Traditional Chinese Medicine: Salvia miltiorrhiza Enhances Survival Rate of Autologous Adipose Tissue Transplantation in Rabbit Model

Epigenetic Studies of Chinese Herbal Medicine: Pleiotropic Role of DNA Methylation

Accumulating knowledge has been achieved on DNA methylation participating in numerous cellular processes and multiple human diseases; however, few studies have addressed the pleiotropic role of DNA methylation in Chinese herbal medicine (CHM). CHM has been used worldwide for the prevention and treatment of multiple diseases. Newly developed epigenetic techniques have brought great opportunities for the development of CHM. In this review, we summarize the DNA methylation studies and portray the pleiotropic role of DNA methylation in CHM. DNA methylation serves as a mediator participating in plant responses to environmental factors, and thus affecting CHM medicinal plants growth and bioactive compound biosynthesis which are vital for therapeutic effects. Furthermore, DNA methylation helps to uncover the pharmaceutical mechanisms of CHM formulae, herbs, and herbal-derived compounds. It also provides scientific validation for constitution theory and other essential issues of CHM. This newly developed field of DNA methylation is up-and-coming to address many complicated scientific questions of CHM; it thus not only promotes disease treatment but also facilitates health maintenance.

Salvianolic acid-B improves fat graft survival by promoting proliferation and adipogenesis

Background

Our previous study proved that Salvia miltiorrhiza could enhance fat graft survival by promoting adipogenesis. However, the effect of salvianolic acid B (Sal-B), the most abundant and bioactive water-soluble compound in Salvia miltiorrhiza, on fat graft survival has not yet been investigated.

Objective

This study aims to investigate whether salvianolic acid B could improve fat graft survival and promote preadipocyte differentiation. The underlying mechanism has also been studied.

Methods

In vivo, 0.2 ml of Coleman fat was transplanted into nude mice with salvianolic acid B. The grafts were evaluated by HE and IF at 2 and 4 weeks posttransplantation and by micro-CT at 4 weeks posttransplantation. In vitro, the adipogenesis and proliferative activities of salvianolic acid B were analyzed in cultured human adipose-derived stem cells (h-ADSCs) and 3T3-L1 cells to detect the mechanism by which salvianolic acid B affects graft survival.

Results

In vivo, the weights and volumes of the fat grafts in the Sal-B-treated groups were significantly higher than those of the fat grafts in the control group. In addition, higher fat integrity and more viable adipocytes were observed in the Sal-B-treated groups. In vitro, salvianolic acid B showed the ability to promote 3T3-L1 and h-ADSC proliferation and adipogenesis.

Conclusions

Our in vitro experiments demonstrated that salvianolic acid B can promote the proliferation of adipose stem cells and enhance the differentiation of adipose stem cells. Simultaneously, in vivo experiments showed that salvianolic acid B can improve the survival rate of fat transplantation. Therefore, our research shed light on the potential therapeutic usage of salvianolic acid B in improving the survival rate of fat transplantation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13287-021-02575-4.

Salvia miltiorrhiza Injection Promotes the Adipogenic Differentiation of Human Adipose-Derived Stem Cells

BACKGROUND

Autologous fat grafting is a commonly used strategy to repair soft-tissue defects that has shown an approximately 40 percent increase in use in the past 5 years. However, the high reabsorption rates (average, 50 percent) often result in an unsatisfactory outcome. Current approaches aimed at increasing the blood supply of grafted fat have little clinical support. Here, we found that Salvia miltiorrhiza could improve fat graft survival by promoting adipogenic differentiation of adipose-derived stem cells by means of peroxisome proliferator-activated receptor gamma (PPARγ) and CCAAT-enhancer binding protein alpha (C/EBPα) signaling.

