|
1
|
La Padula S, Pensato R, Errico C, D'Andrea F, Persichetti P, Chesné C, Jamin A, Ben Mosbah I, Toia F, Cordova A, Meningaud JP, Hersant B. Effects of Nanofat and PRP on Type I Collagen Production in Striae Distensae: Preliminary Findings from a Prospective, Randomized Single-Blind Study. Aesthetic Plast Surg 2025; 49:2076-2084. [PMID: 39627329 DOI: 10.1007/s00266-024-04560-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 11/14/2024] [Indexed: 04/26/2025]
Abstract
INTRODUCTION Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called "striae rubrae" (SR) and a chronic phase in which they are called striae albae (SA). This study investigates the synergistic effect of nanofat and platelet-rich plasma (PRP) injections on collagen production in fibroblasts derived from SA (SAF). MATERIAL AND METHODS A prospective, randomized single-blind study was conducted in fifty women presenting with SA in the abdominal region who had voluntarily sought a conventional abdominoplasty procedure and accepted to test an autologous treatment for their SDs. SA were treated using: PrP 10 ml; PrP 2ml (20%) + nanofat 8ml (80%); nanofat 10ml. Following the abdominal dermolipectomy, biopsies from treated and untreated SDs were taken and analyzed for type I collagen quantification. Results were processed through statistical analysis models using the Student's t test. RESULTS Collagen concentration in untreated SA biopsies was significantly lower than in healthy skin. Both PRP and nanofat treatments significantly increased collagen biosynthesis compared to controls, with the combined PRP-nanofat treatment showing the highest increase in collagen levels (p < 0.0001). A superior clinical improvement was observed in the areas that received the combined treatment of PRP and nanofat (p = 0.001). CONCLUSION Our findings indicate that both PRP and nanofat treatments effectively enhance collagen production in SA, with the combined PRP-nanofat treatment showing a synergistic effect. This combined therapy holds promise for effectively treating SA, providing a new potential treatment avenue for SMs and similar skin conditions. Further studies are needed to validate these results and explore clinical applications. LEVEL OF EVIDENCE I 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 .
Collapse
Affiliation(s)
- Simone La Padula
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy.
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
- , 50 rue Saint, 75011 PARIS, Sébastien, France.
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Concetta Errico
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Francesco D'Andrea
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Paolo Persichetti
- Department of Plastic and Reconstructive Surgery, Università Campus Biomedico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy
| | - Christophe Chesné
- Biopredic International, Parc d'activité de la Bretèche Bâtiment A4, 35760, Saint Grégoire, France
| | - Agnes Jamin
- Biopredic International, Parc d'activité de la Bretèche Bâtiment A4, 35760, Saint Grégoire, France
| | - Ismail Ben Mosbah
- Biopredic International, Parc d'activité de la Bretèche Bâtiment A4, 35760, Saint Grégoire, France
- IMRB - Institut Mondor de Recherche Biomédicale. 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Francesca Toia
- Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy
| | - Adriana Cordova
- Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy
| | - Jean Paul Meningaud
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Barbara Hersant
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| |
Collapse
|
|
2
|
Davies C, Miron RJ. Autolougous platelet concentrates in esthetic medicine. Periodontol 2000 2025; 97:363-419. [PMID: 39086171 PMCID: PMC11808453 DOI: 10.1111/prd.12582] [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: 02/11/2024] [Revised: 04/15/2024] [Accepted: 05/22/2024] [Indexed: 08/02/2024]
Abstract
This narrative review summarizes current knowledge on the use of autologous platelet concentrates (APCs) in esthetic medicine, with the goal of providing clinicians with reliable information for clinical practice. APCs contain platelets that release various growth factors with potential applications in facial and dermatologic treatments. This review examines several facial esthetic applications of APCs, including acne scarring, skin rejuvenation, melasma, vitiligo, stretchmarks, peri-orbital rejuvenation, peri-oral rejuvenation, hair regeneration and the volumizing effects of APC gels. A systematic review of literature databases (PubMed/MEDLINE) was conducted up to October 2023 to identify randomized controlled trials (RCTs) in the English language on APCs for facial rejuvenation and dermatology. A total of 96 articles were selected including those on platelet rich plasma (PRP), plasma-rich in growth factors (PRGF), and platelet-rich fibrin (PRF). Clinical recommendations gained from the reviews are provided. In summary, the use of APCs in facial esthetics is a promising yet relatively recent treatment approach. Overall, the majority of studies have focused on the use of PRP with positive outcomes. Only few studies have compared PRP versus PRF with all demonstrating superior outcomes using PRF. The existing studies have limitations including small sample sizes and lack of standardized assessment criteria. Future research should utilize well-designed RCTs, incorporating appropriate controls, such as split-face comparisons, and standardized protocols for APC usage, including optimal number of sessions, interval between sessions, and objective improvement scores. Nevertheless, the most recent formulations of platelet concentrates offer clinicians an ability to improve various clinical parameters and esthetic concerns.
Collapse
Affiliation(s)
- Catherine Davies
- ZD Hair ClinicJohannesburgSouth Africa
- Advanced PRF EducationVeniceFloridaUSA
| | - Richard J. Miron
- Advanced PRF EducationVeniceFloridaUSA
- Department of PeriodontologyUniversity of BernBernSwitzerland
| |
Collapse
|
|
3
|
Cai Y, Jia Z, Gu J, Kang B, Li W, Zhang W. Autologous Cell-Free Fat Extract: A Novel Approach for Infraorbital Rejuvenation-A Pilot Study. J Cosmet Dermatol 2025; 24:e16682. [PMID: 39645645 PMCID: PMC11845974 DOI: 10.1111/jocd.16682] [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: 05/01/2024] [Revised: 10/23/2024] [Accepted: 11/05/2024] [Indexed: 12/09/2024]
Abstract
BACKGROUND AND OBJECTIVE CEFFE (Cell-free fat extract) treatment for periocular fine lines requires thorough clinical evaluation to determine its efficacy and safety in enhancing skin quality. The research enrolled 10 healthy female participants aged 31-58, focusing on skin texture, elasticity, and barrier function. METHODS AND RESULTS CEFFE treatment demonstrated significant benefits, with notable improvements observed as early as 3 months posttreatment, which continued throughout the 12-month follow-up period. Objective assessments revealed reductions in SEr% and SEw%, indicative of reduced skin roughness and wrinkles, particularly pronounced after the third month of treatment. Enhanced skin elasticity, as indicated by improvements in R2%, R5%, and R7%, was observed, with the most significant enhancements noted at the 6-month follow-up. Furthermore, TEWL decreased consistently, highlighting CEFFE's potential in maintaining the skin's barrier function and moisture retention. High patient satisfaction levels, with 70% expressing satisfaction ranging from satisfied to very satisfied, underscored CEFFE's clinical significance. CONCLUSIONS CEFFE demonstrates potential as an effective and safe intervention for addressing periocular fine lines, providing a solution for fine lines while ensuring skin health (ChiCTR1900024329).
Collapse
Affiliation(s)
- Yizuo Cai
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue EngineeringNational Tissue Engineering Center of ChinaShanghaiChina
| | - Zhuoxuan Jia
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue EngineeringNational Tissue Engineering Center of ChinaShanghaiChina
| | - Jiancheng Gu
- Division of Plastic SurgeryShanghai Basilica ClinicShanghaiChina
| | - Bijun Kang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue EngineeringNational Tissue Engineering Center of ChinaShanghaiChina
| | - Wei Li
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue EngineeringNational Tissue Engineering Center of ChinaShanghaiChina
| | - Wenjie Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue EngineeringNational Tissue Engineering Center of ChinaShanghaiChina
| |
Collapse
|
|
4
|
Fakih-Gomez N, Manay R, Nazari S, Martins L, Muñoz-Gonzalez C. Regenerative Nanofat Membrane Development Process. Aesthetic Plast Surg 2024:10.1007/s00266-024-04562-5. [PMID: 39663222 DOI: 10.1007/s00266-024-04562-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 11/11/2024] [Indexed: 12/13/2024]
Abstract
INTRODUCTION Chronic wounds present a significant challenge in clinical practice due to complications like infections and prolonged healing times. Conventional treatments often fall short, necessitating advancements in wound healing strategies. This article introduces a novel approach using a combination of adipose-derived stem cells (ADSCs) from fat and growth factors from platelet-rich fibrin (PRF) to enhance wound healing outcomes. METHODS The Fakih-Manay fat membrane device was utilized to prepare fat membranes. Microfat was harvested and emulsified to produce nanofat, which was then combined with PRF to create a Nanofat-PRF membrane. The resulting membrane was uniform, versatile, and suture-friendly, making it ideal for various medical and surgical applications. RESULTS Between April 2019 and April 2024, 172 patients received treatment using a nanofat membrane. The membrane showed significant improvement in wound healing in various cases including diabetic foot ulcers, cleft palate surgeries, facial dermabrasion, skin necrosis, revision rhinoplasties, and post-cosmetic surgery complications. Postoperative follow-up after healing ranged from 1 to 16 months, showing high patient satisfaction and significant improvements in wound healing and no reported complications. CONCLUSION The nanofat membrane presents a versatile and innovative approach to enhancing healing across a broad range of medical and surgical applications. This study provides the first evidence on the method for creating these membranes, demonstrating their clinical efficacy and safety, with no reported complications over a 5-year period. 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 .
Collapse
Affiliation(s)
- Nabil Fakih-Gomez
- Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon.
- Department of Surgery, University of Salamanca, Salamanca, Spain.
| | - Roshini Manay
- Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon
| | - Shahriar Nazari
- Department of Otorhinolaryngology and Head and Neck Surgery, BMI Hospital, Tehran, Iran
| | - Lessandro Martins
- Private Practice, 2653 Orion Business Health and Center, Goiania, Brazil
| | - Cristina Muñoz-Gonzalez
- Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon
- Department of Surgery, University of Salamanca, Salamanca, Spain
| |
Collapse
|
|
5
|
Lu Y, Pan G, Wei Z, Li Y, Pan X. Role of fibroblast autophagy and proliferation in skin anti-aging. Exp Gerontol 2024; 196:112559. [PMID: 39182739 DOI: 10.1016/j.exger.2024.112559] [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: 06/16/2024] [Revised: 08/13/2024] [Accepted: 08/22/2024] [Indexed: 08/27/2024]
Abstract
Skin, as the outermost protective barrier of the body, becomes damaged with age and exposure to external stimuli. Dermal fibroblasts age and undergo apoptosis, which decreases collagen, collagen fibers, elastic fibers, hyaluronic acid, etc., leading skin to loss of elasticity and appearance of wrinkles. Skin aging is complex, involving several biological reactions，and various treatment methods are used to treat it. This review focuses on the importance of autophagy and cell proliferation in skin anti-aging, summarizes research progress on skin anti-aging by regulating autophagy and promoting the proliferation of dermal fibroblasts, and discusses future directions on skin anti-aging research.
