Mesenchymal stem cell-derived extracellular matrix for musculoskeletal tissue regeneration

Mesenchymal stem cell-derived extracellular matrix (mECM) is increasingly recognized in tissue regeneration due to its high biocompatibility, controllability, and customizability. In musculoskeletal diseases, mECM provides a 3D scaffold mimicking the natural cellular environment and contains bioactive components regulating cell behavior and fate to promote tissue regeneration and repair. This review summarizes the preparation methods and composition of mECM, its effects on regulating cell behavior, and its applications in bone, cartilage, muscle, nerve, and blood vessel repair. It also analyzes the potential mechanisms of mECM's effects and identifies key challenges to be addressed prior to clinical translation, outlining future development directions.