METHODS

Adipose tissue was harvested from the thighs of two women. Adipose-derived stem cells were characterized by flow cytometry (CD29, CD90, and CD105). The samples (2 × 104 cells/liter) were incubated with or without S. miltiorrhiza injection (0.001, 0.005, 0.01, 0.05, 0.1, 0.5, 1, and 5 g/liter) during adipogenic differentiation. Oil Red O staining, triglyceride content, and adipogenic gene expression (PPARγ and C/EBPα) were performed to detect adipogenic differentiation.

RESULTS

The triglyceride content in the 0.5-g/liter group was increased significantly compared with that in control groups (0.231 ± 0.010, 76.90 percent versus control, p < 0.001, day 9; 0.303 ± 0.010, 91.28 percent versus control, p < 0.001, day 10; 0.361 ± 0.008, 86.65 percent versus control, p < 0.001, day 11). The expression levels of PPARγ and C/EBPα in the 0.5-g/liter group were both increased significantly compared with those in control groups (0.0097 ± 0.0015, 48.1 percent versus control, p < 0.05 for PPARγ; 0.0423 ± 0.003, 112 percent versus control, p < 0.001 for C/EBPα).

CONCLUSIONS

S. miltiorrhiza injection has a positive effect on adipogenesis of adipose-derived stem cells in vitro. The effect of this treatment on improving fat graft survival needs more in vivo research.

Fat Graft Enrichment Strategies: A Systematic Review

BACKGROUND

Autologous fat grafting is a dynamic modality used in plastic surgery as an adjunct to improve functional and aesthetic form. However, current practices in fat grafting for soft-tissue augmentation are plagued by tremendous variability in long-term graft retention, resulting in suboptimal outcomes and repetitive procedures. This systematic review identifies and critically appraises the evidence for various enrichment strategies that can be used to augment and improve the viability of fat grafts.

METHODS

A comprehensive literature search of the Medline and PubMed databases was conducted for animal and human studies published through October of 2017 with multiple search terms related to adipose graft enrichment agents encompassing growth factors, platelet-rich plasma, adipose-derived and bone marrow stem cells, gene therapy, tissue engineering, and other strategies. Data on level of evidence, techniques, complications, and outcomes were collected.

RESULTS

A total of 1382 articles were identified, of which 147 met inclusion criteria. The majority of enrichment strategies demonstrated positive benefit for fat graft survival, particularly with growth factors and adipose-derived stem cell enrichment. Platelet-rich plasma and adipose-derived stem cells had the strongest evidence to support efficacy in human studies and may demonstrate a dose-dependent effect.

CONCLUSIONS

Improved understanding of enrichment strategies contributing to fat graft survival can help to optimize safety and outcomes. Controlled clinical studies are lacking, and future studies should examine factors influencing graft survival through controlled clinical trials in order to establish safety and to obtain consistent outcomes.

Effect of Salvia Miltiorrhiza Injection in Patients With Autologous Fat Grafting to the Breast: A Preliminary Comparative Study

BACKGROUND

Salvia miltiorrhiza (SM) is an herb used in Chinese medicine formulations for promoting blood circulation and minimizing vascular stasis. It has been successfully utilized in treating cardiovascular diseases, such as atherosclerosis, thromboembolism, and angina.

OBJECTIVES

The authors sought to study the effect of SM injections in autologous fat grafting to the breast.

METHODS

Fifteen women who elected to undergo breast augmentation with autologous fat grafting were included in this study. Of these, 10 were given intravenous infusions of SM for 4 weeks perioperatively, and the remaining 5 did not receive herbal infusion. The increase in breast volume after fat grafting was measured in both the groups using a three-dimensional scanner. Breast tissue specimens were harvested just before the second fat injection procedure and were analyzed by the immunofluorescence staining test.

RESULTS

All of the patients showed improvement in breast volume after fat grafting. The fat graft retention rate in the SM group was 60.06 ± 16.12%, whereas that in the non-SM group was 34.04 ± 11.15%. In addition, the SMG showed good breast morphology and absence of cyst formation.

CONCLUSIONS

SM has the potential to increase the retention rate of fat grafts in breast augmentation.

LEVEL OF EVIDENCE: 3