Collapse
Affiliation(s)
- Yantong Lu
- Guangxi University of Chinese Medicine, Nanning 530200, China
| | - Guangjuan Pan
- Guangxi University of Chinese Medicine, Nanning 530200, China
| | - Zhiying Wei
- Guangxi University of Chinese Medicine, Nanning 530200, China; Guangxi Key Laboratory of Zhuang and Yao Ethnic Medicine, Nanning 530200, China
| | - Yaohua Li
- Guangxi University of Chinese Medicine, Nanning 530200, China; Guangxi Key Laboratory of Zhuang and Yao Ethnic Medicine, Nanning 530200, China; The Collaborative Innovation Center of Zhuang and Yao Ethnic Medicine, Nanning 530200, China; Guangxi Engineering Research Center of Ethnic Medicine Resources and Application, Nanning 530200, China.
| | - Xiaojiao Pan
- Guangxi University of Chinese Medicine, Nanning 530200, China; Guangxi Key Laboratory of Zhuang and Yao Ethnic Medicine, Nanning 530200, China; The Collaborative Innovation Center of Zhuang and Yao Ethnic Medicine, Nanning 530200, China; Guangxi Engineering Research Center of Ethnic Medicine Resources and Application, Nanning 530200, China.
| |
Collapse
|
|
6
|
Akbari F, Hadibarhaghtalab M, Parvar SY, Dehghani S, Namazi MR. Toward facial rejuvenation; A clinical trial to assess the efficacy of nano fat grafting on wrinkles. J Cosmet Dermatol 2024; 23:600-606. [PMID: 37822183 DOI: 10.1111/jocd.16004] [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: 05/01/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION With increasing age, patients' facial volume decrease. For this reason, nano fat grafting has recently gained popularity as adjunctive treatment to facial rejuvenation procedures. However, few quantitative studies have been conducted to investigate the impact of nano fat on facial wrinkles. AIMS In the present study, authors aim to investigate the therapeutic effect of intradermal injection of nano fat on fine facial wrinkles and assess their changes over 7 months of follow-up. METHODS In this randomized trial, 15 patients with fine facial wrinkles were enrolled. The fat was harvested from the abdomen and processed into nano fat. Nano fat was injected into the facial wrinkles intradermally with a needle of 27 gauge. The patients were evaluated before and 7 months postinjection utilizing Visio face 1000D (CK electronic, manufactured in Germany); and four parameters of wrinkles (area, volume, depth, and percent area) were evaluated before and after the nano fat injection. RESULTS Our evaluation with Visio face showed that nano fat injection was significantly reduced the volume, area, depth, and percent area of wrinkles after 7 months of follow-up without serious long-lasting adverse effects. Moreover, wrinkles with higher percent area, depth and volume loss show greater improvement after the treatment. Our results also indicate that males and females equally benefit from this treatment except for the percent area parameter that was improved more significantly in male patients. CONCLUSION Our study showed that intradermal injection of nano fat significantly decreases the volume, area, depth, and percent area of fine facial wrinkles. Further quantitative studies with control groups and larger sample sizes are required.
Collapse
Affiliation(s)
- Farzaneh Akbari
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student research committee, Shiraz University of medical sciences, Shiraz, Iran
| | - Sara Dehghani
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Namazi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
|
7
|
Strong AL, Rohrich RJ, Tonnard PL, Vargo JD, Cederna PS. Technical Precision with Autologous Fat Grafting for Facial Rejuvenation: A Review of the Evolving Science. Plast Reconstr Surg 2024; 153:360-377. [PMID: 37159906 DOI: 10.1097/prs.0000000000010643] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
SUMMARY The scientific study of facial aging has transformed modern facial rejuvenation. As people age, fat loss in specific fat compartments is a major contributor to structural aging of the face. Autologous fat grafting is safe, abundant, readily available, and completely biocompatible, which makes it the preferred soft-tissue filler in the correction of facial atrophy. The addition of volume through fat grafting gives an aging face a more youthful, healthy, and aesthetic appearance. Harvesting and preparation with different cannula sizes and filter-cartridge techniques have allowed for fat grafts to be divided based on parcel size and cell type into three major subtypes: macrofat, microfat, and nanofat. Macrofat and microfat have the benefit of providing volume to restore areas of facial deflation and atrophy in addition to improving skin quality; nanofat has been shown to improve skin texture and pigmentation. In this article, the authors discuss the current opinions regarding fat grafting and how the evolving science of fat grafting has led to the clinical utility of each type of fat to optimize facial rejuvenation. The opportunity exists to individualize the use of autologous fat grafting with the various subtypes of fat for the targeted correction of aging in different anatomic areas of the face. Fat grafting has become a powerful tool that has revolutionized facial rejuvenation, and developing precise, individualized plans for autologous fat grafting for each patient is an important advancement in the evolution of facial rejuvenation.
Collapse
Affiliation(s)
- Amy L Strong
- From the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan
| | - Rod J Rohrich
- Dallas Plastic Surgery Institute
- Baylor College of Medicine
| | | | - James D Vargo
- From the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan
| | - Paul S Cederna
- From the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan
| |
Collapse
|
|
8
|
Wang H, Liu Y, Li Y, Han F, Chen Q, Han J, Hu D. Autologous nanofat harvested from donor site of full-thickness skin or skin flap grafting for the treatment of early postburn scarring: a case series. Scars Burn Heal 2024; 10:20595131241230739. [PMID: 38385064 PMCID: PMC10880530 DOI: 10.1177/20595131241230739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Introduction Postburn scarring often presents a specific reconstructive challenge from both functional and cosmetic perspectives. The purpose of this study was to investigate whether autologous nanofat harvested from the donor site of full skin or a skin flap can be reused for the treatment of early postburn scaring. Methods From July 2018 to April 2022, patients with early postburn scarring underwent scar reconstruction surgery with full-thickness skin or a skin flap for a contour deformity and/or scar contracture, and autologous nanofat grafting was performed during the same operation. The Vancouver Scar Score (VSS) and the itch and pain scores were evaluated at the preoperation time point as well as at 2-3 weeks and 3-months postoperation. A comparison was made among the same patients at different time points. Results A total of 17 patients, aged from 18 months to 62 years old were included in this analysis. The VSS was reduced from 10.00 ± 2.12 to 7.41 ± 1.277 at the 2-3-week postoperation time point, and to 5.53 ± 1.37 at the 3-month postoperation time point. The pain and itch score were reduced from 4.65 ± 1.37 and 6.35 ± 1.27, to 3.70 ± 1.10 and 4.94 ± 1.30 at the 2-3-week postoperation time point, and to 3.00 ± 1.28 and 3.94 ± 0.97 at the 3-month postoperation time point respectively. The VSS and pain and itch scores showed a statistically significant reduction (P < 0.05) at the 2-3-week and 3-month postoperative follow-ups compared with the preoperation time point. Conclusion Autologous nanofat grafting from donor sites of full thickness skin or skin flap may be a promising treatment for an early postburn scaring as it promotes scar softening, improves itching and pain within the scar. However, this is a small case series with only 17 patients. Further conclusions need to be drawn through expanded samples for randomized controlled clinical trials. Lay Summary Hypertrophic scarring is the most common complication after partial thickness burn injury, and the complex pathogenesis and prolonged dynamic process render treatments only marginally effective. In the past few decades, with the technological advances of liposuction and fat grafting, nanofat grafting has been used in a variety of surgical fields, including wound healing, scleroderma, facial rejuvenation, and neuralgia. However, the role of nanofat grafting is not well documented in the prevention and treatment of early postburn scarring. Full-thickness skin grafting or skin flap transplantation is the most common method for the reconstruction of a hypertrophic scaring until now. In the current study, we harvested subcutaneous fat during the preparation of the full-thickness skin or skin flap, prepared nanofat and injected it in the scar located at a nonsurgical site. Comparison of the pre- and postoperation scores for scar color, scar thickness, scar stiffness, and scar regularity showed that the postoperation scores were decreased significantly and that there was a significant improvement in scar pigmentation and thickness as well astheaesthetic outcome after treatment. Most importantly, reductions in the scores for pain and itching could be assessed objectively. It seems that the nanofat grafting is a potential method for prevention and treatment for early postburn scaring.
Collapse
Affiliation(s)
- Hongtao Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an City, China
| | - Yang Liu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an City, China
| | - Yan Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an City, China
| | - Fu Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an City, China
| | - Qiaohua Chen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an City, China
| | - Juntao Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an City, China
| | - Dahai Hu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an City, China
| |
Collapse
|
|
9
|
Schipper JAM, van Laarhoven CJHCM, Schepers RH, Tuin AJ, Harmsen MC, Spijkervet FKL, Jansma J, van Dongen JA. Mechanical Fractionation of Adipose Tissue-A Scoping Review of Procedures to Obtain Stromal Vascular Fraction. Bioengineering (Basel) 2023; 10:1175. [PMID: 37892905 PMCID: PMC10604552 DOI: 10.3390/bioengineering10101175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Clinical indications for adipose tissue therapy are expanding towards a regenerative-based approach. Adipose-derived stromal vascular fraction consists of extracellular matrix and all nonadipocyte cells such as connective tissue cells including fibroblasts, adipose-derived stromal cells (ASCs) and vascular cells. Tissue stromal vascular fraction (tSVF) is obtained by mechanical fractionation, forcing adipose tissue through a device with one or more small hole(s) or cutting blades between syringes. The aim of this scoping review was to assess the efficacy of mechanical fractionation procedures to obtain tSVF. In addition, we provide an overview of the clinical, that is, therapeutic, efficacy of tSVF isolated by mechanical fraction on skin rejuvenation, wound healing and osteoarthritis. Procedures to obtain tissue stromal vascular fraction using mechanical fractionation and their associated validation data were included for comparison. For clinical outcome comparison, both animal and human studies that reported results after tSVF injection were included. We categorized mechanical fractionation procedures into filtration (n = 4), centrifugation (n = 8), both filtration and centrifugation (n = 3) and other methods (n = 3). In total, 1465 patients and 410 animals were described in the included clinical studies. tSVF seems to have a more positive clinical outcome in diseases with a high proinflammatory character such as osteoarthritis or (disturbed) wound healing, in comparison with skin rejuvenation of aging skin. Isolation of tSVF is obtained by disruption of adipocytes and therefore volume is reduced. Procedures consisting of centrifugation prior to mechanical fractionation seem to be most effective in volume reduction and thus isolation of tSVF. tSVF injection seems to be especially beneficial in clinical applications such as osteoarthritis or wound healing. Clinical application of tSVF appeared to be independent of the preparation procedure, which indicates that current methods are highly versatile.
