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Chen Y, Li Y, Li B, Hu D, Dong Z, Lu F. Migrasomes from adipose derived stem cells enrich CXCL12 to recruit stem cells via CXCR4/RhoA for a positive feedback loop mediating soft tissue regeneration. J Nanobiotechnology 2024; 22:219. [PMID: 38698419 PMCID: PMC11067256 DOI: 10.1186/s12951-024-02482-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Adipose-derived stem cells (ASCs) represent the most advantageous choice for soft tissue regeneration. Studies proved the recruitment of ASCs post tissue injury was mediated by chemokine CXCL12, but the mechanism by which CXCL12 is generated after tissue injury remains unclear. Migrasomes are newly discovered membrane-bound organelles that could deliver CXCL12 spatially and temporally in vivo. In this study, we sought to investigate whether migrasomes participate ASC-mediated tissue regeneration. METHODS Discrepant and asymmetrical soft tissue regeneration mice model were established, in which HE staining, immunofluorescent staining, western blot and qPCR were conducted to confirm the role of CXCL12 and migrasomes in ASC-mediated tissue regeneration. Characterization of ASC-derived migrasomes were carried out by confocal microscopy, scanning electron microscopy, transmission electron microscopy as well as western blot analysis. The function and mechanism of migrasomes were further testified by assisting tissue regeneration with isolated migrasomes in vivo and by in vitro transwell combined with co-culture system. RESULTS Here, we show for the first time that migrasomes participate in soft tissue regeneration. ASCs generate migrasomes enriched with CXCL12 to mediate tissue regeneration. Migrasomes from ASCs could promote stem cells migration by activating CXCR4/RhoA signaling in vivo and in vitro. Chemoattracted ASCs facilitate regeneration, as demonstrated by the upregulation of an adipogenesis-associated protein. This positive feed-back-loop creates a favorable microenvironment for soft tissue regeneration. Thus, migrasomes represent a new therapeutic target for ASC-mediated tissue regeneration. CONCLUSIONS Our findings reveal a previously unknown function of ASCs in mediating tissue regeneration by generating migrasomes. The ASC-derived migrasomes can restore tissue regeneration by recruiting stem cells, which highlighting the potential application of ASC-derived migrasomes in regenerative medicine.
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Affiliation(s)
- Yunzi Chen
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, 510515, P.R. China
| | - Ye Li
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, 510515, P.R. China
| | - Bin Li
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, 510515, P.R. China
| | - Delin Hu
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, 510515, P.R. China
| | - Ziqing Dong
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, 510515, P.R. China.
| | - Feng Lu
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, 510515, P.R. China.
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Zhang YA, Li FW, Dong YX, Xie WJ, Wang HB. PPAR-γ regulates the polarization of M2 macrophages to improve the microenvironment for autologous fat grafting. FASEB J 2024; 38:e23613. [PMID: 38661048 DOI: 10.1096/fj.202400126r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
The unpredictable survival rate of autologous fat grafting (AFG) seriously affects its clinical application. Improving the survival rate of AFG has become an unresolved issue in plastic surgery. Peroxisome proliferator-activated receptor-γ (PPAR-γ) regulates the adipogenic differentiation of adipocytes, but the functional mechanism in AFG remains unclear. In this study, we established an animal model of AFG and demonstrated the superior therapeutic effect of PPAR-γ regulation in the process of AFG. From day 3 after fat grafting, the PPAR-γ agonist rosiglitazone group consistently showed better adipose integrity, fewer oil cysts, and fibrosis. Massive macrophage infiltration was observed after 7 days. At the same time, M2 macrophages begin to appear. At day 14, M2 macrophages gradually became the dominant cell population, which suppressed inflammation and promoted revascularization and fat regeneration. In addition, transcriptome sequencing showed that the differentially expressed genes in the Rosiglitazone group were associated with the pathways of adipose regeneration, differentiation, and angiogenesis; these results provide new ideas for clinical treatment.
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Affiliation(s)
- Ya-An Zhang
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Fang-Wei Li
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yun-Xian Dong
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Wen-Jie Xie
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Hai-Bin Wang
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
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3
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Lu W, Yang Z, Wang M, Li S, Bi H, Yang X. Identification and verification of AK4 as a protective immune-related biomarker in adipose-derived stem cells and breast cancer. Heliyon 2024; 10:e27357. [PMID: 38560200 PMCID: PMC10980947 DOI: 10.1016/j.heliyon.2024.e27357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 02/05/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Background Breast cancer (BC) remains the most common cancer among women, and novel post-surgical reconstruction techniques, including autologous fat transplantation, have emerged. While Adipose-derived stem cells (ADSCs) are known to impact the viability of fat grafts, their influence on breast cancer progression remains unclear. This study aims to elucidate the genetic interplay between ADSCs and breast cancer, focusing on potential therapeutic targets. Methods Using the GEO and TCGA databases, we pinpointed differentially expressed (DE) mRNAs, miRNAs, lncRNAs, and pseudogenes of ADSCs and BC. We performed functional enrichment analysis and constructed protein-protein interaction (PPI), RNA binding protein (RBP)-pseudogene-mRNA, and lncRNA-miRNA-transcription factor (TF)-gene networks. Our study delved into the correlation of AK4 expression with 33 different malignancies and examined its impact on prognostic outcomes across a pan-cancer cohort. Additionally, we scrutinized immune infiltration, microsatellite instability, and tumor mutational burden, and conducted single-cell analysis to further understand the implications of AK4 expression. We identified novel sample subtypes based on hub genes using the ConsensusClusterPlus package and examined their association with immune infiltration. The random forest algorithm was used to screen DE mRNAs between subtypes to validate the powerful prognostic prediction ability of the artificial neural network. Results Our analysis identified 395 DE mRNAs, 3 DE miRNAs, 84 DE lncRNAs, and 26 DE pseudogenes associated with ADSCs and BC. Of these, 173 mRNAs were commonly regulated in both ADSCs and breast cancer, and 222 exhibited differential regulation. The PPI, RBP-pseudogene-mRNA, and lncRNA-miRNA-TF-gene networks suggested AK4 as a key regulator. Our findings support AK4 as a promising immune-related therapeutic target for a wide range of malignancies. We identified 14 characteristic genes based on the AK4-related cluster using the random forest algorithm. Our artificial neural network yielded excellent diagnostic performance in the testing cohort with AUC values of 0.994, 0.973, and 0.995, indicating its ability to distinguish between breast cancer and non-breast cancer cases. Conclusions Our research sheds light on the dual role of ADSCs in BC at the genetic level and identifies AK4 as a key protective mRNA in breast cancer. We found that AK4 significantly predicts cancer prognosis and immunotherapy, indicating its potential as a therapeutic target.
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Affiliation(s)
- Wei Lu
- Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Zhenyu Yang
- Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Mengjie Wang
- Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Shiqi Li
- Chinese Academy of Medical Sciences & Peking Union Medical College, 4+4 M.D. Program, Beijing, 100144, China
| | - Hui Bi
- Department of Internal Medicine, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Xiaonan Yang
- Department of Hemangioma and Vascular Malformation, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
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4
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Liu M, An Y. Letter on "Strategies to Improve AFT Volume Retention After Fat Grafting". Aesthetic Plast Surg 2024; 48:987-988. [PMID: 37731075 DOI: 10.1007/s00266-023-03563-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 09/22/2023]
Affiliation(s)
- Meiling Liu
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 of North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Yang An
- Department of Plastic Surgery, Peking University Third Hospital, No. 49 of North Huayuan Road, Haidian District, Beijing, 100191, China.
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Gabriel A, Kabaria N, Fang CH, Lombardi JA, Stec E, Huang LT, Li H, Sandor M. In Vitro Characterization of Fat Grafts Processed Using the REVOLVE ENVI System versus Decantation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5615. [PMID: 38333025 PMCID: PMC10852388 DOI: 10.1097/gox.0000000000005615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/28/2023] [Indexed: 02/10/2024]
Abstract
Background This preclinical study evaluated benchtop/in vitro properties and fat viability and activity of grafts processed using the REVOLVE ENVI 600 system compared with decantation and evaluated properties of REVOLVE ENVI waste. Methods Lipoaspirate from six donors was processed using REVOLVE ENVI or decantation. The composition of each graft, hematocrit/red blood cell content, fat particle size/macrostructure, viable adipocyte count, and adipocyte activity were analyzed. Stromal vascular fraction was analyzed for viable progenitor cell count and colony-forming units. Results REVOLVE ENVI grafts had a higher mean (±SD) fat content at 85.6% ± 6.1% than decanted grafts at 72.1% ± 4.0% (P < 0.001), with negligible free oil (0.4% ± 1.1%) and cellular debris (<0.1%), whereas REVOLVE ENVI waste contained primarily aqueous fluid (91.0% ± 2.2%) with negligible viable fat. REVOLVE ENVI grafts had significantly lower hematocrit levels (P < 0.001) and contained significantly more large fat globules (P < 0.001) than decanted grafts or REVOLVE ENVI waste. The percentage of tissue particles of more than 1000 µm was highest for REVOLVE ENVI grafts at 61.6% ± 9.2% (decantation: 52.5% ± 13.4%; REVOLVE ENVI waste: 0.49% ± 1.50%), and the percentage of particles less than 200 µm was lowest for REVOLVE ENVI grafts at 15.7% ± 2.6% (decantation: 32.2% ± 8.9%; REVOLVE ENVI waste: 97.9% ± 4.5%). REVOLVE ENVI grafts contained 145.2% ± 36.0% more viable adipocytes, 145.7% ± 46.2% greater activity, 195.5% ± 104.2% more progenitors in SVF, and 363.5% ± 161.2% more SVF colony-forming units than decanted grafts. Conclusion Fat grafts processed using REVOLVE ENVI demonstrated greater viability and activity than decanted grafts in vitro.
