Complementing Muscle Regeneration: Fibro-Adipogenic Progenitor and Macrophage-Mediated Repair of Elderly Human Skeletal Muscle

The capacity to regenerate skeletal muscle function after injury requires a complex and well-coordinated cellular response. Here, we unravel the intricate dynamics of human skeletal muscle regeneration by combining spatial, temporal, and single cell transcriptomics. Using spatial RNA sequencing, we profiled the expression of human protein-coding genes in elderly human skeletal muscle biopsies before as well as 2-, 8-, and 30-days post injury. Single Cell-Spatial deconvolution analysis highlights monocytes/macrophages and fibro-adipogenic progenitors (FAPs) as pivotal players in human muscle regeneration. By utilizing flow cytometry and cell sorting we confirmed increased cellular content and activity during regeneration. Spatial correlation analysis unveils FAPs and monocytes/macrophages co-localization and intercellular communication, mediated by complement factor C3. Immunostaining confirms C3 expression in FAPs and FAP secretion of C3, suggesting a role in phagocytosis. Functional assays demonstrate C3s impact on monocyte metabolism, survival and phagocytosis, unveiling its involvement in skeletal muscle regeneration. These insights elucidate FAP-macrophage interplay with perspectives for future therapeutic interventions.