Collapse
Affiliation(s)
- Jan Aart M. Schipper
- Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | | | - Rutger H. Schepers
- Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | - A. Jorien Tuin
- Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | - Marco C. Harmsen
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands
| | - Fred K. L. Spijkervet
- Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | - Johan Jansma
- Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | - Joris A. van Dongen
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht University, 3584 Utrecht, The Netherlands
| |
Collapse
|
|
10
|
Ichihashi M, Tanaka M, Iizuka T, Totsuka H, Tominaga E, Hitomi Y, Ando H, Nishikata T, Mizutani KI. A Single Intradermal Injection of Autologous Adipose-Tissue-Derived Stem Cells Rejuvenates Aged Skin and Sharpens Double Eyelids. J Pers Med 2023; 13:1162. [PMID: 37511775 PMCID: PMC10381540 DOI: 10.3390/jpm13071162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Facial skin aging is the most visible manifestation of aging in the body. In this study, we aimed to rejuvenate aging skin via a one-time intradermal injection of autologous adipose-derived stem cells (ADSCs). Eight patients were enrolled for study. Photographs of patients taken immediately before and 1, 3, 6, and 12 months after ADSC injections were comparatively evaluated for visible skin manifestations. ADSCs were cultured from the abdominal-skin-derived subcutaneous fat tissue, and 1 × 108 cultured ADSCs were injected intradermally into the facial skin. Cultured myoblasts were incubated with the supernatant derived from ADSCs, and the effect was evaluated via glucose consumption and lactic acid production in the medium. Eight cases showed the shallowing and disappearance of wrinkles, including those of the glabella, lower eyelids, crow`s feet, and forehead and nasolabial grooves, a month to several months after treatment. Double eyelids became prominent, and facial pores significantly reduced in size. These effects lasted for over one year. Myoblasts cultured in the presence of an ADSC-derived exosome were activated compared to that of ADSCs cultured without supernatant. The result supports the role of muscle in ADSC skin rejuvenation. The present study first reports that a single intradermal administration of cultured ADSCs rejuvenates aged facial skin over the course of one year. Further, patients exhibited definite double eyelids and pore shrinkage, strongly indicating the active involvement of muscle, which was supported by an in vitro study. Our study also suggested the important role of biological factors delivered from injected stem cells, although the detailed mechanism of rejuvenation effects of ADSC skin injection remains to be clarified.
Collapse
Affiliation(s)
- Masamitsu Ichihashi
- Kobe University, Kobe 657-8501, Japan
- Arts Ginza Clinic, Tokyo 105-0004, Japan
| | | | | | | | | | | | - Hideya Ando
- Department of Applied Chemistry and Biotechnology, Okayama University of Science, Okayama 700-0005, Japan
| | - Takahiro Nishikata
- Frontier of Innovative Research in Science and Technology, Konan University, Kobe 658-8501, Japan
| | - Ken-Ichi Mizutani
- Laboratory of Stem Cell Biology, Graduate School of Pharmaceutical Science, Kobe Gakuin University, Kobe 650-8586, Japan
| |
Collapse
|
|
11
|
Kelishadi S. Commentary on: Autologous Fat Grafting in Female Genital Area Improves Sexual Function by Increasing Collagenesis, Angiogenesis, and Estrogen Receptors. Aesthet Surg J 2023; 43:885-886. [PMID: 37082936 DOI: 10.1093/asj/sjad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023] Open
|
|
12
|
Lai YW, Wu SH, Chou PR, Lin C, Yeh JL, Lin TM, Chai CY, Hsieh MCW, Huang SH. Autologous Fat Grafting in Female Genital Area Improves Sexual Function by Increasing Collagenesis, Angiogenesis, and Estrogen Receptors. Aesthet Surg J 2023; 43:872-884. [PMID: 36849597 DOI: 10.1093/asj/sjad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Vulvovaginal laxity, atrophic vaginitis, and orgasmic dysfunction are not only aesthetic but also sexual problems. Autologous fat grafting (AFG) facilitates tissue rejuvenation through the effects of adipose-derived stem cells; the fat grafts serve as soft-tissue filler. However, few studies have reported the clinical outcomes of patients undergoing vulvovaginal AFG. OBJECTIVES The aim of this study was to describe a new technique, micro-autologous fat transplantation (MAFT), for AFG in the vulvovaginal area. Posttreatment histologic changes in the vaginal canal that imply improved sexual function were assessed. METHODS This retrospective study enrolled females who underwent vulvovaginal AFG performed through MAFT between June 2017 and 2020. Assessments were based on the Female Sexual Function Index (FSFI) questionnaire and on histologic and immunohistochemical staining. RESULTS In total, 20 female patients (mean age, 38.1 years) were included. On average, 21.9 mL of fat was injected into the vagina and 20.8 mL in the vulva and mons pubis area. Six months afterwards, the patients' mean total FSFI score (68.6) was significantly higher than that at baseline (43.8; P < .001). Histologic and immunohistochemical staining of vaginal tissues revealed substantially increased levels of neocollagenesis, neoangiogenesis, and estrogen receptors. By contrast, the level of protein gene product 9.5, which is associated with neuropathic pain, was considerably lower after AFG. CONCLUSIONS AFG performed through MAFT in the vulvovaginal area may help manage sexual function-related problems in females. In addition, this technique improves aesthetics, restores tissue volume, alleviates dyspareunia with lubrication, and reduces scar tissue pain.
Collapse
|
|
13
|
Grégoire S, Man PD, Maudet A, Le Tertre M, Hicham N, Changey F, Gaëlle BS, Tran C, Laurence V. Hyaluronic acid skin penetration evaluated by tape stripping using ELISA kit assay. J Pharm Biomed Anal 2023; 224:115205. [PMID: 36549259 DOI: 10.1016/j.jpba.2022.115205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/09/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
Hyaluronic Acid (HA) is an endogenous skin matrix component with moisturizing and anti-inflammatory and healing properties. Cosmetic formulations containing HA aim to enhance skin structure, hydrate skin and reduce wrinkles. Therefore, the skin diffusion of HA into stratum corneum after application of a formulation containing two different size of HA, High Molecular weight (HMW-HA) and Low Molecular Weight (LMW-HA)) was evaluated. Ex vivo human skin samples were used to validate an ELISA assay measuring HA in the stratum corneum (SC), viable epidermis and dermis, and to identify optimal washing and extraction methods. These methods were used to measure HA levels in the SC of subjects before and after daily topical application of an HA-containing formulation for 7 days. Samples of SC (5 tape strips) were taken before and 2 h after the application on D0, D1 and D7. The ELISA assay was suitable for measuring HA in the SC but not epidermal or dermal layers. The upper and lower limits of quantitation were the same for both sizes of HA (200 and 3.1 ng/ml, respectively). In both ex vivo human skin and human volunteers, the "dry method" of removing the formulation led to much higher levels of HA in the SC samples, whereas the "wet method" involving one cotton swab soaked with an aqueous solution containing 10% soap and a second cotton swab for drying, was effective in removing the formulation and more relevant to simulate washing/showering. In the clinical study, the amount of HA in SC layers 3-5 were used to represent the HA level in the SC, whereas layers 1 and 2 were considered as surface "residual film". After each application, there was a significantly higher amount of HA compared to the amount before application, which was observed using both wash methods. The residual level 24 h after the first application was at least 8 times higher than before the first application and at least 31 times higher after 7 applications. In conclusion, these investigations validated the use of the ELISA method for the measurement of HA in SC samples. The ex vivo experiments provided recommendations for the clinical study, including the preferred cleansing and optimal sampling methods. The clinical study demonstrated the diffusion, accumulation and maintenance of HA levels in the SC after repeated application of the formulation containing HMW-HA and LMW-HA.
Collapse
Affiliation(s)
- Sébastien Grégoire
- L'Oréal R&I, Advanced Research, 1 avenue Eugène Schueller, 93601 Aulnay-sous-Bois, France.
| | - Pham Dang Man
- L'Oréal R&I, 188 rue Paul-Hochart, 94550 Chevilly-Larue, France
| | - Aurelie Maudet
- L'Oréal R&I, 188 rue Paul-Hochart, 94550 Chevilly-Larue, France
| | | | - Nocairi Hicham
- L'Oréal R&I, Advanced Research, 1 avenue Eugène Schueller, 93601 Aulnay-sous-Bois, France
| | | | | | - Christian Tran
- L'Oréal R&I, Advanced Research, 1 avenue Eugène Schueller, 93601 Aulnay-sous-Bois, France
| | | |
Collapse
|
|
14
|
Mahmoodabadi RA, Golafshan HA, Pezeshkian F, Shahriarirad R, Namazi MR. Evaluation of the Effect of Platelet-Rich Fibrin Matrix in the Correction of Periorbital Wrinkles: An Experimental Clinical Trial. Dermatol Pract Concept 2023; 13:e2023050. [PMID: 36892335 PMCID: PMC9946120 DOI: 10.5826/dpc.1301a50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Skin rejuvenation techniques have gained substantial popularity due to increased life expectancy over recent years. Platelet-rich fibrin matrix (PRFM) is the new generation of platelet aggregate products that have surfaced in recent years to treat skin aging. OBJECTIVES We intend to use PRF to correct periorbital wrinkles in 15 volunteers and evaluate its effectiveness in this study. METHODS To evaluate the efficacy of PRFM intervention, eight men and women over the age of thirty entered our study. Blood samples were taken and were immediately centrifuged at 700rpm for 5 minutes. PRFM was extracted from the plasma and injected at the sub-dermis site in periorbital areas. The initial severity of periorbital wrinkles was determined by Visioface 1000D, and obtained data were delivered to the statistical unit for statistical analysis. Scoring and evaluation were based on tissue volume and depth and were measured before and twelve weeks after injection. Adverse effects were also taken into consideration. RESULTS The results demonstrated noticeable improvement in deep, fine, and small wrinkles, periocular hyperpigmentation, and overall skin freshness of the injection site. The subjects had swelling in the injection site for up to one day after the injection, which resolved without complications. CONCLUSIONS PRFM was observed to have potential in skin rejuvenation, demonstrating promising outcomes in terms of safety and long-term effects in improving skin condition.
