New normal: two aspects of adipose tissue in COVID-19-treat and threat?

Autologization of Exosomes with Deparenchymized Adipose Tissue: An Innovative Approach for Regenerative Medicine and Surgery

Background

Among all regenerative applications developed in recent years, the use of exosomes has generated by far the greatest interest. Exosome products from allogeneic and xenogeneic sources are available on the market. A key challenge is controlling the effects of nonautologous exosomes. We hypothesized that combining exosomes with a patient's own extracellular matrix (ECM) can create "autologization," enabling control over their effects. This study aimed to provide the rationale and a guide for future research exploring the autologization of exosome applications using deparenchymized adipose tissue (DPAT).

Methods

DPAT adipose tissue was achieved using 1200-, 400-, and 35-micrometer blades in an ultrasharp blade system (Adinizer), and then "autologization" was achieved by combining the obtained DPAT with allogeneic exosomes. DPAT was evaluated histochemically, and exosomes were counted and analyzed with the Nanosight device.

Results

The DPAT process using ultrasharp blades is easily performed. DPAT obtained from adipose tissue was then combined with allogenic exosomes. It has been demonstrated histopathologically that adipocytes are eliminated in deparenchymized fat tissue, and only ECM and stromal cells remain. It has also been proven that the number of exosomes is not affected by the combination.

Conclusions

This study introduces two novel concepts previously unknown in the literature, "deparenchymization" and "autologization," representing an innovative approach in plastic surgery and regenerative medicine. Our novel approach enriches regenerative cells while preserving critical ECM signals, overcoming the limitations of existing isolation methods. Extensive research is still needed, but autologization using DPAT ECM holds great promise for translating exosome-based treatments into practice.

Bothrops moojeni snake venom induces an inflammatory response in preadipocytes: Insights into a new aspect of envenomation

Bothrops envenomation is a public health problem in Brazil. Despite the advances in the knowledge of the pathogenesis of systemic and local effects induced by Bothrops venom, the target tissues to this venom are not completely characterised. As preadipocytes are important cells of the adipose tissue and synthesize inflammatory mediators, we investigated the ability of B. moojeni snake venom (Bmv) to stimulate an inflammatory response in 3T3-L1 preadipocytes in vitro, focusing on (1) the release of PGE2, IL-6, TNF-α, MCP-1, KC, leptin and adiponectin; (2) the mechanisms involved in PGE2 release and (3) differentiation of these cells. Cytotoxicity of Bmv was determined by MTT assay. The concentrations of PGE2, cytokines and adipokines were quantified by EIA. Participation of the COX-1 and COX-2 enzymes, NF-κB and PGE2 receptors (EP1-4) was assessed using a pharmacological approach, and protein expression of the COX enzymes and P-NF-κB was analysed by western blotting. Preadipocyte differentiation was quantified by Oil Red O staining. Bmv (1 μg/mL) induced release of PGE2, IL-6 and KC and increased expression of COX-2 in preadipocytes. Basal levels of TNF-α, MCP-1, leptin and adiponectin were not modified. Treatment of cells with SC560 (COX-1 inhibitor) and NS398 (COX-2 inhibitor) inhibited Bmv-induced PGE2 release. Bmv induced phosphorylation of NF-κB, and treatment of the cells with TPCK and SN50, which inhibit distinct NF-κB domains, significantly reduced Bmv-induced PGE2 release, as did the treatment with an antagonist of PGE2 receptor EP1, unlike treatment with antagonists of EP2, EP3 or EP4. Bmv also induced lipid accumulation in differentiating cells. These results demonstrate that Bmv can activate an inflammatory response in preadipocytes by inducing the release of inflammatory mediators; that PGE2 production is mediated by the COX-1, COX-2 and NF-κB pathways; and that engagement of EP1 potentiates PGE2 synthesis via a positive feedback mechanism. Our findings highlight the role of the adipose tissue as another target for Bmv and suggest that it contributes to Bothrops envenomation by producing inflammatory mediators.

COVID-19 in Joint Ageing and Osteoarthritis: Current Status and Perspectives

COVID-19 is a trending topic worldwide due to its immense impact on society. Recent trends have shifted from acute effects towards the long-term morbidity of COVID-19. In this review, we hypothesize that SARS-CoV-2 contributes to age-related perturbations in endothelial and adipose tissue, which are known to characterize the early aging process. This would explain the long-lasting symptoms of SARS-CoV-2 as the result of an accelerated aging process. Connective tissues such as adipose tissue and musculoskeletal tissue are the primary sites of aging. Therefore, current literature was analyzed focusing on the musculoskeletal symptoms in COVID-19 patients. Hypovitaminosis D, increased fragility, and calcium deficiency point towards bone aging, while joint and muscle pain are typical for joint and muscle aging, respectively. These characteristics could be classified as early osteoarthritis-like phenotype. Exploration of the impact of SARS-CoV-2 and osteoarthritis on endothelial and adipose tissue, as well as neuronal function, showed similar perturbations. At a molecular level, this could be attributed to the angiotensin-converting enzyme 2 expression, renin-angiotensin system dysfunction, and inflammation. Finally, the influence of the nicotinic cholinergic system is being evaluated as a new treatment strategy. This is combined with the current knowledge of musculoskeletal aging to pave the road towards the treatment of long-term COVID-19.

Three states of stromal cells-solid, liquid, and aerosol-and innovative delivery methods not previously reported

Clinical applications of stromal cells obtained mechanically from adipose tissue are quite popular methods. However, generally accepted protocols still do not exist. In this study, three new delivery methods using different protocols are presented as innovative methods in accordance with an approach called “Indication-based protocols.” In mechanical methods, before cutting the fat tissue with ultra-sharp blades, which we define as “Adinizing,” mixing it with different liquids such as saline or plasma provides the stromal cells in liquid form with high number and viability as a final product. At the same time, since stromal cells and extracellular matrix are preserved by mechanical methods, it was deemed appropriate to use the term total stromal cells (TOST) instead of stromal vascular fraction for this final product, unlike the product obtained with the enzyme. TOST can be combined with plasma and used for dermal filling in “solid” form. In addition to this filling effect, it will also cause a change in the tissue regeneratively. Finally, the stromal cells obtained from liquid can be applied clinically in aerosol form with the help of nebulizer. We believe that three innovative delivery methods can be used successfully in the treatment of many clinical situations in the future.