Improving Fat Transplantation Survival and Vascularization with Adenovirus E4+ Endothelial Cell-Assisted Lipotransfer

A Protocol for co-Injecting Cells with Pulverized Fibers for Improved Cell Survival and Engraftment

Adipose tissue is crucial for medical applications such as tissue reconstruction, cosmetic procedures, and correcting soft tissue deformities. Significant advances in the use of adipose tissue have been achieved through Coleman's studies in fat grafting, which gained widespread acceptance due to its effectiveness and safety. Despite its benefits, adipose tissue grafting faces several limitations, including high absorption rates due to insufficient support or anchorage, replacement by fibrous tissue, migration from the intended site, and loss of the initial desired morphology post-administration. To counteract these constraints, there is a need for improved grafting techniques that enhance the predictability and consistency of outcomes. Biomaterials are extensively used in tissue engineering to support cell adhesion, proliferation, and growth. Both natural and synthetic materials have shown promise in creating suitable microenvironments for adipose tissue regeneration. PLGA, a synthetic copolymer, is particularly notable for its biocompatibility, biodegradability, and tunable mechanical properties. Here, we describe a protocol using milled electrospun poly(lactic-co-glycolic acid) (PLGA) fibers combined with lipoaspirated tissue to create a fibrous slurry for injection. By pulverizing PLGA fiber mats to create fiber fragments with increased pore size and porosity, we can influence key cellular responses and enhance the success of adipose tissue-grafting procedures. This approach improves anchorage and support for adipocytes, thereby increasing cell viability. This method aims to enhance vascularity, perfusion, and volume retention in adipose tissue grafts, which addresses many of the limitations of current approaches to adipose tissue grafting and holds promise for more consistent and successful outcomes. Key features • Adipose tissue for tissue reconstruction. • Need for improved engraftment and volume retention. • Pulverized PLGA fiber mats to create a fibrous "slurry" that allows injection. • PLGA fibers co-injected with lipoaspirated tissue. • Improved adipose engraftment outcomes (e.g., perfusion, vascularity, and retention of graft volume).

Modulating endothelial cell dynamics in fat grafting: the impact of DLL4 siRNA via adipose stem cell extracellular vesicles

In the context of improving the efficacy of autologous fat grafts (AFGs) in reconstructive surgery, this study delineates the novel use of adipose-derived mesenchymal stem cells (ADSCs) and their extracellular vesicles (EVs) as vehicles for delivering delta-like ligand 4 (DLL4) siRNA. The aim was to inhibit DLL4, a gene identified through transcriptome analysis as a critical player in the vascular endothelial cells of AFG tissues, thereby negatively affecting endothelial cell functions and graft survival through the Notch signaling pathway. By engineering ADSC EVs to carry DLL4 siRNA (ADSC EVs-siDLL4), the research demonstrated a marked improvement in endothelial cell proliferation, migration, and lumen formation, and enhanced angiogenesis in vivo, leading to a significant increase in the survival rate of AFGs. This approach presents a significant advancement in the field of tissue engineering and regenerative medicine, offering a potential method to overcome the limitations of current fat grafting techniques.NEW & NOTEWORTHY This study introduces a groundbreaking method for enhancing autologous fat graft survival using adipose-derived stem cell extracellular vesicles (ADSC EVs) to deliver DLL4 siRNA. By targeting the delta-like ligand 4 (DLL4) gene, crucial in endothelial cell dynamics, this innovative approach significantly improves endothelial cell functions and angiogenesis, marking a substantial advancement in tissue engineering and regenerative medicine.

Injectable pulverized electrospun poly(lactic-co-glycolic acid) fibers improve human adipose tissue engraftment and volume retention

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.