Collapse
Affiliation(s)
| | | | | | - Reza Shahriarirad
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Namazi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
|
15
|
Aubry S, Collart-Dutilleul PY, Renaud M, Batifol D, Montal S, Pourreyron L, Carayon D. Benefit of Hyaluronic Acid to Treat Facial Aging in Completely Edentulous Patients. J Clin Med 2022; 11:5874. [PMID: 36233741 PMCID: PMC9570954 DOI: 10.3390/jcm11195874] [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: 07/26/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022] Open
Abstract
Hyaluronic acid (HA) is widely used in aesthetic medicine for its moisturizing and anti-aging action. This molecule, which is naturally present in the body, has an interesting response to aging, accentuated in totally edentulous patients. While its aesthetic benefits for facial rejuvenation are well-documented, there is a lack of description and investigation on its therapeutic usefulness for edentulous patients. The management of completely edentulous patients is a daily reality in dental practice and requires specific attention. The aesthetic and functional challenge is considerable. The displacement of the bone base, which is often marked, and lack of soft tissue support are sometimes difficult to correct with prosthetic reconstruction. This review aims to present the physiological processes appearing in completely edentulous patients and prosthetic solutions available to recreate oral functions and counteract facial aging. As prosthetic rehabilitations are not fully satisfying for counterbalancing the impression of excessive facial aging, we investigated the applications of HA injection in the perioral area, in order to improve edentulism treatment, and discussed the advantages and disadvantages, compared to other dermal fillers and rejuvenation therapies. Considering the specific situations of edentulous patients, dermal HA injections help to correct uncompensated bone losses and mucous volume losses and appear to be a therapeutically beneficial for treating completely edentulous patients, without the requirement to full rejuvenation therapy.
Collapse
Affiliation(s)
- Selene Aubry
- Centre de Soins, d’Enseignement et de Recherche Dentaires CSERD, Centre Hospitalier Universitaire de Montpellier, 34193 Montpellier, France
- Faculty of Dentistry, University of Montpellier, 34193 Montpellier, France
| | - Pierre-Yves Collart-Dutilleul
- Centre de Soins, d’Enseignement et de Recherche Dentaires CSERD, Centre Hospitalier Universitaire de Montpellier, 34193 Montpellier, France
- Faculty of Dentistry, University of Montpellier, 34193 Montpellier, France
- Laboratory Bioengineering Nanosciences LBN, University of Montpellier, 34193 Montpellier, France
| | - Matthieu Renaud
- Laboratory Bioengineering Nanosciences LBN, University of Montpellier, 34193 Montpellier, France
| | - Dominique Batifol
- Maxillo-Facial Surgery Department, Centre Hospitalier Universitaire de Montpellier, 34295 Montpellier, France
| | - Sylvie Montal
- Centre de Soins, d’Enseignement et de Recherche Dentaires CSERD, Centre Hospitalier Universitaire de Montpellier, 34193 Montpellier, France
- Faculty of Dentistry, University of Montpellier, 34193 Montpellier, France
| | - Laurence Pourreyron
- Centre de Soins, d’Enseignement et de Recherche Dentaires CSERD, Centre Hospitalier Universitaire de Montpellier, 34193 Montpellier, France
- Faculty of Dentistry, University of Montpellier, 34193 Montpellier, France
| | - Delphine Carayon
- Centre de Soins, d’Enseignement et de Recherche Dentaires CSERD, Centre Hospitalier Universitaire de Montpellier, 34193 Montpellier, France
- Faculty of Dentistry, University of Montpellier, 34193 Montpellier, France
- Laboratory Bioengineering Nanosciences LBN, University of Montpellier, 34193 Montpellier, France
| |
Collapse
|
|
16
|
Buzalaf MAR, Levy FM. Autologous platelet concentrates for facial rejuvenation. J Appl Oral Sci 2022; 30:e20220020. [PMID: 36074433 PMCID: PMC9444188 DOI: 10.1590/1678-7757-2022-0020] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/02/2022] [Indexed: 12/04/2022] Open
Abstract
Autologous platelet concentrates (APCs) are promising therapeutic agents in facial rejuvenation since they are a great source of cytokines, growth factors and other biologically active substances. Obtained from the patient’s blood, they have the advantages of reducing immunological reactions, making the procedure safer, well tolerated, with minimal adverse effects and lower cost. Currently, they are used for facial rejuvenation both in combination with microneedling and in mesotherapy techniques, as well as to treat facial acne scars, melasma and wounds after laser ablative treatments. This review summarizes current knowledge on the use of APCs, ranging from basic concepts related to their composition and mechanisms of action to up-to-date information on their clinical efficacy.
Collapse
Affiliation(s)
- Marília Afonso Rabelo Buzalaf
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Flávia Mauad Levy
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| |
Collapse
|
|
17
|
Ding P, Lu E, Li G, Sun Y, Yang W, Zhao Z. Research Progress on Preparation, Mechanism, and Clinical Application of Nanofat. J Burn Care Res 2022; 43:1140-1144. [PMID: 35015870 PMCID: PMC9435497 DOI: 10.1093/jbcr/irab250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Autologous adipose tissue is an ideal soft tissue filling material in theory, which has the advantages of easy access, comprehensive source, and high biocompatibility and is now widely used in clinical practice. Based on the above benefits of autologous fat, autologous fat grafting is an essential technique in plastic surgery. Conventional macrofat is used to improve structural changes after soft tissue damage or loss caused by various causes such as disease, trauma, or aging. Due to the large diameter of particles and to avoid serious complications such as fat embolism, blunt needles with larger diameters (2 mm) are required, making the macrofat grafting difficult to the deep dermis and subdermis. Nanofat grafting is a relatively new technology that has gained popularity in cosmetic surgery in recent years. Nanofat is produced by mechanical shuffling and filtration of microfat, which is harvested by liposuction. The harvesting and processing of nanofat are cost-effective as it does not require additional equipment or culture time. Unlike microfat, nanofat particles are too small to provide a notable volumizing effect. Studies have shown that nanofat contains abundant stromal vascular fraction cells and adipose-derived stem cells, which help reconstruct dermal support structures, such as collagen, and regenerate healthier, younger-looking skin. Moreover, the fluid consistency of nanofat allows application in tissue regeneration, such as scars, chronic wounds, and facial rejuvenation. This article reviews the current research progress on the preparation, mechanism, and clinical application of nanofat.
Collapse
Affiliation(s)
- Pengbing Ding
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Enhang Lu
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Guan Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Yidan Sun
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Wenhui Yang
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Zhenmin Zhao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| |
Collapse
|
|
18
|
Protein profiling of mechanically processed lipoaspirates: discovering wound healing and anti-fibrotic biomarkers in nanofat. Plast Reconstr Surg 2022; 150:341e-354e. [PMID: 35666150 DOI: 10.1097/prs.0000000000009345] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Nanofat is an injectable oily emulsion, rich in adipose derived stem cells (ADSCs) and growth factors. It is prepared from lipoaspirates through mechanical emulsification and filtration. Despite being successfully used in several procedures in regenerative medicine such as scar attenuation, skin rejuvenation and treatment of chronic wounds, little is known about exactly how nanofat induces regeneration in treated skin at the molecular level. METHODS Microfat and nanofat samples were isolated from 18 healthy patients. Proteomic profiling was performed through untargeted mass spectrometry proteomics and multiplex antibody arrays. Pathway enrichment analysis of differentially expressed proteins between microfat and nanofat was performed using Gene Ontology, Reactome and KEGG as reference databases. RESULTS Untargeted proteomics showed that upregulated genes in nanofat are involved in innate immunity responses, coagulation and wound healing, while downregulated genes were linked to cellular migration and extracellular matrix (ECM) production. Secretome array screening of microfat and nanofat samples showed no significantly different expression, which strongly suggests that the mechanical emulsification step does not affect the concentration of tissue regeneration biomarkers. The identified proteins are involved in wound healing, cellular migration, extracellular matrix remodelling, angiogenesis, stress response and immune response. CONCLUSIONS Mechanical processing of lipoaspirates into nanofat significantly influences the proteome profile by enhancing inflammation, antimicrobial and wound healing pathways. Nanofat is extremely rich in tissue repair and tissue remodelling factors. CLINICAL RELEVANCE STATEMENT This study shows that the effects of Micro- and Nanofat treatment are based on upregulated inflammation, antimicrobial and wound healing pathways. Mechanical emulsification does not alter the concentration of tissue regeneration biomarkers.
Collapse
|
|
19
|
Hung MJ, Tsai CP, Ying TH, Chen GD, Su HL, Tseng CJ. Improved symptoms and signs of refractory interstitial cystitis in women after intravesical Nanofat plus platelet-rich plasma grafting: A pilot study. J Chin Med Assoc 2022; 85:730-735. [PMID: 35507021 DOI: 10.1097/jcma.0000000000000735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by bladder pain accompanied by irritative urinary symptoms, and typical cystoscopic and histological features. In this pilot study, we assessed the impact of lesion-targeted bladder injection therapy using a biocellular regenerative medicine on patients with refractory IC/BPS. The medicine, which was an autologous emulsified fat (Nanofat) and platelet-rich plasma (PRP) combination, was prepared intraoperatively. Six patients (aged 40-54 years), who completed a standard protocol of four consecutive treatments at 3-month intervals, were followed up at 6 months postoperatively. All patients (100%) reported marked (+3; +3 ~ -3) improvement of their overall bladder conditions. Mean bladder pain (from 8.2 to 1.7; range: 0 ~ 10), IC-related symptoms (from 18.5 to 5.7; range: 0 ~ 20), and bother (from 14.8 to 3.8; range: 0 ~ 16) improved significantly (p < 0.01). The normalization of bladder mucosal morphology with treatments was remarkable under cystoscopic examination, and no significant adverse events were found. The cultured mesenchymal stem cells from Nanofat samples of the six patients were verified in vitro. Our preliminary results suggest novel intravesical therapy with autologous Nanofat plus PRP grafting is safe and effective for refractory IC/BPS. Surgical efficacy might be attributed to an in vivo tissue engineering process.