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Affiliation(s)
- Allen Gabriel
- From the Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, Calif
| | | | | | | | - Eric Stec
- Allergan Aesthetics, an AbbVie Company, Branchburg, N.J
| | - Li Ting Huang
- Allergan Aesthetics, an AbbVie Company, Branchburg, N.J
| | - Hui Li
- Allergan Aesthetics, an AbbVie Company, Branchburg, N.J
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Berkane Y, Oubari H, van Dieren L, Charlès L, Lupon E, McCarthy M, Cetrulo CL, Bertheuil N, Uygun BE, Smadja DM, Lellouch AG. Tissue engineering strategies for breast reconstruction: a literature review of current advances and future directions. ANNALS OF TRANSLATIONAL MEDICINE 2024; 12:15. [PMID: 38304901 PMCID: PMC10777243 DOI: 10.21037/atm-23-1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/15/2023] [Indexed: 02/03/2024]
Abstract
Background and Objective Mastectomy is a primary treatment for breast cancer patients, and both autologous and implant-based reconstructive techniques have shown excellent results. In recent years, advancements in bioengineering have led to a proliferation of innovative approaches to breast reconstruction. This article comprehensively explores the promising perspectives offered by bioengineering and tissue engineering in the field of breast reconstruction. Methods A literature review was conducted between April and June 2023 on PubMed and Google Scholar Databases. All English and French articles related to bioengineering applied to the field of breast reconstruction were included. We used the Evidence-Based Veterinary Medicine Association (EBVM) Toolkit 14 checklist for narrative reviews as a quality assurance measure and the Scale for the Assessment of Narrative Review Articles (SANRA) tool to self-assess our methodology. Key Content and Findings Over 130 references related to breast bioengineering were included. The analysis revealed four key applications: enhancing the quality of the skin envelope, improving the viability of fat grafting, creating breast shape and volume via bio-printing, and optimizing nipple reconstruction through engineering techniques. The primary identified approaches revolved around establishing structural support and enhancing cellular viability. Structural techniques predominantly involved the implementation of 3D printed, decellularized, or biocompatible material scaffolds. Meanwhile, promoting cellular content trophicity primarily focused on harnessing the regenerative potential of adipose-derived stem cells (ADSCs) and increasing the tissue's survivability and cell trophicity. Conclusions Tissue and bioengineering hold immense promise in the field of breast reconstruction, offering a diverse array of approaches. By combining existing techniques with novel advancements, they have the potential to significantly enhance the therapeutic options available to plastic and reconstructive surgeons.
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Affiliation(s)
- Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes, Rennes, France
- Unité Mixte de Recherche UMR 1236 Suivi Immunologique des Thérapeutiques Innovantes, INSERM and University of Rennes, Rennes, France
| | - Haizam Oubari
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Grenoble University Hospital Center, Grenoble, France
| | - Loïc van Dieren
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic Surgery, University of Antwerp, Wilrijk, Belgium
| | - Laura Charlès
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
| | - Elise Lupon
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Reconstructive Surgery, Pasteur 2 Hospital, University Côte d’Azur, Sophia Antipolis, Nice, France
| | - Michelle McCarthy
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes, Rennes, France
- Unité Mixte de Recherche UMR 1236 Suivi Immunologique des Thérapeutiques Innovantes, INSERM and University of Rennes, Rennes, France
| | - Basak E. Uygun
- Shriners Children’s Boston, Boston, MA, USA
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David M. Smadja
- Unité Mixte de Recherche UMR-S 1140 Innovative Therapies in Haemostasis, INSERM and University of Paris, Paris, France
- Department of Hematology, European Georges Pompidou Hospital, Paris, France
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Shriners Children’s Boston, Boston, MA, USA
- Unité Mixte de Recherche UMR-S 1140 Innovative Therapies in Haemostasis, INSERM and University of Paris, Paris, France
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7
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Sun Y, Wu G, Dai T, Li S, Cao W, Dai T. Stromal Vascular Fraction Gel (SVF-Gel) Combined with Nanofat for Tear Trough Deformity. Aesthetic Plast Surg 2024; 48:213-220. [PMID: 37957391 DOI: 10.1007/s00266-023-03698-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/20/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Tear trough deformity makes patients appear tired. Patients with less severe tear trough deformity prefer a less invasive method to correct the deformity. The infraorbital area is a multilayered tissue, and the aging of various components leads to tear trough deformity. To this end, we utilized the different characteristics of different fat derivatives to correct tear trough deformity. METHODS Thirty-two patients with Barton Grade I/II tear trough deformity were enrolled in this study between September 2020 and March 2021. We injected Stromal Vascular Fraction Gel (SVF-Gel) into the suborbicularis oculi fat layer and Nanofat into the subcutaneous. After 12 months of follow-up, we evaluated the changes using standardized clinical photogrammetric techniques, volume, global aesthetic improvement scale, and patient self-evaluation. RESULTS There were no major complications in any of the 32 patients. The measured data points demonstrated improvements in all aesthetic parameters. The width of the tear trough and the distance from the pupil to the tear trough improved. The Global Aesthetic Improvement Scale (GAIS) showed a high score (2.45±0.64 points), with patient self-assessment showing satisfactory results. CONCLUSION SVF-Gel combined with Nanofat injection can effectively correct tear trough deformities. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yiyu Sun
- Department of Wound Reconstructive Surgery, Tongji Hospital, Tongji University, Shanghai, China
| | - Gaoyang Wu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, China
| | - Tao Dai
- Department of Wound Reconstructive Surgery, Tongji Hospital, Tongji University, Shanghai, China
| | - Shengli Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, China
| | - Weigang Cao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, China.
| | - Tingting Dai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, China.
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Das D, Lawrence WR, Diaz-Starokozheva L, Salazar-Puerta A, Ott N, Goebel ER, Damughtala A, Vidal P, Gallentine S, Moore JT, Kayuha D, Mendonca NC, Albert JB, Houser R, Johnson J, Powell H, Higuita-Castro N, Stanford KI, Gallego-Perez D. Injectable pulverized electrospun poly(lactic-co-glycolic acid) fibers improve human adipose tissue engraftment and volume retention. J Biomed Mater Res A 2023; 111:1722-1733. [PMID: 37326365 PMCID: PMC10527741 DOI: 10.1002/jbm.a.37581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/08/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023]
Abstract
Autologous adipose tissue is commonly used for tissue engraftment for the purposes of soft tissue reconstruction due to its relative abundance in the human body and ease of acquisition using liposuction methods. This has led to the adoption of autologous adipose engraftment procedures that allow for the injection of adipose tissues to be used as a "filler" for correcting cosmetic defects and deformities in soft tissues. However, the clinical use of such methods has several limitations, including high resorption rates and poor cell survivability, which lead to low graft volume retention and inconsistent outcomes. Here, we describe a novel application of milled electrospun poly(lactic-co-glycolic acid) (PLGA) fibers, which can be co-injected with adipose tissue to improve engraftment outcomes. These PLGA fibers had no significant negative impact on the viability of adipocytes in vitro and did not elicit long-term proinflammatory responses in vivo. Furthermore, co-delivery of human adipose tissue with pulverized electrospun PLGA fibers led to significant improvements in reperfusion, vascularity, and retention of graft volume compared to injections of adipose tissue alone. Taken together, the use of milled electrospun fibers to enhance autologous adipose engraftment techniques represents a novel approach for improving upon the shortcomings of such methods.
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Affiliation(s)
- Devleena Das
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - William R. Lawrence
- Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ludmila Diaz-Starokozheva
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Ana Salazar-Puerta
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Neil Ott
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Erin R. Goebel
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Abhishek Damughtala
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Pablo Vidal
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, OH, USA
| | - Summer Gallentine
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Jordan T. Moore
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | | | - Natalia C. Mendonca
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Jared B. Albert
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Robert Houser
- Cosmetic & Plastic Surgery of Columbus, Columbus, OH, USA
| | | | - Heather Powell
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Shriners Hospitals-Ohio, Dayton, OH, USA
| | | | - Kristin I. Stanford
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, OH, USA
| | - Daniel Gallego-Perez
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
- Department of Surgery, The Ohio State University, Columbus, OH, USA
- Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, OH, USA
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9
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Bourne DA, Egro FM, Bliley J, James I, Haas GL, Meyer EM, Donnenberg V, Donnenberg AD, Branstetter B, Coleman S, Rubin JP. Stem Cell Therapy Enriched Fat Grafting for the Reconstruction of Craniofacial Deficits. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5056. [PMID: 37342306 PMCID: PMC10278723 DOI: 10.1097/gox.0000000000005056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/19/2023] [Indexed: 06/22/2023]
Abstract
Fat grafting is an effective treatment for craniofacial deformities. Stromal vascular fraction (SVF) is a concentrated form of adipose derived stem cells that can be isolated from fat. The aim of this clinical trial was to assess the impact of SVF enrichment on craniofacial fat grafting. Methods Twelve subjects with at least two regions of craniofacial volume deficit were enrolled, and they underwent fat grafting with SVF-enriched or standard fat grafting to each area. All patients had bilateral malar regions injected with SVF-enriched graft on one side and control standard fat grafting to the contralateral side. Outcome assessments included demographic information, volume retention determined by CT scans, SVF cell populations assessed by flow cytometry, SVF cell viability, complications, and appearance ratings. Follow-up was 9 months. Results All patients had improvement in appearance. There were no serious adverse events. There was no significant difference in volume retention between the SVF-enriched and control regions overall (50.3% versus 57.3%, P = 0.269) or comparing malar regions (51.4% versus 56.7%, P = 0.494). Patient age, smoking status, obesity, and diagnosis of diabetes did not impact volume retention. Cell viability was 77.4% ± 7.3%. Cellular subpopulations were 60.1% ± 11.2% adipose derived stem cells, 12.2 ± 7.0% endothelial cells, and 9.2% ± 4.4% pericytes. A strong positive correlation was found between CD146+ CD31-pericytes and volume retention (R = 0.863, P = 0.027). Conclusions Autologous fat transfer for reconstruction of craniofacial defects is effective and safe, leading to reliable volume retention. However, SVF enrichment does not significantly impact volume retention.
