Characteristics of dermal fibroblasts and their biotherapeutic value in musculoskeletal system diseases

As the principal functional cells in the dermal layer of the skin, dermal fibroblasts can not only synthesize and remodel extracellular matrix components such as collagen and elastin, but also secrete a variety of growth factors and exert immunomodulatory functions. They play a pivotal role in maintaining skin structural homeostasis and wound repair, and their unique biological properties also make them a key subject of research in regenerative medicine. Musculoskeletal diseases (such as tendinopathy, fracture and intervertebral disc degeneration) are often accompanied by insufficient local tissue repair capacity, chronic inflammation and extracellular matrix degradation. In recent years, autologous or allogeneic fibroblast transplantation therapy has attracted increasing attention in orthopedic regenerative medicine. A number of clinical trials and basic studies have confirmed the beneficial effects of fibroblasts in promoting cartilage repair, alleviating inflammatory responses, improving tendon healing, and delaying intervertebral disc degeneration. This review systematically examines the sources, phenotypes, and functional characteristics of dermal fibroblasts. It focuses on their therapeutic potential in musculoskeletal system diseases (MSDs), including tendon injury, disc degeneration, and fracture healing. At the same time, it analyzes the challenges faced by current applications and the future directions for development, providing a theoretical reference for their clinical transformation.