Collapse
Affiliation(s)
- Man-Jung Hung
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC
- Department of Obstetrics and Gynecology, School of Medicine, Colleague of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| | - Ching-Pei Tsai
- Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Tsung-Ho Ying
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC
- Department of Obstetrics and Gynecology, School of Medicine, Colleague of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| | - Gin-Den Chen
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC
- Department of Obstetrics and Gynecology, School of Medicine, Colleague of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| | - Hong-Lin Su
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Chih-Jen Tseng
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC
- Department of Obstetrics and Gynecology, School of Medicine, Colleague of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| |
Collapse
|
|
20
|
Che D, Zhou Y, Wang J, Liu Y, Gao F, Lv T, Cui C, Xiao Z. Experimental study on the influence of different aperture connectors on nanofat. J Plast Reconstr Aesthet Surg 2022; 75:3595-3602. [PMID: 35672247 DOI: 10.1016/j.bjps.2022.04.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 03/12/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Nanofat, as a derivative of adipose tissue, has gradually become a research hotspot in beauty and regenerative medicine. However, the nanofat preparation method has not yet been standardized; it remains unknown whether the aperture of the connector has any influence on the transplantation effect. METHODS Adipose tissue was mechanically emulsified into nanofat tissue through different connector apertures (1.0, 1.5, and 2.0 mm). Cell survival and apoptosis were measured using the volume of oil droplets, glucose transportation test, flow cytometry, cell counting kit-8 (CCK-8), wound healing assay, transwell migration assay, and fluorescence staining. The expression of adiponectin, GluT4, and PPAR-γ in nanofat-derived stem cells (NFSCs) was detected using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS The fineness of nanofat tissue texture decreased with an increase in the aperture connector. The amounts of glucose transferred in the three groups (1, 1.5, and 2 mm) were 4.7 ± 0.894, 6.1 ± 1.026, and 6.9 ± 0.868 mmol/L, respectively. Flow cytometric analysis showed that the proportion of NFSCs in the 2.0 mm group was the highest (91.267±1.210%). Cell proliferation and migration abilities were stronger in the 1.5 and 2.0 mm groups. The numbers of late apoptotic and dead cells in the 2.0 mm group were significantly fewer than those in the two other groups. Expression levels of lipid-related genes were as follows: adiponectin > GluT4 > PPAR-γ in each component. CONCLUSIONS As nanofat is emulsified, the use of larger aperture connectors (2.0 mm) appeared to decrease the degree of adipocyte lysis and increase the biological activity of adipose tissue.
Collapse
Affiliation(s)
- Dehui Che
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Yongting Zhou
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Jie Wang
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Ying Liu
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Feng Gao
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Tianqi Lv
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Chenyang Cui
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Zhibo Xiao
- Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China.
| |
Collapse
|
|
21
|
Mourad SI, Al-Dubai SA, Elsayed SA, El-Zehary RR. Efficacy of platelet-rich fibrin and tacrolimus on facial nerve regeneration: an animal study. Int J Oral Maxillofac Surg 2022; 51:279-287. [PMID: 34090756 DOI: 10.1016/j.ijom.2021.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/16/2021] [Accepted: 05/20/2021] [Indexed: 01/16/2023]
Abstract
This study was performed to investigate the effect of platelet-rich fibrin membrane (PRFM), alone and with topical tacrolimus application, on regeneration of the crushed facial nerve (FN). Thirty healthy 7-week-old albino rats were used. The left FN was damaged by crushing in all rats. Three random groups of rats were formed: group 1, untreated; group 2, treated with PRFM; group 3, treated with PRFM plus topical tacrolimus. Functional recovery and histological and immunohistochemical evaluations were performed 4 and 8 weeks later. Anti-S100 was used to detect myelin sheath. At 4 weeks, blinking reflex recovery was more rapid in group 3 than in groups 2 and 1 (4.30 ± 0.48, 3.40 ± 0.52, and 2.20 ± 0.42, respectively); the difference was statistically significant (P = 0.001). Histologically, group 3 showed more apparent normal FN structures than the other groups. Immunohistochemical caspase-3 evaluation of the axon area revealed a significant difference between group 2 (PRFM alone; 8.67 ± 0.029) and group 3 (PRFM plus topical tacrolimus; 4.42 ± 0.028) (P = 0.001). Group 3 showed the greatest positive staining in the myelin sheath. Based on the results of this animal study, clinical studies should be performed to determine whether the combination of PRF and tacrolimus also improves the outcome of nerve regeneration in humans.
Collapse
Affiliation(s)
- S I Mourad
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - S A Al-Dubai
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - S A Elsayed
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt.
| | - R R El-Zehary
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| |
Collapse
|
|
22
|
Tripathy S, VinayKumar D, Mohsina S, Sharma R, Bhatia A. Histological analysis of the effect of nanofat grafting in scar rejuvenation. J Cutan Aesthet Surg 2022; 15:147-153. [PMID: 35965912 PMCID: PMC9364463 DOI: 10.4103/jcas.jcas_106_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: Aims: Materials and Methods: Results: Conclusion:
Collapse
|
|
23
|
Semsarzadeh N, Khetarpal S. Rise of stem cell therapies in aesthetics. Clin Dermatol 2022; 40:49-56. [DOI: 10.1016/j.clindermatol.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
|
24
|
Atiyeh B, Ghieh F, Oneisi A. Nanofat Cell-Mediated Anti-Aging Therapy: Evidence-Based Analysis of Efficacy and an Update of Stem Cell Facelift. Aesthetic Plast Surg 2021; 45:2939-2947. [PMID: 34085105 DOI: 10.1007/s00266-021-02353-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/09/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Fat grafting has been extensively applied as natural filler and has been very promising in restoring volume loss. Lipografting has also been credited to reduce age-related skin changes due to the regenerative potential of adipose derived stem cells. Cell-mediated therapies in plastic surgery are rapidly evolving with growing applications. Nanofat, a bio-regenerative liquid suspension rich in stromal vascular fraction cells without viable adipocytes, has been described as an efficient cutaneous anti-aging therapy. We have published in 2013 a review entitled "stem cell facelift: between reality and fiction." Available clinical evidence at that time did not substantiate marketing and promotional claims of "stem cell facelift". The same year, the report about nanofat was published demonstrating striking clinical outcome. The current literature search is aimed at reviewing any evidence that has emerged since then regarding clinical efficacy of this modality. METHODS A thorough PICO tool-based comprehensive literature search of PubMed database for "the efficacy of nanofat cell-mediated anti-aging therapy" was conducted with a time frame from 2013 till present. RESULTS Despite apparent increasing popularity of stem cell rejuvenation, well-controlled clinical studies about this modality are surprisingly very scarce. Only seven papers published after 2013 were identified and were included in this review CONCLUSION: Though considered to be a safe procedure, and despite documented histologic improvement and striking clinical outcome in some reports, available evidence can hardly support clinical improvement of skin quality. Before cell-mediated aesthetic rejuvenation applications can be routinely undertaken, more robust evidence with well-defined primary outcome end points and objective outcome measures is required. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Bishara Atiyeh
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Ghieh
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmad Oneisi
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
| |
Collapse
|
|
25
|
|
|
26
|
Jeyaraman M, Muthu S, Sharma S, Ganta C, Ranjan R, Jha SK. Nanofat: A therapeutic paradigm in regenerative medicine. World J Stem Cells 2021; 13:1733-1746. [PMID: 34909120 PMCID: PMC8641019 DOI: 10.4252/wjsc.v13.i11.1733] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/15/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Adipose tissue is a compact and well-organized tissue containing a heterogeneous cellular population of progenitor cells, including mesenchymal stromal cells. Due to its availability and accessibility, adipose tissue is considered a "stem cell depot." Adipose tissue products possess anti-inflammatory, anti-fibrotic, anti-apoptotic, and immunomodulatory effects. Nanofat, being a compact bundle of stem cells with regenerative and tissue remodeling potential, has potential in translational and regenerative medicine. Considering the wide range of applicability of its reconstructive and regenerative potential, the applications of nanofat can be used in various disciplines. Nanofat behaves on the line of adipose tissue-derived mesenchymal stromal cells. At the site of injury, these stromal cells initiate a site-specific reparative response comprised of remodeling of the extracellular matrix, enhanced and sustained angiogenesis, and immune system modulation. These properties of stromal cells provide a platform for the usage of regenerative medicine principles in curbing various diseases. Details about nanofat, including various preparation methods, characterization, delivery methods, evidence on practical applications, and ethical concerns are included in this review. However, appropriate guidelines and preparation protocols for its optimal use in a wide range of clinical applications have yet to be standardized.