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Affiliation(s)
- Debra A. Bourne
- From the University of Kentucky, Division of Plastic and Reconstructive Surgery, Lexington, Ky
| | - Francesco M. Egro
- University of Pittsburgh Medical Center, Department of Plastic Surgery, Pittsburgh, Pa
| | - Jacqueline Bliley
- University of Pittsburgh Medical Center, Department of Plastic Surgery, Pittsburgh, Pa
- University of Pittsburgh Department of Bioengineering, Pittsburgh, Pa
| | - Isaac James
- University of Pittsburgh Medical Center, Department of Plastic Surgery, Pittsburgh, Pa
| | - Gretchen L. Haas
- University of Pittsburgh Medical Center, Department of Psychiatry, and the VA Pittsburgh Healthcare System, Pittsburgh, Pa
| | | | - Vera Donnenberg
- University of Pittsburgh McGowan Institute of Regenerative Medicine, Pittsburgh, Pa
| | - Albert D. Donnenberg
- University of Pittsburgh McGowan Institute of Regenerative Medicine, Pittsburgh, Pa
| | - Barton Branstetter
- University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, Pa
| | - Sydney Coleman
- New York University Langone Medical Center, New York, N.Y
| | - J. Peter Rubin
- University of Pittsburgh Medical Center, Department of Plastic Surgery, Pittsburgh, Pa
- University of Pittsburgh Department of Bioengineering, Pittsburgh, Pa
- University of Pittsburgh McGowan Institute of Regenerative Medicine, Pittsburgh, Pa
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10
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Khouri AN, Adidharma W, MacEachern M, Haase SC, Waljee JF, Cederna PS, Strong AL. The Current State of Fat Grafting in the Hand: A Systematic Review for Hand Diseases. Hand (N Y) 2023; 18:543-552. [PMID: 35130761 PMCID: PMC10233632 DOI: 10.1177/15589447211066347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Autologous fat grafting (AFG) has traditionally been used for facial rejuvenation and soft tissue augmentation, but in recent years, its use has expanded to treat diseases of the hand. Autologous fat grafting is ideal for use in the hand because it is minimally invasive, can restore volume, and has regenerative capabilities. This review summarizes the emerging evidence regarding the safety and efficacy of AFG to the hand in several conditions, including systemic sclerosis, Dupuytren disease, osteoarthritis, burns, and traumatic fingertip injuries. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant literature search on the use of AFG in hand pathologies was performed on October 8, 2020, in Ovid MEDLINE, Elsevier Embase, Clarivate Web of Science, and Wiley Cochrane Central Register of Controlled Trials. The retrieved hits were screened and reviewed by 2 independent reviewers and a third reviewer adjudicated when required. Reviewers identified 919 unique hits. Screening of the abstracts identified 22 manuscripts which described the use of AFG to treat an identified hand condition. Studies suggest AFG in the hands is a safe, noninvasive option for the management of systemic sclerosis, Dupuytren contracture, osteoarthritis, burns, and traumatic fingertip injuries. While AFG is a promising therapeutic option for autoimmune, inflammatory, and fibrotic disease manifestations in the hand, further studies are warranted to understand its efficacy and to establish more robust clinical guidelines. Studies to date show the regenerative, immunomodulatory, and volume-filling properties of AFG that facilitate wound healing and restoration of hand function with limited complications.
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11
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Liu M, Shang Y, Liu N, Zhen Y, Chen Y, An Y. Strategies to Improve AFT Volume Retention After Fat Grafting. Aesthetic Plast Surg 2023; 47:808-824. [PMID: 36316460 DOI: 10.1007/s00266-022-03088-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/28/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Autologous fat grafting has gained increasing popularity used in plastic surgery as a strategy to improve functional and aesthetic outcome. However, variable augmentation results have concerned surgeons in that volume loss of grafted fat reported fluctuates unsteadily. AIM An optimal technique that clinically maximizes the long-term survival rate of transplantation is in urgent need to be identified. METHOD The PubMed/MEDLINE database was queried to search for animal and human studies published through March of 2022 with search terms related to adipose grafting encompassing liposuction, adipose graft viability, processing technique, adipose-derived stem cell, SVF and others. RESULTS 45 in vivo studies met inclusion criteria. The principal of ideal processing technique is effective purification of fat and protection of tissue viability, such as gauze rolling and washing-filtration devices. Cell-assisted lipotransfer including SVF, SVF-gel and ADSCs significantly promotes graft retention via differentiation potential and paracrine manner. ADSCs induce polarization of macrophages to regulate inflammatory response, mediate extracellular matrix remodeling and promote endothelial cell migration and sprouting, and differentiate into adipocytes to replace necrotic cells, providing powerful evidence for the benefits and efficacy of cell-assisted lipotransfer. CONCLUSION Based on the current evidence, the best strategy can not be decided. Cell-assisted lipotransfer has great potential for use in regenerative medicine. But so far mechanically prepared SVF-gel is conducive to clinical promotion. PRP as endogenous growth factor sustained-release material shows great feasibility. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Meiling Liu
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yujia Shang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
- College of Traditional Chinese Materia Medica, Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Na Liu
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
- College of Traditional Chinese Materia Medica, Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Youbai Chen
- Department of Plastic and Reconstructive Surgery, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yang An
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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12
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Abstract
SUMMARY Over the past 30 years, there has been a dramatic increase in the use of autologous fat grafting for soft-tissue augmentation and to improve facial skin quality. Several studies have highlighted the impact of aging on adipose tissue, leading to a decrease of adipose tissue volume and preadipocyte proliferation and increase of fibrosis. Recently, there has been a rising interest in adipose tissue components, including adipose-derived stem/stromal cells (ASCs) because of their regenerative potential, including inflammation, fibrosis, and vascularization modulation. Because of their differentiation potential and paracrine function, ASCs have been largely used for fat grafting procedures, as they are described to be a key component in fat graft survival. However, many parameters as surgical procedures or adipose tissue biology could change clinical outcomes. Variation on fat grafting methods have led to numerous inconsistent clinical outcomes. Donor-to-donor variation could also be imputed to ASCs, tissue inflammatory state, or tissue origin. In this review, the authors aim to analyze (1) the parameters involved in graft survival, and (2) the effect of aging on adipose tissue components, especially ASCs, that could lead to a decrease of skin regeneration and fat graft retention. CLINICAL RELEVANCE STATEMENT This review aims to enlighten surgeons about known parameters that could play a role in fat graft survival. ASCs and their potential mechanism of action in regenerative medicine are more specifically described.
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13
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Zhang K, Jin D, Zhao X, Lu B, Guo W, Ren R, Wu S, Zhang J, Li Y. HIF-1α-Induced Mitophagy Regulates the Regenerative Outcomes of Stem Cells in Fat Transplantation. Cell Transplant 2023; 32:9636897231210750. [PMID: 38009534 PMCID: PMC10683376 DOI: 10.1177/09636897231210750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/29/2023] Open
Abstract
Hypoxia is a crucial factor with type diversity that plays an important role in stem cell transplantation. However, the effects of hypoxia on adipose-derived stem cells (ADSCs) are largely unclear in the autologous fat transplantation (AFT) model, which shows a special type of "acute-progressively resolving hypoxia." Here, an AFT model in nude mice and a hypoxic culture model for ADSCs were combined to explore the link between hypoxia-inducible factor-1 α subunit (HIF-1α) and mitophagy under hypoxic conditions. The results showed that the activity of ADSCs in the first 7 days after grafting was the key stage for volume retention, and the expression of HIF-1α, light chain 3 beta (LC3B), and Beclin1 in ADSCs increased during this period. We also found that hypoxia for longer than 48 h damaged the differentiation and mitochondrial respiration of ADSCs in vitro, but hypoxia signals also activate HIF-1α to initiate mitophagy and maintain the activities of ADSCs. Pre-enhancing mitophagy by rapamycin effectively improves mitochondrial respiration in ADSCs after grafting and ultimately improves AFT outcomes.
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Affiliation(s)
- Kai Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
| | - Dan Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
| | - Xin Zhao
- Xijing 986 Hospital Department, Fourth Military Medical University, Xi’an, P.R. China
| | - Bin Lu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
| | - Weiwei Guo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
| | - Rui Ren
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
| | - Simo Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
| | - Junrui Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
| | - Yunpeng Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, P.R. China
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Fluidic Device System for Mechanical Processing and Filtering of Human Lipoaspirate Enhances Recovery of Mesenchymal Stem Cells. Plast Reconstr Surg 2023; 151:72e-84e. [PMID: 36205654 PMCID: PMC10156086 DOI: 10.1097/prs.0000000000009798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Adipose tissue is an easily accessible source of stem and progenitor cells that offers exciting promise as an injectable autologous therapeutic for regenerative applications. Mechanical processing is preferred over enzymatic digestion, and the most common method involves shuffling lipoaspirate between syringes and filtering to produce nanofat. Although nanofat has shown exciting clinical results, the authors hypothesized that new device designs could enhance recovery of stem/progenitor cells through optimization of fluid dynamics principles, integration, and automation. METHODS The authors designed and fabricated the emulsification and micronization device (EMD) and the filtration device (FD) to replace the manual nanofat procedures. Using human lipoaspirate samples, the EMD and the FD were optimized and compared to traditional nanofat using ex vivo measurements of cell number, viability, and percentage of mesenchymal stem cells and endothelial progenitor cells. RESULTS The EMD produced results statistically similar to nanofat, and these findings were confirmed for a cohort of diabetic patients. Combining the FD with the EMD was superior to manually filtered nanofat in terms of both recovered cell percentages (>1.5-fold) and numbers (two- to three-fold). Differences were statistically significant for total mesenchymal stem cells and a DPP4 + /CD55 + subpopulation linked to improved wound healing in diabetes. CONCLUSIONS The new EMD and the FD improved mechanical processing of human lipoaspirate in terms of mesenchymal stem cell enrichment and number compared to traditional nanofat. Future work will seek to investigate the wound healing response both in vitro and in vivo, and to refine the technology for automated operation within clinical settings. CLINICAL RELEVANCE STATEMENT The new devices improved mechanical processing of human lipoaspirate in terms of stem cell enrichment and number compared to traditional methods. Future work will seek to validate wound healing response and refine the technology for automated operation within clinical settings.
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15
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Tutak FN, Kıvrak EG. The Effect of Human Umbilical Cord-Derived Lyophilized Stem Cells on Fat Graft Viability: An Experimental Study. Aesthetic Plast Surg 2022; 46:1973-1982. [PMID: 35303121 DOI: 10.1007/s00266-022-02836-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/24/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The extended use of autologous adipose tissue has increased the importance of the viability of fat graft cells. This experimental animal study assesses the effects of lyophilized mesenchymal stem cells on the viability and survival of autologous fat grafts. METHODS For this prospective treatment control study, 27 male Wistar albino rats were divided into three groups, each containing nine animals. In Group 1 (control), an incision was made in the right inguinal region, and the skin was closed with 4/0 prolene sutures. In Groups 2 and 3, fat pads collected from the right groin of the rats were lipoaspirated and placed on the sternum as a subcutaneous fat graft. The skin was then closed with 4/0 prolene sutures. Saline was added to the fat grafts of the Group 2 (sham) rats, and placenta-derived mesenchymal stem cell lyophilizate (MSC-L) was administered to the fat graft in the Group 3 (treatment) rats. After three months of treatment, the adipose tissue harvested from Group 1 and the fat grafts taken from Groups 2 and 3 were assessed histopathologically, stereologically and biochemically. RESULTS Adipose tissue volume was lower in Group 2 than in Groups 1 and 3, and the adipose tissue treated with MSC-L in Group 3 was better preserved than that in Group 1. Connective tissue and vascular volumes were greater in Group 3 than those in the other groups. The normal structures of adipocytes, fibrous tissues and vessels were better preserved in Group 3 than in Group 2, and a large number of new blood vessels were noted to have formed in Group 3. Damaged cystic cells, areas of calcification and degenerated adipocytes were noted in Group 2, while the G3PDH levels increased significantly more in Group 3 than in Group 2. CONCLUSION It was shown that MSC-L treatment plays an active role in maintaining the volume and survival of fat grafts by promoting neovascularization in this animal experimental study. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Fatma Nilay Tutak
- Division of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty, Adiyaman University, Adiyaman, Turkey.
