain an efficient regenerative pathway is severely compromised. Nevertheless, if skeletal muscle possesses a stem cell compartment it is not clear why the muscle fails to regenerate under pathological conditions. Either the resident muscle stem cells are too rare or intrinsically incapable of repairing major damage, or perhaps the injured/pathological muscle is a prohibitive environment for stem cell activation and function. Although we lack definitive answers, recent experimental evidences suggest that the mere presence of endogenous stem cells may not be sufficient to guarantee muscle regeneration, and that the presence of appropriate stimuli and factors are necessary to provide a permissive environment that permits stem cell mediated muscle regeneration and repair. In this review we discuss the molecular basis of muscle regeneration and how aging impacts stem cell mediated muscle regeneration and repair.
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