Collapse
Affiliation(s)
- Madhan Jeyaraman
- Department of Biotechnology, School of Engineering and Technology, Sharda University , Greater Noida 201306, Uttar Pradesh, India
| | - Sathish Muthu
- Department of Biotechnology, School of Engineering and Technology, Sharda University , Greater Noida 201306, Uttar Pradesh, India
| | - Shilpa Sharma
- Indian Stem Cell Study Group, Lucknow 226010, Uttar Pradesh, India
| | - Charan Ganta
- Indian Stem Cell Study Group, Lucknow 226010, Uttar Pradesh, India
| | - Rajni Ranjan
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida 201306, Uttar Pradesh, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University , Greater Noida 201306, Uttar Pradesh, India
| |
Collapse
|
|
27
|
Laidding SR, Josh F, Battung S, Bukhari A, Warsinggih, Patellongi IJ, Massi MN, Islam AA, Dososaputro I, Faruk M. Combination of platelet rich plasma and stromal vascular fraction on the level of vascular endothelial growth factor in rat subjects experiencing deep dermal burn injury. Ann Med Surg (Lond) 2021; 64:102254. [PMID: 33898027 PMCID: PMC8053889 DOI: 10.1016/j.amsu.2021.102254] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023] Open
Abstract
Background The healing process of burns includes coagulation, inflammation, and remodeling. Vascular endothelial growth factor (VEGF) is involved throughout this healing process. Stem cells from the platelet-rich plasma (PRP) with stromal vascular fraction (SVF) can increase concentrations of growth factors, including VEGF. This is expected to accelerate burn healing. The aim of this study was to determine the effect of a combination of PRP and SVF on VEGF levels in a rats model of deep dermal burn wound healing. Materials and methods This is an experimental research study in rats using a post-test control group design with 4 groups: A) control, B) Vaseline, C) topical PRP and SVF, and D) PRP and SVF injection. Burn wounds were induced according to the modified Guo method. Results In a rats model of deep dermal wound healing, topical Vaseline significantly increased serum VEGF compared to control. Topical application and injection of stem cells also significantly increased serum VEGF compared to control and Vaseline. The VEGF concentration was significantly higher following injection of PRP and SVF, suggesting that the injection route is more effective at increasing VEGF levels compared to the topical application of stem cells. Conclusion The combination of PRP and SVF, either by injection or topical application, can increase VEGF levels during the healing process from deep dermal burns.
Stem cells can increase concentrations of growth factors. Topical application and injection of stem cells significantly increased serum VEGF compared to control. The VEGF concentration was significantly higher following injection of PRP and SVFs. The injection route of stem cells is more effective at increasing VEGF levels compared to the topical application.
Collapse
Affiliation(s)
- Sachraswaty Rachman Laidding
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Fonny Josh
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Sartian Battung
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Agussalim Bukhari
- Department of Clinical Nutrition, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Warsinggih
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Ilham Jaya Patellongi
- Department of Biostatistics, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Muh Nassrum Massi
- Departement of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Andi Asadul Islam
- Department of Neurosurgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Iswinarno Dososaputro
- Department of Plastic and Reconstructive Surgery, Airlangga University, Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Muhammad Faruk
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| |
Collapse
|
|
28
|
Liang Z, Huang D, Nong W, Mo J, Zhu D, Wang M, Chen M, Wei C, Li H. Advanced-platelet-rich fibrin extract promotes adipogenic and osteogenic differentiation of human adipose-derived stem cells in a dose-dependent manner in vitro. Tissue Cell 2021; 71:101506. [PMID: 33607525 DOI: 10.1016/j.tice.2021.101506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 01/01/2023]
Abstract
Advanced platelet-rich fibrin (A-PRF) is an autogenous biological material obtained from peripheral blood. A-PRF extract (A-PRFe) contains a high concentration of various cytokines that are increasingly appreciated for their roles in improving stem cell repairing function during tissue regeneration. However, the optimal A-PRFe concentration to stimulate stem cells is unknown. This study aimed to identify the optimal concentrations of A-PRFe to promote adipogenic and osteogenic differentiation of human adipose-derived stem cells (ASCs). We produced A-PRFe from A-PRF clots by centrifuging fresh peripheral blood samples and isolated and identified ASCs using surface CD markers and multilineage differentiation potential. Enzyme-linked immunosorbent assay (ELISA) showed the concentrations of several cytokines, including b-FGF, PDGF-BB, and others, increased gradually, peaked on day 7 and then decreased. Cell proliferation assays showed A-PRFe significantly stimulated ASC proliferation, and proliferation significantly increased at higher A-PRFe doses. The degree of adipogenic and osteogenic differentiation increased at higher A-PRFe concentrations in the culture medium, as determined by oil red O and alizarin red staining. Reverse transcription polymerase chain reaction (RT-PCR) showed that expression levels of genes related to adipogenic/osteogenic differentiation (PPARγ2, C/EBPα, FABP4, Adiponectin, and ALP, OPN, OCN, RUNX2), paracrine (HIF-1α, VEGF, IGF-2) and immunoregulation (HSP70, IL-8) function were higher in groups with a higher concentration of A-PRFe than in lower concentration groups. This study demonstrates that A-PRFe is ideal for use in ASC applications in regenerative medicine because it improves biological functions, including proliferation, adipogenic/osteogenic differentiation, and paracrine function in a dose-dependent manner.
Collapse
Affiliation(s)
- Zhijie Liang
- Department of Wound Repair Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China; Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Donglin Huang
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China
| | - Wenhai Nong
- Department of Orthopaedics, the People's Hospital of Binyang County, Binyang, Guangxi, China
| | - Jinping Mo
- Department of Orthopaedics, the People's Hospital of Binyang County, Binyang, Guangxi, China
| | - Dandan Zhu
- Department of Wound Repair Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China
| | - Mengxin Wang
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Maojian Chen
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Changyuan Wei
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Hongmian Li
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China.
| |
Collapse
|
|
29
|
Copcu HE, Oztan S. Not Stromal Vascular Fraction (SVF) or Nanofat, but Total Stromal-Cells (TOST): A New Definition. Systemic Review of Mechanical Stromal-Cell Extraction Techniques. Tissue Eng Regen Med 2021; 18:25-36. [PMID: 33231864 PMCID: PMC7862455 DOI: 10.1007/s13770-020-00313-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/04/2020] [Accepted: 10/19/2020] [Indexed: 12/25/2022] Open
Abstract
The most important and greatest source in the body for regenerative cells is fat tissue. Obtaining regenerative cells from adipose tissue can be done in two ways: Enzymatic and mechanical. The regenerative cell cocktail obtained by the enzymatic method, including stem cells, is called Stromal vascular fracture (SVF). In the literature, there is no clear definition of regenerative cells obtained by mechanical method. We systematically searched the techniques and definitions for stromal cells obtained from adipose tissue by scanning different databases. To evaluate the mechanical stromal-cell isolation techniques and end products from adipose tissue. Systematic review of English and non-English articles using Embase, PubMed, Web of Science and Google scholar databases. Search terms included Nanofat, fragmented fat, mechanical stromal / stem cell, mechanical SVF, SVF gel. We screened all peer-reviewed articles related with mechanical stromal-cell isolation. Author performed a literature query with the aforementioned key words and databases. A total of 276 publications containing the keywords we searched were reached. In these publications, there are 46 different definitions used to obtain mechanical stromal cells. The term SVF is only suitable for enzymatic methods. A different definition is required for mechanical. The most used term nanofat is also not suitable because the product is not in both "fat" and in "nanoscale". We think that the term total stromal-cells would be the most appropriate definition since both extracellular matrix and all stromal cells are protected in mechanical methods.
Collapse
Affiliation(s)
- H. Eray Copcu
- Plastic and Reconstructive Surgery, MEST Medical Services, Cumhuriyet Bulv. No:161/A,1,2 Alsancak, Izmir, Turkey
| | - Sule Oztan
- Plastic and Reconstructive Surgery, MEST Medical Services, Cumhuriyet Bulv. No:161/A,1,2 Alsancak, Izmir, Turkey
| |
Collapse
|
|
30
|
Ghiasloo M, Lobato RC, Díaz JM, Singh K, Verpaele A, Tonnard P. Expanding Clinical Indications of Mechanically Isolated Stromal Vascular Fraction: A Systematic Review. Aesthet Surg J 2020; 40:NP546-NP560. [PMID: 32358957 DOI: 10.1093/asj/sjaa111] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mechanically isolated stromal vascular fraction (tSVF, tissue SVF) is a potent regenerative solution, increasingly used as a therapeutic modality for a variety of pathologies. With recent evidence conclusively favoring mechanical isolation over enzymatic alternatives, the therapeutic share and indications of tSVF are expected to grow even further. OBJECTIVES The aim of this study was to provide a systematic review of all studies reporting on the use of tSVF. METHODS A systematic search was undertaken of the Embase, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials databases. Outcome measures included clinical indications, such as recipient area, adverse events, clinical results recipient area, method of application, follow-up duration and evaluation methods. RESULTS Of the total of 4505 articles identified, 186 full-texts were screened. Thirty-four studies, reporting on 1443 patients were included. tSVF-based therapy was observed for 10 different pathologies, including aged skin (8 studies), scars (5), wounds (6), osteoarthritis (6), tendinopathy (2), temporomandibular joint disorders (1), androgenic alopecia (1), perianal fistula (3), migraine (1), and vocal fold scarring (1). Across all studies, tSVF-based therapy resulted in favorable clinical results. Overall, 50 (3.43%) minor and one (0.07%) major adverse events were observed, mainly related to the liposuction procedure. CONCLUSIONS tSVF offers a safe, easy and legal treatment modality for a range of indications. Future research is indicated to identify the optimal isolation protocol, dose and timing. In addition, basic research remains crucial to identify the mechanism of action of SVF within different pathologies. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Mohammad Ghiasloo
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium
| | | | | | - Kashika Singh
- Department of General and Visceral Surgery, Evangelical Hospital Bethel, Bielefeld, Germany
| | | | | |
Collapse
|
|
31
|
Reply: The Effects of Facial Lipografting on Skin Quality: A Systematic Review. Plast Reconstr Surg 2020; 146:93e-94e. [PMID: 32590670 DOI: 10.1097/prs.0000000000006942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
|
32
|
Cohen SR, Goodacre AK, Womack H, Delaunay F, Wood D, Wesson T, Tiryaki T. Topical Nanofat Biocrème Improves Aesthetic Outcomes of Nonablative Fractionated Laser Treatment: A Preliminary Report. Aesthet Surg J 2020; 40:892-899. [PMID: 31504170 DOI: 10.1093/asj/sjz240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Improvements in skin erythema and elasticity have been observed with topical application of platelet-rich plasma after fractional laser (FXD) treatment. Injections of nanofat via small needles into the dermis improves tissue thickness, discoloration and wrinkle depth. OBJECTIVES The aim of this study was to evaluate improvements in skin following a nonablative FXD treatment combined with the application of a novel topical nanofat biocrème, called neo-U. METHODS Fifty patients were treated with a nonablative FXD followed by application of a topical nanofat biocrème. Harvested fat was processed into nanofat, which was compounded with a transdermal liposomal delivery vector to produce a topical biocrème. In 2 patients, postauricular skin punch biopsies were performed before and after treatment and examined for histologic changes. Photographs of a historical group treated with only the FXD were compared with photographs of patients treated with a combination of topical nanofat biocrème and FXD. Skin types were evaluated for improvements in nasolabial folds, wrinkles, and skin texture. RESULTS Findings from postauricular skin biopsies show the skin exposed to FXD with nanofat biocrème had more elastin fibers and a slight increase in the thickness of the epidermis. Patients treated with FXD plus nanofat biocrème had a statistically significant improvement in the degree of wrinkles, nasolabial fold depth, and texture compared with historical controls. CONCLUSIONS Transdermal delivery of nanofat topical biocrème applied after FXD treatment can serve as a delivery system to improve fine lines, nasolabial fold depth, and overall texture of the tissue to a greater degree than laser resurfacing alone.