| | - Elfide Gizem Kıvrak
- Division of Histology and Embryology, Medical Faculty, Adiyaman University, Adiyaman, Turkey
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16
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Chen J, Liu R, Huang T, Sun H, Jiang H. Adipose stem cells-released extracellular vesicles as a next-generation cargo delivery vehicles: a survey of minimal information implementation, mass production and functional modification. Stem Cell Res Ther 2022; 13:182. [PMID: 35505389 PMCID: PMC9062865 DOI: 10.1186/s13287-022-02849-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/12/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To investigate current situation of minimal information implementation highlighted by minimal information for studies of extracellular vesicles 2018 (MISEV2018) guidelines, and explore technological advances towards mass production and functional modification in aesthetic, plastic and reconstructive surgery. METHODS Original articles on extracellular vesicles (EVs) of adipose stem cells (ASCs) were identified. Statistics upon minimal information for EVs research, such as species, cell types, culture conditions, conditioned media harvesting parameters, EVs isolation/storage/identification/quantification, functional uptake and working concentration, were analyzed. RESULTS The items of cell culture conditions such as passage number, seeding density, conditioned media harvesting time, functional uptake and working concentration were poorly documented, with a reporting percentage of 47.13%, 54.02%, 29.89%, 62.07% and 36.21%, respectively. However, there were some studies not reporting information of ASCs origin, culture medium, serum, EVs isolation methods, quantification and identification of EVs, accounting for 3.45%, 10.34%, 6.90%, 3.45%, 18.39% and 4.02%, respectively. Serum deprivation and trophic factors stimuli were attempted for EVs mass production. Several technological advances towards functional modification included hypoxia pre-condition, engineering EVs and controlled release. Presently, ASCs EVs have been applied in multiple fields, including diabetic/non-diabetic wound healing, angiogenesis, inflammation modulation, fat grafting, hair regeneration, antiaging, and healing and regeneration of cartilage/bone/peripheral nerve/tendon. CONCLUSION Our results highlight normative reporting of ASCs EVs in functional studies to increase reliability and reproducibility of scientific publications. The advances towards mass production and functional modification of ASCs EVs are also recommended to enhance therapeutic effects.
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Affiliation(s)
- Jianguo Chen
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Ruiquan Liu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Tianyu Huang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Hengyun Sun
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Haiyue Jiang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
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17
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Qiu H, Jiang Y, Chen C, Wu K, Wang H. The Effect of Different Diameters of Fat Converters on Adipose Tissue and Its Cellular Components: Selection for Preparation of Nanofat. Aesthet Surg J 2021; 41:NP1734-NP1744. [PMID: 33769461 DOI: 10.1093/asj/sjab146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Nanofat is an autologous product prepared mechanically from harvested fat. In nanofat grafting, converters are employed for mechanical emulsification to facilitate fat injection. To date, the study of different converters has received scant attention regarding whether they affect the characteristics of nanofat in terms of the practical applications and indications. OBJECTIVES The authors set out to investigate the influence of different internal diameters of converters on biological functionality of nanofat during shuffling. METHODS The 3-dimensional finite element method was employed to simulate the process of mechanical emulsification of fat and to research the stress with 5 different converters (3.76 mm, 2.00 mm, 1.20 mm, 1.00 mm, 0.80 mm). An assessment of the morphology of emulsified fat was conducted. Isolated stromal vascular fraction (SVF) was analyzed for cellular components, number, and viability through flowcytometry and live/ dead staining. Adipocytic and angiogenic differentiation assay allowed assessment of differentiation capacity of the SVF. RESULTS The smaller the aperture of the converter, the greater the mechanical force on adipose tissue during mechanical emulsification, showing the different macroscopic and microscopic structure of the emulsified fat. No difference in viability or ratio of endothelial progenitor cells and other cells was found. Angiogenic and adipogenic differentiation capacity of the SVF significantly changed in 5 different converters. CONCLUSIONS The mechanical emulsification from different apertures of converters exerts different effects of adipose tissue structure, cell content, and multipotency differentiation but not its viability. Converters with different apertures can be selected according to clinical needs.
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Affiliation(s)
- He Qiu
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu,China
| | - Yichen Jiang
- Department of General Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqinng,China
| | - Chang Chen
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu,China
| | - Kelun Wu
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu,China
| | - Hang Wang
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu,China
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18
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Platoff R, Villalobos MA, Hagaman AR, Liu Y, Matthews M, DiSanto ME, Carpenter JP, Zhang P. Effects of radiation and chemotherapy on adipose stem cells: Implications for use in fat grafting in cancer patients. World J Stem Cells 2021; 13:1084-1093. [PMID: 34567427 PMCID: PMC8422936 DOI: 10.4252/wjsc.v13.i8.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/30/2021] [Accepted: 07/29/2021] [Indexed: 02/06/2023] Open
Abstract
Autologous fat transplantation is a versatile tool in reconstructive surgery. Adipose-derived stem cells (ASCs) increase survival of fat grafts and thus are increasingly used for breast reconstruction in breast cancer patients. However, radiation and/or chemotherapy have been proposed to inhibit soft tissue regeneration in wound healing thus suggesting alteration in stem cell pathways. Therefore, elucidating effects of radiation and chemotherapy on ASCs is critical if one desires to enhance the survival of fat grafts in patients. This review outlines our work evaluating the function and recoverability of ASCs from radiation or chemotherapy patients, focusing specifically on their availability as a source of autologous stem cells for fat grafting and breast reconstruction in cancer patients. Even though evidence suggests radiation and chemotherapy negatively influence ASCs at the cellular level, the efficiency of the isolation and differentiation capacity did not appear influenced in patients after receiving chemotherapy treatment, although fat from radiated patients exhibited significantly altered ASC differentiation into endothelial-like cells. Further, the in vitro growth rates of patient’s ASCs do not differ significantly before or after treatment. Taken together, these studies suggest ASCs as an important new tool for grafting and reconstruction even when radiation and chemotherapy treatment are involved.
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Affiliation(s)
- Rebecca Platoff
- Department of Surgery, Cooper University Health Care, Camden, NJ 08103, United States
| | - Miguel A Villalobos
- Department of Surgery, Cooper University Health Care, Camden, NJ 08103, United States
| | - Ashleigh Rapp Hagaman
- Department of Surgery, Cooper University Health Care, Camden, NJ 08103, United States
| | - Yuan Liu
- Department of Surgery, Cooper University Health Care, Camden, NJ 08103, United States
- Department of Surgery, Cooper Medical School of Rowan University, Camden, NJ 08103, United States
| | - Martha Matthews
- Department of Surgery, Cooper University Health Care, Camden, NJ 08103, United States
- Department of Surgery, Cooper Medical School of Rowan University, Camden, NJ 08103, United States
| | - Michael E DiSanto
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ 08103, United States
| | - Jeffrey P Carpenter
- Department of Surgery, Cooper University Health Care, Camden, NJ 08103, United States
- Department of Surgery, Cooper Medical School of Rowan University, Camden, NJ 08103, United States
| | - Ping Zhang
- Department of Surgery, Cooper University Health Care, Camden, NJ 08103, United States
- Department of Surgery, Cooper Medical School of Rowan University, Camden, NJ 08103, United States
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19
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Changing the Paradigm of Craniofacial Reconstruction: A Prospective Clinical Trial of Autologous Fat Transfer for Craniofacial Deformities. Ann Surg 2021; 273:1004-1011. [PMID: 30985369 DOI: 10.1097/sla.0000000000003318] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to prospectively assess outcomes for surgical autologous fat transfer (AFT) applied for traumatic and postsurgical craniofacial deformities. The minimally invasive nature of AFT has potential for reduced risk and superior outcomes compared with current reconstructive options. BACKGROUND Craniofacial deformities have functional and psychosocial sequelae and can profoundly affect quality of life. Traditional reconstructive options are invasive, invasive, complex, and often lack precision in outcomes. Although AFT is safe, effective, and minimally invasive, only anecdotal evidence exists for reconstruction of craniofacial deformities. METHODS In this Institutional Review Board-approved prospective cohort study, 20 subjects underwent AFT (average volume: 23.9 ± 13.2 mL). Volume retention over time was determined using high-resolution computed tomography. Flow cytometry was used to assess cellular subpopulations and viability in the stromal vascular fraction. Quality of life assessments were performed. After the completion of 9-month follow-up, 5 subjects were enrolled for a second treatment. RESULTS No serious adverse events occurred. Volume retention averaged 63 ± 17% at 9 months. Three-month retention strongly predicted 9-month retention (r=0.996, P < 0.0001). There was no correlation between the total volume injected and retention. Patients undergoing a second procedure had similar volume retention as the first (P = 0.05). Age, sex, body mass index, and stromal vascular fraction cellular composition did not impact retention. Surprisingly, former smokers had greater volume retention at 9 months compared with nonsmokers (74.4% vs 56.2%, P = 0.009). Satisfaction with physical appearance (P = 0.002), social relationships (P = 0.02), and social functioning quality of life (P = 0.05) improved from baseline to 9 months. CONCLUSIONS For craniofacial defects, AFT is less invasive and safer than traditional reconstructive options. It is effective, predictable, and reaches volume stability at 3 months. Patient-reported outcomes demonstrate a positive life-changing impact.
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20
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Klietz ML, Kückelhaus M, Wiebringhaus P, Raschke MJ, Hirsch T, Aitzetmüller MM. [The influence of harvesting and processing on the regenerative potential in fat grafting]. HANDCHIR MIKROCHIR P 2021; 53:412-419. [PMID: 33530127 DOI: 10.1055/a-1306-0566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The autologous lipotransfer represents an established method in the field of Plastic Surgery. As a reliable and safe method for breast reconstruction and breast augmentation it offers an alternative to established methods such as implants and flap surgery.Survival rate of adipose derived stromal cells limits success or failure of fat grafting. Slight changes in the fat grafting process can lead to huge changes in ADSC-survival rate.This review wants to optimize the fat-grafting process to ensure best outcomes.
