Decellularized extracellular matrix as a promising biomaterial for musculoskeletal tissue regeneration

Abstract The emergence of tissue engineering provides an alternative therapeutic strategy for various regeneration. It is the crucial step for choosing an ideal scaffold to support the cellular behaviors of various functional cells. Various biomaterials have been found or synthesized and applied to tissue repair. Among these biomaterials, as a natural-derived material, decellularized extracellular matrix (dECM) derived from cells, tissues, and organs is attracting more and more interest due to its good biocompatibility, biodegradability, and the ability to mimic a microenvironment similar to extracellular matrix. More and more researchers utilized dECM derived from cells, tissues, and organs to fabricate tissue-engineered scaffolds to repair musculoskeletal tissues, since the bioactive molecules of dECM, such as fibrous proteins, proteoglycans, and adhesive glycoproteins, could provide various bioactive cues for tissue regeneration and remodeling. The physiochemical properties of dECM can be enhanced by changing decellularization and modification techniques. In addition, dECM can act as carriers of drugs, factors, or exosomes, delivering agents to injured tissues and promoting tissue repair and regeneration. Therefore, we conduct this review to discuss the current status and challenges of dECM in repairing the musculoskeletal system. Furthermore, the fabrication and modification of dECM were also discussed in our study.