Collapse
Affiliation(s)
- Steven R Cohen
- Division of Plastic Surgery, University of California, San Diego, San Diego, CA
| | | | | | - Flore Delaunay
- Division of Plastic Surgery, Le Belvedere Hospital, Mont Saint Aignan, France
| | | | | | | |
Collapse
|
|
33
|
Xu Y, Deng M, Cai Y, Zheng H, Wang X, Yu Z, Zhang W, Li W. Cell-Free Fat Extract Increases Dermal Thickness by Enhancing Angiogenesis and Extracellular Matrix Production in Nude Mice. Aesthet Surg J 2020; 40:904-913. [PMID: 31679030 DOI: 10.1093/asj/sjz306] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although adipose-derived stem cells (ADSCs) and nanofat exert antiaging effects on skin, they contain cellular components that have certain limitations in clinical practice. Cell-free fat extract (Ceffe) is a fraction purified from nanofat through removal of cellular components and lipid remnants that contains various growth factors. OBJECTIVES The purpose of this study was to evaluate the effects of Ceffe on cultured human dermal fibroblasts in vitro and on the dermis of nude mice in vivo. METHODS In the in vitro study, human dermal fibroblasts were cultured with Ceffe for 72 hours, followed by flow cytometry measurement of cell proliferation and cell cycle. In the in vivo study, different concentrations of Ceffe were injected into the dorsal skin of nude mice for 4 weeks. The thickness of the dermis; proliferation of cells; density of the capillary; and expressions of type I and III collagen (Col-1 and Col-3), matrix metalloproteinase-1, matrix metalloproteinase-3, tissue inhibitor of metalloproteinase-1, and tissue inhibitor of metalloproteinase-3 were measured through histologic and Western blot analyses. RESULTS Ceffe significantly increased cell proliferation in cultured dermal fibroblasts. In the mouse skin, Ceffe significantly increased the thickness of the dermis, number of proliferating cells, density of the capillary, and expressions of Col-1 and Col-3. CONCLUSIONS Ceffe increased the dermal thickness of nude mice, possibly by enhancing angiogenesis and extracellular matrix production, and can therefore be used for skin rejuvenation.
Collapse
Affiliation(s)
- Yuda Xu
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mingwu Deng
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yizuo Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hongjie Zheng
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiangsheng Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ziyou Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjie Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
|
34
|
The Effects of Facial Lipografting on Skin Quality: A Systematic Review. Plast Reconstr Surg 2020; 146:92e-93e. [PMID: 32590669 DOI: 10.1097/prs.0000000000006941] [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]
|
|
35
|
Kamat P, Frueh FS, McLuckie M, Sanchez-Macedo N, Wolint P, Lindenblatt N, Plock JA, Calcagni M, Buschmann J. Adipose tissue and the vascularization of biomaterials: Stem cells, microvascular fragments and nanofat-a review. Cytotherapy 2020; 22:400-411. [PMID: 32507607 DOI: 10.1016/j.jcyt.2020.03.433] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/27/2020] [Accepted: 03/12/2020] [Indexed: 12/13/2022]
Abstract
Tissue defects in the human body after trauma and injury require precise reconstruction to regain function. Hence, there is a great demand for clinically translatable approaches with materials that are both biocompatible and biodegradable. They should also be able to adequately integrate within the tissue through sufficient vascularization. Adipose tissue is abundant and easily accessible. It is a valuable tissue source in regenerative medicine and tissue engineering, especially with regard to its angiogenic potential. Derivatives of adipose tissue, such as microfat, nanofat, microvascular fragments, stromal vascular fraction and stem cells, are commonly used in research, but also clinically to enhance the vascularization of implants and grafts at defect sites. In plastic surgery, adipose tissue is harvested via liposuction and can be manipulated in three ways (macro-, micro- and nanofat) in the operating room, depending on its ultimate use. Whereas macro- and microfat are used as a filling material for soft tissue injuries, nanofat is an injectable viscous extract that primarily induces tissue remodeling because it is rich in growth factors and stem cells. In contrast to microfat that adds volume to a defect site, nanofat has the potential to be easily combined with scaffold materials due to its liquid and homogenous consistency and is particularly attractive for blood vessel formation. The same is true for microvascular fragments that are easily isolated from adipose tissue through collagenase digestion. In preclinical animal models, it has been convincingly shown that these vascular fragments inosculate with host vessels and subsequently accelerate scaffold perfusion and host tissue integration. Adipose tissue is also an ideal source of stem cells. It yields larger quantities of cells than any other source and is easier to access for both the patient and doctor compared with other sources such as bone marrow. They are often used for tissue regeneration in combination with biomaterials. Adipose-derived stem cells can be applied unmodified or as single cell suspensions. However, certain pretreatments, such as cultivation under hypoxic conditions or three-dimensional spheroids production, may provide substantial benefit with regard to subsequent vascularization in vivo due to induced growth factor production. In this narrative review, derivatives of adipose tissue and the vascularization of biomaterials are addressed in a comprehensive approach, including several sizes of derivatives, such as whole fat flaps for soft tissue engineering, nanofat or stem cells, their secretome and exosomes. Taken together, it can be concluded that adipose tissue and its fractions down to the molecular level promote, enhance and support vascularization of biomaterials. Therefore, there is a high potential of the individual fat component to be used in regenerative medicine.
Collapse
Affiliation(s)
- Pranitha Kamat
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, University of Zurich, Zurich, Switzerland
| | - Florian S Frueh
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Michelle McLuckie
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nadia Sanchez-Macedo
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Petra Wolint
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nicole Lindenblatt
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Jan A Plock
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, University of Zurich, Zurich, Switzerland
| | - Maurizio Calcagni
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Johanna Buschmann
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
| |
Collapse
|
|
36
|
Abstract
Several reports have been published wherein intradermal filling with nanofat has been used for skin rejuvenation, texture improvement and scar treatment. A study was conducted between August 2017 and August 2018 which included 20 female patients having wrinkles, hyperpigmentation, erythema, and enlarged pores. Lidocaine cream, local infiltration with lidocaine or sedation was used in accordance with the patient’s convenience. Nanofat was injected intradermally in all the facial regions. All patients filled a questionnaire at sixth month post treatment which consisted of questions regarding pain, bumps area and resolution, grade of improvement of skin (wrinkles, smoothness, wrinkles, pores and redness), recovery of donor area, time to reincorporate to normal routine, nanofat-time efficacy and recommendation of the treatment. Patients undergoing it with sedation had less bruising and pain. Lateral thigh as the donor area had less pain in the recovery period. The residual bumps persisted for more time in non-mobile areas while average time to disappear was 3.6 weeks. Patients started to notice the change after nanofat injections at about 1.12 months later. The improvement was noticed for smoothness of skin (100% patients), wrinkles (40% patients), pore size reduction (15% patients), improvement in redness (10% patients). The effect of nanofat was felt by patients for an average time of 3.85 months. All the patients were satisfied and recommended it. No major complications were reported. Nanofat treatment is safe and it conveys beneficial effects on skin rejuvenation as per the post-operative skin texture changes and the satisfaction of patients.
Collapse
|
|
37
|
Abstract
BACKGROUND Autologous lipografting for improvement of facial skin quality was first described by Coleman in 2006. The current dogma dictates that adipose tissue-derived stromal cells that reside in the stromal vascular fraction of lipograft contribute to skin rejuvenation (e.g., increased skin elasticity), a more homogenous skin color, and softening of skin texture. Nowadays, many studies have been reported on this "skin rejuvenation" effect of autologous fat grafting. This systematic review was undertaken to assess the efficacy of autologous lipografting on skin quality. METHODS The MEDLINE, Embase, Cochrane Central, Web of Science, and Google Scholar databases were searched for studies evaluating the effect of autologous lipografting on facial skin quality (May 11, 2018). Outcomes of interest were skin texture, color, and elasticity in addition to histologic outcomes and number of complications. RESULTS Nine studies were included, with 301 patients treated in total. No meta-analysis could be performed because of heterogeneity of the metrics and outcomes. Eight studies reported increased skin elasticity; improvement in skin texture; and a more homogeneous skin color after treatment with lipografting, cellular stromal vascular fraction, or nanofat. One study reported no increased skin elasticity after lipografting. Histologic improvement was seen after lipografting and adipose tissue-derived stromal cell injections. However, in general, the level of evidence of the included studies was low. No serious complications were reported. CONCLUSION Autologous facial lipografting and cellular stromal vascular fraction and adipose tissue-derived stromal cell injections hardly seem to improve facial skin quality but can be considered a safe procedure.