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Affiliation(s)
- Marie-Luise Klietz
- Sektion Plastische Chirurgie an der Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.,Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.,Abteilung für Plastische und Rekonstruktive Chirurgie, Institut für Muskuloskelettale Medizin, Westfälische Wilhelms-Universität Münster
| | - Maximilian Kückelhaus
- Sektion Plastische Chirurgie an der Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.,Abteilung für Plastische und Rekonstruktive Chirurgie, Institut für Muskuloskelettale Medizin, Westfälische Wilhelms-Universität Münster.,Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Fachklinik Hornheide, Münster
| | - Philipp Wiebringhaus
- Sektion Plastische Chirurgie an der Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.,Abteilung für Plastische und Rekonstruktive Chirurgie, Institut für Muskuloskelettale Medizin, Westfälische Wilhelms-Universität Münster.,Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Fachklinik Hornheide, Münster
| | - Michael J Raschke
- Sektion Plastische Chirurgie an der Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.,Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster
| | - Tobias Hirsch
- Sektion Plastische Chirurgie an der Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.,Abteilung für Plastische und Rekonstruktive Chirurgie, Institut für Muskuloskelettale Medizin, Westfälische Wilhelms-Universität Münster.,Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Fachklinik Hornheide, Münster
| | - Matthias M Aitzetmüller
- Sektion Plastische Chirurgie an der Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster.,Abteilung für Plastische und Rekonstruktive Chirurgie, Institut für Muskuloskelettale Medizin, Westfälische Wilhelms-Universität Münster.,Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Fachklinik Hornheide, Münster
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Jin S, Yang Z, Han X, Li F. Blood Impairs Viability of Fat Grafts and Adipose Stem Cells: Importance of Washing in Fat Processing. Aesthet Surg J 2021; 41:86-97. [PMID: 32564062 DOI: 10.1093/asj/sjaa170] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Fat processing plays a pivotal role in graft survival. Each component of the blood in lipoaspirate affects fat survival in different ways, but the mechanisms are not clear. OBJECTIVES The aim of this study was to investigate, by various experimental methods, the effect of blood on the viability of fat grafts and adipose stem cells (ASCs). METHODS Blood and fat samples were obtained from 6 female patients undergoing aesthetic liposuction. For the in vivo experiment, we compared fat mixed with normal saline or various ratios of blood in nude mice. The samples were explanted at 2 and 8 weeks to evaluate the gross volume retention and histologic and immunohistochemical characteristics. For in vitro experiments, ASCs were pretreated with hemoglobin at different concentrations and for different times. We then assessed the proliferation, migration, adipogenesis, and reactive oxygen species production of ASCs. RESULTS Blood in the graft led to a decrease in graft viability, as evaluated by general observation and histologic and immunohistochemical morphology in vivo. In vitro experiments showed inhibited proliferation, migration, and adipogenesis, and increased reactive oxygen species production in ACSs, after hemoglobin treatment, suggesting impaired ASC viability. CONCLUSIONS This study suggests that blood impairs the viability of fat grafts and ASCs and provides evidence that washing to remove blood is important in fat processing.
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Li Z, Zhang J, Li M, Tang L, Liu H. Concentrated nanofat: a modified fat extraction promotes hair growth in mice via the stem cells and extracellular matrix components interaction. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1184. [PMID: 33241033 PMCID: PMC7576054 DOI: 10.21037/atm-20-6086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Fat graft transplantation seems a promising cell therapy for hair loss. However, impurities in lipoaspirate weaken the treatment effect. Here, we developed the lipoaspirate extraction method then investigate the effect and mechanism on hair growth-promoting in a mouse model. Methods Fat graft was prepared into concentrated nanofat (CNF), decellularized CNF (DCNF), and adipose-derived stem cells (ADSCs). They were injected subcutaneously in the back of depilated mice to test the hair promoting effect. Conditioned media (CM) from the adipose extracts were applied to dermal papilla cells (DPCs) to evaluate the cell viability and the anagen related signal. Results CNF and a high dose of ADSCs promoted hair growth and induced telogen-to-anagen transition in depilated mice. DCNF and a low dose of ADSCs did not show such effect; however, hair growth was promoted when they were used in combination. In vitro study showed the CNF-CM treated DPCs exhibited increased proliferation, migration, cell cycle progression, and elevated Wnt/β-catenin pathway protein levels compared with the other treatment groups. Conclusions CNF has a better effect than ADSCs in hair promotion via activating the DPCs and anagen induction. In this nature complex of stem cells (SCs) and extracellular matrix (ECM), ECM serves a significant supplementary role and amplifies the power of ADSCs. These results supply a theoretical basis on the clinical application of CNF to treat hair loss.
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Affiliation(s)
- Zehua Li
- Department of Plastic Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China.,Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, China
| | - Jinrong Zhang
- Department of Plastic Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China.,Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, China
| | - Meng Li
- Department of Plastic Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lingzhi Tang
- Department of Plastic Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hongwei Liu
- Department of Plastic Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
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Abstract
Fat grafting has been shown to improve diseased soft issue. Although the mechanism behind fat grafting’s regenerative properties is currently debated, published studies agree that there is an associated vasculogenic effect. A systematic literature review was conducted to elucidate the biochemical pathways responsible for establishing neo-vasculature to grafted fat.
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Abstract
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.
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Which Fat Processing Can Achieve Optimal Transplantation in Patients With Insufficient Fat Resource? Ann Plast Surg 2020; 85:93-94. [PMID: 32539284 DOI: 10.1097/sap.0000000000002384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Promotion of Hair Growth by Conditioned Medium from Extracellular Matrix/Stromal Vascular Fraction Gel in C57BL/6 Mice. Stem Cells Int 2020; 2020:9054514. [PMID: 32612663 PMCID: PMC7306841 DOI: 10.1155/2020/9054514] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/11/2020] [Accepted: 05/25/2020] [Indexed: 12/17/2022] Open
Abstract
Adipose-derived stem cell- (ADSC-) based regenerative medicine has expanded to include the treatment of hair loss. However, stem cell therapy remains a relatively recent technique, and reports of its use for treating alopecia are rare. ADSCs exert biological functions via the paracrine actions of various growth factors and cytokines. Conditioned medium from ADSCs (ADSCs-CM) is a cell-free suspension rich in growth factors and cytokines that has demonstrated a significant role in stimulating hair growth, with encouraging outcomes in terms of hair regeneration and hair growth. Extracellular matrix/stromal vascular fraction gel (ECM/SVF-gel) is an ADSC- and adipose native extracellular matrix-enriched product for cytotherapy. In this study, we compared the effects of CM from ECM/SVF-gel (ECM/SVF-CM) and from stem cells (SVF-CM) on hair growth in mice. ECM/SVF-CM stimulated hair growth more than SVF-CM, through promoting the proliferation of dermal papilla cells and cells in the bulge, neovascularization, and anagen induction. ECM/SVF-CM might, thus, provide an effective and improved strategy for promoting hair growth. These data provide a theoretical foundation for the clinical administration of ECM/SVF-CM for the treatment of hair loss.
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Reiter R, Pickhard A, Heyduck A, Brosch S, Hoffmann TK. [Update on vocal fold augmentation]. HNO 2020; 68:461-472. [PMID: 32377780 DOI: 10.1007/s00106-020-00863-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Unilateral vocal fold palsy is a frequent cause of hoarseness. In the presence of glottis closure insufficiency, the effectiveness of conservative voice therapy is often limited and phonosurgery may be indicated. Injection laryngoplasty is effective for correction of insufficiency. Early intervention during the first 6 months after diagnosis is desired to avoid subsequent insufficient endogenous compensation. Particularly patients with glottic closure insufficiency ≤2 mm in stroboscopy may benefit from this procedure. With appropriate patient selection, duration of the effect exceeding 12 months has been described for hyaluronic acid, calcium hydroxylapatite, and autologous fat. Due to rare complications such as allergic swelling at the injection site, regular laryngoscopic monitoring and observation for two nights after injection are recommended. The voice must only be rested for a few hours.
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Affiliation(s)
- R Reiter
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Sektion für Phoniatrie und Pädaudiologie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
| | - A Pickhard
- Hals-Nasen-Ohrenklinik, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - A Heyduck
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - S Brosch
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Sektion für Phoniatrie und Pädaudiologie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
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Recipient-Site Preconditioning with Deferoxamine Increases Fat Graft Survival by Inducing VEGF and Neovascularization in a Rat Model. Plast Reconstr Surg 2020; 144:619e-629e. [PMID: 31568298 DOI: 10.1097/prs.0000000000006036] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The authors hypothesize that ischemic preconditioning of the recipient site with deferoxamine will increase fat graft survival by enhancing angiogenesis in a rat model. METHODS Cell viability, tube formation, and mRNA expression were measured in human umbilical vein endothelial cells treated with deferoxamine. A total of 36 rats were then used for an in vivo study. A dose of 100 mg/kg of deferoxamine was injected subcutaneously into the rat scalp every other day for five treatments. On the day after the final injection, the scalp skin was harvested from half the animals to evaluate the effects of deferoxamine on the recipient site. In the remaining animals, inguinal fat tissue was transplanted to the scalp. Eight weeks after transplantation, the grafts were harvested to evaluate the effects of deferoxamine preconditioning on fat graft survival. RESULTS In human umbilical vein endothelial cells, treatment with a deferoxamine concentration higher than 400 μM decreased cell viability compared with the control (p = 0.002). Treatment with 100 and 200 μM deferoxamine increased endothelial tube formation (p = 0.001) and mRNA levels of angiogenesis-related factors (p = 0.02). Rat scalps treated with deferoxamine exhibited increased capillary neoformation (p = 0.001) and vascular endothelial growth factor protein expression (p = 0.024) compared with controls. Fat graft volume retention, capillary density (p < 0.001), and adipocyte viability (p < 0.001) in the grafted fat increased when the recipient site was preconditioned with deferoxamine. CONCLUSION This study demonstrated that recipient site preconditioning with deferoxamine increases fat graft survival by inducing vascular endothelial growth factor and neovascularization.
