Vascular and musculoskeletal interactions: structure, function, and therapeutic strategies for sarcopenia and...

Muscle and bone, key tissues that maintain the body's structure and function, are closely connected via mechanical and biochemical interactions. The vascular system plays a crucial role in musculoskeletal health, not only by providing nutrients and oxygen but also by regulating growth, regeneration, and metabolism. This review systematically examines the vascular structure and function of the musculoskeletal system, and explores the complex biochemical signaling networks involving myokines, osteokines, and vascular-derived factors. Vascular dysfunction is a key contributor to the pathogenesis of degenerative diseases like sarcopenia (SP) and osteoporosis (OP), making vascular-targeted therapies a promising approach for their treatment. Potential strategies for restoring vascular health include molecular targeting, exercise training, nutritional supplementation, cardiovascular pharmacotherapy, hormone therapies, and tissue engineering-all of which may help slow aging-related musculoskeletal degeneration. Despite significant research progress, challenges remain in the clinical translation of these interventions. Future research should focus on elucidating the molecular mechanisms of muscle-bone-vascular interactions and exploring innovative tissue engineering techniques. This review provides a comprehensive understanding of the dynamic interactions between muscle, bone, and vascular systems, highlighting the importance of vascular health in musculoskeletal disease management, and proposes novel vascular-targeted approaches for the prevention and treatment of musculoskeletal disorders.