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Cell-Enriched Fat Grafting Improves Graft Retention in a Porcine Model: A Dose-Response Study of Adipose-Derived Stem Cells versus Stromal Vascular Fraction. Plast Reconstr Surg 2020; 144:397e-408e. [PMID: 31461016 DOI: 10.1097/prs.0000000000005920] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cell-enrichment of fat grafts has produced encouraging results, but the optimal concentrations and types of added cells are unknown. The authors investigated the effects of enrichment with various concentrations of ex vivo-expanded adipose-derived stem/stromal cells and stromal vascular fraction on graft retention in a porcine model. METHODS Adipose-derived stem/stromal cells were culture-expanded, and six fat grafts (30 ml) were prepared for each minipig (n = 13). The authors investigated grafts enriched with 2.5 × 10 to 20 × 10 adipose-derived stem cells/ml and stromal vascular fraction and nonenriched control grafts. Each pig served as its own control. Magnetic resonance imaging was performed immediately after grafting and 120 days postoperatively before the pigs were euthanized, and histologic samples were collected. RESULTS The authors recorded an enhanced relative graft retention rate of 41 percent in a pool of all cell-enriched grafts compared to the nonenriched control (13.0 percent versus 9.2 percent; p = 0.0045). A comparison of all individual groups showed significantly higher graft retention in the 10 × 10-adipose-derived stem/stromal cells per milliliter group compared with the control group (p = 0.022). No significant differences were observed between the cell-enriched groups (p = 0.66). All fat grafts showed a significantly better resemblance to normal fat tissue in the periphery than in the center (p < 0.009), but no differences in overall graft morphology were observed between groups (p > 0.17). CONCLUSIONS Cell-enriched fat grafting improved graft retention and was feasible in this porcine model. No significant differences in graft retention were observed among the various adipose-derived stem/stromal cell concentrations or between adipose-derived stem/stromal cell and stromal vascular fraction enrichment. Future studies using this model can help improve understanding of the role of adipose-derived stem/stromal cells in cell-enriched fat grafting.
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Schroeder A, Rubin JP, Kokai L, Sowa G, Chen J, Onishi K. Use of Adipose-Derived Orthobiologics for Musculoskeletal Injuries: A Narrative Review. PM R 2020; 12:805-816. [PMID: 31755664 DOI: 10.1002/pmrj.12291] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/11/2019] [Indexed: 12/11/2022]
Abstract
Musculoskeletal injuries are among the most prevalent, disabling, and costly conditions that Americans face, affecting over half of those over 18 and nearly 75% of those over 65 years old. Current treatments are largely palliative for many of these conditions and unmet needs have warranted the emergence of alternative treatments. Orthobiologics, such as adipose tissue derivatives (ATDs), are of high interest because they can be obtained in the office setting and their cellular components, including adipose stem cells and stromal cells, are thought to be beneficial in the treatment of musculoskeletal injuries. Microfragmented adipose tissue (MFAT) and stromal vascular fraction (SVF) are two ATD injectates that are used in the clinical setting to treat musculoskeletal conditions. Our review aimed to clarify the terminology describing the various ATDs used for orthopedic indications while discussing the promising but low-quality evidence, heterogeneity in MFAT and SVF processing methods, and inconsistencies in reported information such as injectate characterization with cell counts, injection technique, and postprocedural rehabilitation.
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Affiliation(s)
- Allison Schroeder
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
| | - J Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
- McGowan Institute for Regenerative Medicine
| | - Lauren Kokai
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA
- McGowan Institute for Regenerative Medicine
| | - Gwendolyn Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA
| | - Joseph Chen
- University of Pittsburgh Undergraduate, University of Pittsburgh, Pittsburgh, PA
| | - Kentaro Onishi
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA
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Ejaz A, Greenberger JS, Rubin PJ. Understanding the mechanism of radiation induced fibrosis and therapy options. Pharmacol Ther 2019; 204:107399. [DOI: 10.1016/j.pharmthera.2019.107399] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/07/2019] [Indexed: 02/06/2023]
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Abstract
The author provides his preferred approach to fat grafting for facial rejuvenation. The preferred donor sites include low abdomen and inner thigh. Fat grafts should be harvested with low negative pressure to ensure the integrity and viability of adipocytes. Fat grafts can be processed with proper centrifugation that can reliably produce purified fat with concentrated growth factors and adipose-derived stem cells, all of which are beneficial to improve graft survival. The approach described in this article is supported by the most scientific studies and thus may provide a more predictable long-lasting result if performed properly.
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Affiliation(s)
- Lee L Q Pu
- Division of Plastic Surgery, University of California Davis, 2335 Stockton Boulevard, Suite 6008, Sacramento, CA 95817, USA.
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33
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Abstract
Facial fat grafting is a small-volume procedure and is primarily performed for facial rejuvenation, contouring, or regenerative surgery. The unsatisfying retention rate after fat grafting, however, led to unpredictable outcomes, subsequent multiple procedures, and even some complications. A variety of methods have been proposed to enhance the results of facial fat grafting, including several established surgical principles and many possible new techniques. Adding stem cells, fat preparations, and platelet concentrates may improve the survival after fat grafting but randomized controlled clinical studies are needed to determine their safety and efficacy as well as clinical indications for each technique.
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Affiliation(s)
- Shaoheng Xiong
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, No. 15 Changle Western Road, Xi'an, Shaanxi, China
| | - Chenggang Yi
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, No. 15 Changle Western Road, Xi'an, Shaanxi, China.
| | - Lee L Q Pu
- Division of Plastic Surgery, University of California Davis Medical Center, 2335 Stockton Boulevard, Suite 6008, Sacramento, CA 95817, USA.
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Zheng H, Qiu L, Su Y, Yi C. Conventional Nanofat and SVF/ADSC-Concentrated Nanofat: A Comparative Study on Improving Photoaging of Nude Mice Skin. Aesthet Surg J 2019; 39:1241-1250. [PMID: 30869120 DOI: 10.1093/asj/sjz066] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Nanofats could improve photoaging. Stromal vascular fraction (SVF) and adipose-derived stem cells (ADSCs) may play pivotal roles. However, SVFs and ADSCs in nanofats processed by conventional methods cannot be enriched. Some researchers have found that after centrifugation, the SVF/ADSC density increases from top to bottom. OBJECTIVES The authors hypothesized that centrifugation can be used to obtain SVF/ADSC-concentrated nanofats that are superior to conventional nanofats in improving the photoaging of skin. METHODS After a photoaging model was successfully established in nude mice, the back of each mouse was divided into 4 areas and randomly injected with conventional nanofat, centrifuged nanofat (either the middle or lower layer of centrifuged nanofat), or normal saline. Wrinkles, dermis thickness, dermal collagen content, and elastic fiber morphology were measured and compared at weeks 4 and 8. RESULTS Compared with the wrinkles in the physiological saline injection areas, the wrinkles in the areas injected with the 3 nanofats (lower and middle layers of centrifuged nanofat and conventional nanofat) were significantly reduced. All 3 nanofat groups showed increased dermal thickness, increased collagen content, and a more regular distribution of elastic fibers compared with the saline injection areas. CONCLUSIONS The study established the efficacy of nanofats in improving photoaging by reducing wrinkles and increasing the thickness of dermal collagen, making nanofats a promising novel treatment for photoaging. The SVF/ADSC-concentrated nanofats exhibited the most improvement.
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Affiliation(s)
- Hui Zheng
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Lihong Qiu
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yingjun Su
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chenggang Yi
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
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Human adipose liquid extract induces angiogenesis and adipogenesis: a novel cell-free therapeutic agent. Stem Cell Res Ther 2019; 10:252. [PMID: 31412933 DOI: 10.1186/s13287-019-1356-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Taking advantage of cellular paracrine mechanisms, the secretome of adipose-derived stem cells (ADSCs) and adipose tissue has been demonstrated to induce tissue repair and regeneration in various ischemic and impaired conditions. However, these cell-based therapies have been hindered by issues, such as inherent safety and cost-efficiency for clinical applications. In this study, we prepared a liquid cell-free extract from human adipose tissue [adipose liquid extract (ALE)] and evaluated its potential therapeutic efficacy. METHODS ALE was prepared from human subcutaneous adipose tissue using a rapid and physical approach, and the protein components in ALE were identified using mass spectrometry analysis. In vivo, the therapeutic effect of this agent was investigated on wound healing in C57BL/6 mice, and wound healing rate, vessel density, and neo-adipocyte formation in wounded skins were measured at days 3, 7, 11, and 14. In vitro, the effect of ALE on the viability of human ADSCs, tube formation of human umbilical vein endothelial cells (HUVECs), and adipogenic differentiation of ADSCs were tested. RESULTS The results demonstrated that ALE contained a variety of growth factors and did not affect cell viability. ALE-treated wounds exhibited accelerated wound healing with increased vessel density and formation of neo-adipocytes compared to that of control wounds. Moreover, when added as a cell culture supplement, ALE effectively induced tube formation of HUVECs and lipid accumulation in ADSCs. ALE-treated ADSCs also exhibited elevated levels of adipogenic gene expression. CONCLUSIONS ALE is a novel growth-rich therapeutic agent that is cell-free and easy to produce. Besides, it is also able to induce angiogenesis and adipogenesis both in vitro and in vivo, thus indicating that it could be used for wound repair and soft tissue regeneration.
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Cryopreservation of Stromal Vascular Fraction Cells Reduces Their Counts but Not Their Stem Cell Potency. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2321. [PMID: 31942351 PMCID: PMC6952153 DOI: 10.1097/gox.0000000000002321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 11/25/2022]
Abstract
Adipose-derived stem cells are derived from the nonfat component of adipose tissue termed the stromal vascular fraction (SVF). The use of freshly isolated autologous SVF cells as an alternative to adult stem cells is becoming more common. Repeated SVF administration for improved clinical outcomes is complicated by the need for repeated liposuction. This can be overcome by cryopreservation of SVF cells. The current study aimed to assess whether SVF cells retain their stem cell potency during cryopreservation. Methods SVF cells isolated from lipoaspirates (donor age: 46.1 ± 11.7 y; body mass index: 29.3 ± 4.8 kg/m2) were analyzed either immediately after isolation or following cryopreservation at -196°C. Analyses included assessment of nucleated cell counts by methylene blue staining, colony-forming unit fibroblast counts, surface marker expression using a flow cytometric panel (CD45, CD34, CD31, CD73, CD29, and CD105), expansion in culture, and differentiation to fat and bone. Results While cryopreservation reduced the number of viable SVF cells, stem cell potency was preserved, as demonstrated by no significant difference in the proliferation, surface marker expression in culture, bone and fat differentiation capacity, and the number of colony-forming unit fibroblasts in culture, in cryopreserved versus fresh SVF cells. Importantly, reduced cell counts of cryopreserved cells were due, mainly, to a reduction in hematopoietic CD45+ cells, which was accompanied by increased proportions of CD45-CD34+CD31- stem cell progenitor cells compared to fresh SVF cells. Conclusions Cryopreservation of SVF cells did not affect their in vitro stem cell potency and may therefore enable repeated SVF cell administrations, without the need for repeated liposuction.
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39
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Making Sense of Stem Cells and Fat Grafting in Plastic Surgery: The Hype, Evidence, and Evolving U.S. Food and Drug Administration Regulations. Plast Reconstr Surg 2019; 143:417e-424e. [PMID: 30688913 DOI: 10.1097/prs.0000000000005207] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Autologous fat grafting and adipose-derived stem cells are two distinct entities with two different risk profiles, and should be regulated as such. Autologous fat grafting prepared with the additional step of stromal vascular fraction isolation is considered a form of "stem cell therapy" given the high concentration of stem cells found in stromal vascular fraction. Much ambiguity existed in the distinction between autologous fat grafting and stromal vascular fraction initially, in terms of both their biological properties and how they should be regulated. The market has capitalized on this in the past decade to sell unproven "stem cell" therapies to unknowing consumers while exploiting the regulatory liberties of traditional fat grafting. This led to a Draft Guidance from the U.S. Food and Drug Administration in 2014 proposing stricter regulations on fat grafting in general, which in turn elicited a response from plastic surgeons, who have safely used autologous fat grafting in the clinical setting for over a century. After a series of discussions, the U.S. Food and Drug Administration released its Final Guidance in November of 2017, which established clear distinctions between autologous fat grafting and stromal vascular fraction and their separate regulations. By educating ourselves on the U.S. Food and Drug Administration's final stance on fat grafting and stem cell therapy, we can learn how to navigate the regulatory waters for the two entities and implement their clinical use in a responsible and informed manner.
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Abstract
Soft-tissue deficits in amputation stumps can lead to significant pain and disability. An emerging treatment option is stem cell-enriched fat grafting. This is the first study assessing the potential for this treatment modality in lower extremity amputation sites. In this prospective cohort study, five injured military personnel suffering from pain and limited function at amputation sites were recruited. Fat grafting enriched with stromal vascular fraction was performed at amputation sites to provide additional subcutaneous tissue padding over bony structures. Outcomes measures included complications, demographic data, physical examination, cellular subpopulations, cell viability, graft volume retention, pain, Lower Extremity Functional Scale, Functional Mobility Assessment, 36-Item Short-Form Health Survey, and rates of depression. Follow-up was 2 years. There were no significant complications. Volume retention was 61.5 ± 24.0 percent. Overall cell viability of the stromal vascular fraction was significantly correlated with volume retention (p = 0.016). There was no significant correlation between percentage of adipose-derived stem cells or number of cells in the stromal vascular fraction and volume retention. There was a nonsignificant trend toward improvement in pain scores (3.0 ± 2.5 to 1.2 ± 1.6; p = 0.180 at 2 years). There were no significant changes in disability indexes. Results from this pilot study demonstrate that stromal vascular fraction-enriched fat grafting is a safe, novel modality for the treatment of symptomatic soft-tissue defects in traumatic lower extremity amputations. Volume retention can be anticipated at slightly over 60 percent. Further studies are needed to assess efficacy. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.
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Harris WM, Plastini M, Kappy N, Ortiz T, Chang S, Brown S, Carpenter JP, Zhang P. Endothelial Differentiated Adipose-Derived Stem Cells Improvement of Survival and Neovascularization in Fat Transplantation. Aesthet Surg J 2019; 39:220-232. [PMID: 29846494 DOI: 10.1093/asj/sjy130] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Adipose-derived stem cells (ASCs) assisted lipotransfer have been considered to facilitate the survival of fat grafts. However, emerging evidence of insufficient vascularization is another obstacle for fat graft survival in cell-assisted lipotransfer. Objectives This study evaluated if endothelial phenotype ASCs with fat lipoaspirate improves survival and neovascularization in fat transplantation. Methods ASCs were isolated from human periumbilical fat tissue and cultured in endothelial growth medium for 2 weeks. Fat lipoaspirate was mixed with fresh adipose stroma vascular fraction (SVF), endothelial differentiated ASCs (EC/ASCs), and fat lipoaspirate alone. Three fat mixtures were subcutaneously injected into the adult male Sprague-Dawley rat's dorsum at 3 locations. At 8 weeks after transplantation, the grafted fat lipoaspirates were harvested, and the extracted fat was evaluated using photographic, survival weights measurements and histological examination. Neo-vascularization was quantified by immunofluorescence and real-time RT-PCR. Results Grafts from the EC/ASC assisted group had a higher survival rate, morphologic integrity, and most uniform lipid droplets. They also revealed less inflammation and fibrosis with increased number of vessels by histological and immunofluorescence analysis. Quantitative RT-PCR analysis indicated that the expression levels of EC-specific markers of CD31 and vWF were higher in the EC/ASC group compared with in the control and fat with SVF transplants. Conclusions These results indicated that co-implantation of fat lipoaspirate with ASCs differentiated toward an endothelial phenotype improves both survival and neovascularization of the transplanted fat lipoaspirate, which might provide benefits and represents a promising strategy for clinical application in autologous fat transplantation.
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Affiliation(s)
- William M Harris
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Michael Plastini
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Nikolas Kappy
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Telisha Ortiz
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Shaohua Chang
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Spencer Brown
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | | | - Ping Zhang
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
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Browning of Human Subcutaneous Adipose Tissue after Its Transplantation in Nude Mice. Plast Reconstr Surg 2019; 142:392-400. [PMID: 29787512 DOI: 10.1097/prs.0000000000004603] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The clinical unpredictability of autologous fat grafting originates partially from the unique characteristics of adipose tissue. Evidence of adipose remodeling toward browning (developing of brown-like adipocytes in white adipose tissue) in response to trauma has been emerging. With regard to fat grafting surgery by which adipose tissue depots are directly and ubiquitously traumatized, whether it affects adipose phenotype change toward browning has not been previously reported. METHODS Human subcutaneous adipose tissues were harvested from the abdominal region of female patients by means of liposuction and were then injected into the dorsal flanks of athymic nude mice. After 12 weeks, fat grafts were harvested and subjected to histologic analysis. RESULTS Hematoxylin and eosin staining showed the appearance of small multilocular adipocytes in the peripheral region of the grafts. These adipocytes exhibited higher staining for uncoupling protein 1 (a fat browning-specific marker), mitochondrial protein, and CD31 compared with the central ones, indicating the presence of brown-like adipocytes (i.e., beige adipocytes) in this area. Furthermore, immunofluorescence staining demonstrated that these beige adipocytes might be derived from de novo adipogenesis from progenitors of graft origin. CONCLUSION Results of this study suggest that browning of subcutaneous white adipose tissue participates in adaptive tissue remodeling following grafting and contributes to adipose tissue repair.
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Linkov F, Goughnour SL, Adambekov S, Lokshin A, Kelley JL, Sukumvanich P, Comerci JT, Marra KG, Kokai LE, Rubin JP, Vlad AM, Philips BJ, Edwards RP. Inflammatory biomarker in adipose stem cells of women with endometrial cancer. Biomark Med 2018; 12:945-952. [PMID: 30043637 PMCID: PMC6439519 DOI: 10.2217/bmm-2017-0355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 04/11/2018] [Indexed: 01/22/2023] Open
Abstract
AIM To explore inflammatory biomarkers secreted by adipose stem cells (ASCs) in omental, retroperitoneal and subcutaneous adipose tissues of women with endometrial cancer. PATIENTS & METHODS ASCs were collected from 22 women, aged 35-83 years, undergoing hysterectomy for endometrial cancer. Angiopoietin-2, EGF, IL-8, leptin, VEGFA, VEGFC and VEFGD levels in the ASC-conditioned media were analyzed by Luminex. RESULTS We found a significant difference between the three depots for IL-8 (p < 0.0001), with the highest levels of IL-8 in the omental depot. VEGFA levels were highest in the retroperitoneal depot. CONCLUSION This is one of the first studies to explore biomarker expression in ASC-conditioned media in adipose tissue. ASC characteristics may be important to evaluate in relation to cancer risk.
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Affiliation(s)
- Faina Linkov
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, 3380 Blvd of the Allies, Pittsburgh, PA 15213, USA
- Department of Epidemiology, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15216, USA
- UPMC Hillman Cancer Center, 5115 Centre Avenue Pittsburgh, PA 15232, USA
| | - Sharon L Goughnour
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, 3380 Blvd of the Allies, Pittsburgh, PA 15213, USA
| | - Shalkar Adambekov
- Department of Epidemiology, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15216, USA
| | - Anna Lokshin
- Department of Medicine, UPMC Cancer Pavilion, 5150 Centre Avenue, Pittsburgh, PA 15232, USA
| | - Joseph L Kelley
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - Paniti Sukumvanich
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - John T Comerci
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - Kacey G Marra
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, 3550 Terrace Street, Scaife Hall, Pittsburgh, PA 15261, USA
| | - Lauren E Kokai
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, 3550 Terrace Street, Scaife Hall, Pittsburgh, PA 15261, USA
| | - J Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh School of Medicine, 3550 Terrace Street, Scaife Hall, Pittsburgh, PA 15261, USA
| | - Anda M Vlad
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, 3380 Blvd of the Allies, Pittsburgh, PA 15213, USA
| | - Brian J Philips
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, 3380 Blvd of the Allies, Pittsburgh, PA 15213, USA
| | - Robert P Edwards
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, 3380 Blvd of the Allies, Pittsburgh, PA 15213, USA
- UPMC Hillman Cancer Center, 5115 Centre Avenue Pittsburgh, PA 15232, USA
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Bashir MM, Sohail M, Bashir A, Khan FA, Jan SN, Imran M, Ahmad FJ, Choudhery MS. Outcome of Conventional Adipose Tissue Grafting for Contour Deformities of Face and Role of Ex Vivo Expanded Adipose Tissue-Derived Stem Cells in Treatment of Such Deformities. J Craniofac Surg 2018; 29:1143-1147. [PMID: 29481509 DOI: 10.1097/scs.0000000000004367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To evaluate the outcomes of conventional fat grafting for facial contour deformities and to describe clinical outcome of a patient with contour deformity of face treated with ex vivo expanded adipose tissue-derived mesenchymal stem cells (ASCs) enriched fat graft. PLACE AND DURATION OF STUDY The Department of Plastic Surgery and Tissue Engineering and Regenerative Medicine Laboratory, King Edward Medical University/Mayo Hospital, Lahore, from September 2015 to September 2017. METHODS Patients with contour deformities of face requiring soft tissue augmentation were included. Fat was harvested, processed, and injected following a standard protocol. Both subjective and objective assessments were performed and complications were also noted. RESULTS Twenty-five patients underwent 51 fat-grafting sessions over a period of 24 months. Eighteen (72%) patients underwent multiple fat-grafting sessions. Mean (standard deviation) soft tissue thickness after 72 hours and 6 months of first fat graft session was 18.62 (7.2) and 12.88 (6.21) mm, respectively, which corresponds to 30.77 (13)% reduction of transplanted fat. Physician and patient assessment scores were 3.42 (0.92) and 4 (1.04), respectively. Few minor complications were observed. In the patient undergoing ex vivo expanded ASCs enriched fat graft, there was minimal decrease in soft tissue thickness of treated area (44 mm vs 42 mm) 6 months postoperatively and patient was highly satisfied with the outcome after the single session. CONCLUSION Conventional fat grafting is safe for correction of facial contour deformities. However, procedure needs to be repeated multiple times to produce satisfactory results. Beneficial effects of ex vivo expanded ASCs enriched fat grafting have a potential to alter the current treatment paradigm of fat grafting for soft tissue reconstruction.
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Affiliation(s)
| | - Muhammad Sohail
- Department of Plastic Surgery, King Edward Medical University, Mayo Hospital
| | - Afzaal Bashir
- Department of Plastic Surgery, King Edward Medical University, Mayo Hospital
| | - Farid Ahmad Khan
- Department of Plastic Surgery, Principal, Chairman and Dean, Shaikh Zayed Medical Complex
| | - Sadia Nosheen Jan
- Department of Plastic Surgery, King Edward Medical University, Mayo Hospital
| | | | - Fridoon Jawad Ahmad
- Tissue Engineering Laboratory Pediatric Surgery, King Edward Medical University
| | - Mahmood S Choudhery
- Tissue Engineering and Regenerative Medicine Laboratory, Department of Biomedical Sciences, King Edward Medical University, Lahore, Pakistan
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Bukowska J, Frazier T, Smith S, Brown T, Bender R, McCarthy M, Wu X, Bunnell BA, Gimble JM. Bone Marrow Adipocyte Developmental Origin and Biology. Curr Osteoporos Rep 2018; 16:312-319. [PMID: 29667012 PMCID: PMC5948173 DOI: 10.1007/s11914-018-0442-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW This review explores how the relationships between bone marrow adipose tissue (BMAT) adipogenesis with advancing age, obesity, and/or bone diseases (osteopenia or osteoporosis) contribute to mechanisms underlying musculoskeletal pathophysiology. RECENT FINDINGS Recent studies have re-defined adipose tissue as a dynamic, vital organ with functions extending beyond its historic identity restricted solely to that of an energy reservoir or sink. "State of the art" methodologies provide novel insights into the developmental origin, physiology, and function of different adipose tissue depots. These include genetic tracking of adipose progenitors, viral vectors application, and sophisticated non-invasive imaging modalities. While constricted within the rigid bone cavity, BMAT vigorously contributes to local and systemic metabolic processes including hematopoiesis, osteogenesis, and energy metabolism and undergoes dynamic changes as a function of age, diet, bone topography, or sex. These insights will impact future research and therapies relating to osteoporosis.
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Affiliation(s)
- Joanna Bukowska
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Trivia Frazier
- LaCell LLC, New Orleans, LA, USA
- Obatala Sciences, Inc., New Orleans, LA, USA
| | | | - Theodore Brown
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Michelle McCarthy
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Xiying Wu
- LaCell LLC, New Orleans, LA, USA
- Obatala Sciences, Inc., New Orleans, LA, USA
| | - Bruce A Bunnell
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Jeffrey M Gimble
- LaCell LLC, New Orleans, LA, USA.
- Obatala Sciences, Inc., New Orleans, LA, USA.
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
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Bellini E, Grieco MP, Raposio E. The science behind autologous fat grafting. Ann Med Surg (Lond) 2017; 24:65-73. [PMID: 29188051 PMCID: PMC5694962 DOI: 10.1016/j.amsu.2017.11.001] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/10/2017] [Accepted: 11/01/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Adipose grafting has undergone significant changes over time. Many different techniques have been followed by trying to improve the quality of the lipoaspirate and the survival of the fat graft after implantation. MATERIAL AND METHODS The purpose of this review is to analyse the historical evolution of the surgical harvesting and implant technique, describing the changes that have brought significant improvements, revolutionizing the aesthetic and functional results obtainable. RESULTS A standard fat grafting technique is commonly performed in three stages: harvesting of adipose tissue from a suitable donor site; processing of the lipoaspirate to eliminate cellular debris, acellular oil and excess of infiltrated solution, reinjection of the purified adipose tissue. The most widely used surgical technique was described by Coleman. He modified and corrected the methods and results of his predecessors and proposed an atraumatic protocol for the treatment of adipose tissue.He reported that the key to successful fat grafting lies in the technique. In addition, he noticed that adipose tissue was not only a good filler, but improved the quality of the skin. In fact, fat grafts demonstrated to have not only dermal filler properties but also regenerative potential owing to the presence of stem cells in fat tissue. CONCLUSION Adipose tissue, actually, is the closest to the ideal filler because it is readily available; easily obtainable, with low donor-site morbidity; repeatable; inexpensive; versatile; and biocompatible. There is an abundance of literature supporting the efficacy of fat grafting in both aesthetic and reconstructive cases. Recent studies have shown the utility of adipose-derived stem cells in the improvement of wound healing, describing their ability to regenerate soft tissues and their remodelling capacity provided by their unique cytokine and growth factor profiles.Despite ongoing concerns about survival and longevity of fat grafts after implantation and unpredictability of long-term outcome, fat has been successfully used as a filler in many differ clinic situation.
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Affiliation(s)
- Elisa Bellini
- Department of Medicine and Surgery, Plastic Surgery Section, University of Parma, Italy
- Cutaneous, Mini-invasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Michele P. Grieco
- Department of Medicine and Surgery, Plastic Surgery Section, University of Parma, Italy
- Cutaneous, Mini-invasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Edoardo Raposio
- Department of Medicine and Surgery, Plastic Surgery Section, University of Parma, Italy
- Cutaneous, Mini-invasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
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Cantarella G, Mazzola RF, Gaffuri M, Iofrida E, Biondetti P, Forzenigo LV, Pignataro L, Torretta S. Structural Fat Grafting to Improve Outcomes of Vocal Folds’ Fat Augmentation: Long-term Results. Otolaryngol Head Neck Surg 2017; 158:135-143. [DOI: 10.1177/0194599817739256] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Evaluating the long-term outcomes of vocal fold structural fat grafting. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Seventy-nine dysphonic patients (16-82 years; 55 with unilateral laryngeal paralysis and 24 with vocal fold scarring) underwent vocal fold fat injection. Fat was harvested by low-pressure liposuction and then processed by centrifugation. Refined fat aliquots were placed in the vocal fold and paraglottic space in multiple tunnels to enhance graft neovascularization. All patients were followed for 12 months, 15 for 3 years, and 5 for 10 years with videolaryngostroboscopy, maximal phonation time (MPT) measurement, Voice Handicap Index (VHI) questionnaire, and GRBAS (grade, roughness, breathiness, asthenia, strain) perceptual evaluation. Laryngeal computed tomography (CT) and/or magnetic resonance imaging (MRI) studies were performed in 16 patients 3 to 28 months postoperatively; MRI was repeated in 5 cases 12 to 18 months after the first radiological study. Results The voice quality of all patients improved after surgery, and long-term stability was confirmed by MPT, GRBAS, and VHI ( P ranging between .004 and <.001). The results achieved 1 year postoperatively remained stable at 3 and 10 years. Videolaryn-gostroboscopy showed improved glottic closure in all patients despite a limited amount of fat resorption. CT and MRI demonstrated survival of the fat grafts in all of the 16 examined cases. Serial MRI scans showed no change in graft size over time. Conclusions The reported clinical and radiological data demonstrate that fat is an effective filler for permanent vocal fold augmentation if the refined micro-aliquots are placed in multiple tunnels.
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Affiliation(s)
- Giovanna Cantarella
- Otolaryngology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo F. Mazzola
- Otolaryngology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Michele Gaffuri
- Otolaryngology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Iofrida
- Otolaryngology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Pietro Biondetti
- Radiology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura V. Forzenigo
- Radiology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Pignataro
- Otolaryngology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Sara Torretta
- Otolaryngology Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Wei H, Gu SX, Liang YD, Liang ZJ, Chen H, Zhu MG, Xu FT, He N, Wei XJ, Li HM. Nanofat-derived stem cells with platelet-rich fibrin improve facial contour remodeling and skin rejuvenation after autologous structural fat transplantation. Oncotarget 2017; 8:68542-68556. [PMID: 28978136 PMCID: PMC5620276 DOI: 10.18632/oncotarget.19721] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/19/2017] [Indexed: 12/28/2022] Open
Abstract
Traditional autologous fat transplantation is a common surgical procedure for treating facial soft tissue depression and skin aging. However, the transplanted fat is easily absorbed, reducing the long-term efficacy of the procedure. Here, we examined the efficacy of nanofat-assisted autologous fat structural transplantation. Nanofat-derived stem cells (NFSCs) were isolated, mechanically emulsified, cultured, and characterized. Platelet-rich fibrin (PRF) enhanced proliferation and adipogenic differentiation of NFSCs in vitro. We then compared 62 test group patients with soft tissue depression or signs of aging who underwent combined nanofat, PRF, and autologous fat structural transplantation to control patients (77 cases) who underwent traditional autologous fat transplantation. Facial soft tissue depression symptoms and skin texture were improved to a greater extent after nanofat transplants than after traditional transplants, and the nanofat group had an overall satisfaction rate above 90%. These data suggest that NFSCs function similarly to mesenchymal stem cells and share many of the biological characteristics of traditional fat stem cell cultures. Transplants that combine newly-isolated nanofat, which has a rich stromal vascular fraction (SVF), with PRF and autologous structural fat granules may therefore be a safe, highly-effective, and long-lasting method for remodeling facial contours and rejuvenating the skin.
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Affiliation(s)
- Hua Wei
- Department of Endocrinology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Shi-Xing Gu
- Department of Burns & Plastic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Yi-Dan Liang
- Central Laboratory of Medical Science, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Zhi-Jie Liang
- Department of Gland Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Hai Chen
- Department of Gland Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Mao-Guang Zhu
- Department of Gland Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Fang-Tian Xu
- Department of Orthopedics, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Ning He
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Xiao-Juan Wei
- Department of Urinary Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Hong-Mian Li
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
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Purified Adipose-Derived Stromal Cells Provide Superior Fat Graft Retention Compared with Unenriched Stromal Vascular Fraction. Plast Reconstr Surg 2017; 139:911-914. [PMID: 28350672 DOI: 10.1097/prs.0000000000003165] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Cell-assisted lipotransfer has shown much promise as a technique to improve fat graft retention in both mouse and human studies. However, the literature varies as to whether fresh stromal vascular fraction or culture-expanded adipose-derived stromal cells are used to augment volume retention. The authors' study sought to determine whether there was a significant advantage to using adipose-derived stromal cells over unpurified stromal vascular fraction cells in a mouse model of cell-assisted lipotransfer.
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