Collapse
|
|
38
|
Nasirzade J, Kargarpour Z, Hasannia S, Strauss FJ, Gruber R. Platelet-rich fibrin elicits an anti-inflammatory response in macrophages in vitro. J Periodontol 2020; 91:244-252. [PMID: 31376159 PMCID: PMC7065136 DOI: 10.1002/jper.19-0216] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) serves as a reservoir of bioactive molecules to support wound healing and bone regeneration. The beneficial action of PRF might involve macrophage polarization from proinflammatory M1 toward pro-resolving M2 phenotypes. This study aims to evaluate the effect of PRF on macrophage polarization. METHODS Murine primary macrophages and RAW 264.7 cells were exposed to saliva and lipopolysaccharides (LPS) with and without PRF lysates obtained by repeated freeze-thawing or the secretome of PRF membranes, termed PRF conditioned medium. The expression of the M1 marker genes interleukin 1β (IL1β) and interleukin 6 (IL6) along with the M2 markers arginase-1 and chitinase-like 3 (Chil3 or YM1) were evaluated by real time polymerase chain reaction. Immunoassay and immunofluorescence staining were performed for IL6 and p65 translocation, a subunit nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB), respectively. RESULTS We report here that PRF lysates and PRF conditioned medium, the latter containing the secretome, greatly decreased the proinflammatory response of primary macrophages and RAW 264.7 cells as indicated by the expression of IL1β and IL6. The anti-inflammatory activity of PRF lysates was further confirmed by IL6 immunoassay. Moreover, PRF lysates suppressed the translocation of p65 from the cytoplasm into the nucleus after incubation with saliva. In support of M2 polarization, PRF lysates and PRF conditioned medium enhanced the expression of arginase-1 and YM1 in primary macrophages. CONCLUSION Our results indicate that PRF holds an anti-inflammatory activity and shifts the macrophage polarization from an M1 toward an M2 phenotype.
Collapse
Affiliation(s)
- Jila Nasirzade
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of BiochemistryFaculty of Biological SciencesTarbiat Modares UniversityTehranIran
| | - Zahra Kargarpour
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of BiochemistryFaculty of Biological SciencesTarbiat Modares UniversityTehranIran
| | - Sadegh Hasannia
- Department of BiochemistryFaculty of Biological SciencesTarbiat Modares UniversityTehranIran
| | - Franz Josef Strauss
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of Conservative DentistrySchool of DentistryUniversity of ChileSantiagoChile
| | - Reinhard Gruber
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of PeriodontologySchool of Dental MedicineUniversity of BernBernSwitzerland
| |
Collapse
|
|
39
|
Subcutaneous Injections of Nanofat Adipose-derived Stem Cell Grafting in Facial Rejuvenation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2550. [PMID: 32095390 PMCID: PMC7015601 DOI: 10.1097/gox.0000000000002550] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/04/2019] [Indexed: 12/11/2022]
Abstract
We aimed to assess whether our novel Nanofat grafting procedure improves skin quality while yielding a regenerative effect and whether this novel technique can also achieve a lifting effect. Methods Patients who requested nonsurgical facial rejuvenation were enrolled between June 2018 and December 2018. Fat was aspirated from the medial thigh, inner part of the knee, or lower abdomen regions. Following aspiration and flushing, microfat was obtained after washing with saline. This microfat was emulsified to obtain a Nanofat suspension, which was injected using a 25-G cannula into the subcutaneous layer at different facial sites. Images were obtained before and at 1, 3, and 6 months after facial rejuvenation. Patients were also administered a survey. Characterization of the isolated stromal vascular fraction (3 patients), and before/after biopsies were performed. Results Fifty patients were included (2 men and 48 women; mean age, 35-65 years; mean follow-up, 9 months). The clinical results were apparent between 2 and 4 weeks after injection, and improvements were continuously observed until 6 months postoperatively. All patients confirmed an improvement in skin quality. A lifting effect was also observed. The data confirm that the Nanofat procedure does not damage cells, maintaining cell viability, and number of adipose-derived stem cells. Biopsies showed an increased dermal cellularity, vascular density, and elastic and collagen fiber density. Conclusion Facial rejuvenation with subcutaneous Nanofat injections appears to be an effective method, representing a skin rejuvenation effect by modifying the pattern of the dermis, although additional studies are necessary.
Collapse
|
|
40
|
Strauss FJ, Nasirzade J, Kargarpoor Z, Stähli A, Gruber R. Effect of platelet-rich fibrin on cell proliferation, migration, differentiation, inflammation, and osteoclastogenesis: a systematic review of in vitro studies. Clin Oral Investig 2019; 24:569-584. [PMID: 31879804 PMCID: PMC6988133 DOI: 10.1007/s00784-019-03156-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/13/2019] [Indexed: 12/15/2022]
Abstract
Objective To systematically assess the effects of platelet-rich fibrin (PRF) on in vitro cellular behavior. Methods A systematic electronic search using MEDLINE database was performed. In vitro studies using PRF were considered and articles published up to June 31, 2018 were screened. Eligible studies were selected based on the use of human PRF. Results In total, 1746 titles were identified with the search terms, from these 37 met the inclusion criteria and were chosen for data extraction. In addition, 16 new studies, mainly published in 2019, were also included in the analysis resulting in 53 studies. No meta-analysis could be performed due to the heterogeneity of study designs. Included studies show that PRF enhances proliferation, migration, adhesion, and osteogenic differentiation on a variety of cell types along with cell signaling activation. Furthermore, PRF reduces inflammation, suppresses osteoclastogenesis, and increases the expression of various growth factors in mesenchymal cells. Summary and conclusions Despite some notable differences of the studies, the overall findings suggest a positive effect of PRF on cell proliferation, migration, adhesion, differentiation, and inflammation pointing towards a therapeutic potential in regenerative dentistry. Clinical relevance PRF serves as a reservoir of bioactive molecules to support wound healing and bone regeneration. Although the cellular mechanisms by which PRF supports the clinical outcomes remain unclear, in vitro research provides possible explanations. This systematic review aims to provide an update of the existing research on how PRF affects basic physiological processes in vitro. The overall findings suggest that PRF induces cell proliferation, migration, adhesion, and differentiation along with possessing anti-inflammatory properties further supporting its therapeutic potential in wound healing and bone regeneration.
Collapse
Affiliation(s)
- Franz-Josef Strauss
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.,Department of Conservative Dentistry, School of Dentistry, Universidad de Chile, Av. Sergio Livingstone, 943, Santiago, Chile
| | - Jila Nasirzade
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Zahra Kargarpoor
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Alexandra Stähli
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.,Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria. .,Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. .,Austrian Cluster for Tissue Regeneration, Donaueschingenstrasse 13, 1200, Vienna, Austria.
| |
Collapse
|
|
41
|
Emulsified Fat Grafting Accelerates Tissue Expansion: An Experimental Study in a Rat Model. Ann Plast Surg 2019; 85:61-67. [PMID: 31855863 DOI: 10.1097/sap.0000000000002137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Tissue expansion has been applied in tissue repair and reconstruction of large soft tissue defects. Stromal vascular fraction (SVF) transplantation is a promising treatment in raising expansion efficiency. However, the clinical utilization of SVF is limited because of its conventional collagenase-based production. The aim of this study was to evaluate the effect of emulsified fat (EF), SVF obtained by using mechanical method, on accelerating tissue expansion. MATERIALS AND METHODS The microstructure of EF fragments and the proportion of mesenchymal stem cells (MSCs; CD45-/CD34+) in EF were detected. Wistar rats were divided into the following 3 groups randomly: the 1-mL EF group, the 0.5-mL EF group, and the control group. The tissue expansion was carried out twice a week to maintain the capsule pressure at 60 mm Hg. After 4 weeks, inflation volume and histological changes, which includes collagen content, cell proliferation, and capillary density, were observed to evaluate the effect of EF on tissue expansion. RESULTS Mechanical emulsification effectively destroyed the mature adipocytes in adipose tissue. The proportion of MSCs population in the EF fragments was 12.40 ± 0.86%. After expansion, the inflation volume and the levels of collagen deposition, cell proliferation, and capillary density of the expanded tissue in the 1-mL EF group were significantly higher than that in the 0.5-mL EF group and the control group (P < 0.05). However, all these regenerative indicators in the 0.5-mL EF group showed no statistical difference from the control group (P > 0.05). The thickness of epidermal and dermal layers showed no significant difference among the 3 groups (P > 0.05). CONCLUSIONS Our findings suggested that EF grafting can be used as a new alternative to increase tissue expansion efficiency.
Collapse
|
|
42
|
Pourang A, Rockwell H, Karimi K. New Frontiers in Skin Rejuvenation, Including Stem Cells and Autologous Therapies. Facial Plast Surg Clin North Am 2019; 28:101-117. [PMID: 31779934 DOI: 10.1016/j.fsc.2019.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
One of the greatest challenges in the progression of aesthetic medicine lies in providing treatments with long-term results that are also minimally invasive and safe. Keeping up with this demand are developments in autologous therapies such as adipose-derived stem cells, stromal vascular fraction, microfat, nanofat, and platelet therapies, which are being shown to deliver satisfactory results. Innovations in more traditional cosmetic therapies, such as botulinum toxin, fillers, and thread lifts, are even more at the forefront of the advancement in aesthetics. Combining autologous therapies with traditional noninvasive methods can ultimately provide patients with more effective rejuvenation options.
Collapse
Affiliation(s)
- Aunna Pourang
- Department of Dermatology, University of California, Davis, 3301 C Street, Suite 1400, Sacramento, CA 95816, USA
| | - Helena Rockwell
- University of California, San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Kian Karimi
- Rejuva Medical Aesthetics, 11645 Wilshire Boulevard #605, Los Angeles, CA 90025, USA.
| |
Collapse
|
|
43
|
Cai Y, Yu Z, Yu Q, Zheng H, Xu Y, Deng M, Wang X, Zhang L, Zhang W, Li W. Fat Extract Improves Random Pattern Skin Flap Survival in a Rat Model. Aesthet Surg J 2019; 39:NP504-NP514. [PMID: 31001623 DOI: 10.1093/asj/sjz112] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adipose tissue and its derivatives, including adipose-derived stem cells, stromal vascular fraction (SVF), and SVF-gel, have been utilized in the treatment of many ischemic disorders. However, the utilization of these products is limited in clinical applications by concerns related to the presence of cells in these derivatives. OBJECTIVES This study aimed to isolate a cell-free fat extract (FE) from fat tissue and to evaluate its proangiogenic ability in vitro as well as its protective effects on skin flap survival in vivo. METHODS FE was isolated from human fat via a mechanical approach. The concentrations of several growth factors in the FE were determined by enzyme-linked immunosorbent assay. The proangiogenic ability of FE was evaluated utilizing assays of the proliferation, migration, and tube formation in human umbilical vein endothelial cells in vitro. The protective effects of FE on the survival of random pattern skin flaps were investigated by subcutaneous injection into rats. RESULTS Enzyme-linked immunosorbent assay results revealed that FE contained proangiogenic growth factors that promoted proliferation, migration, and tube formation in human umbilical vein endothelial cells in vitro. In addition, FE reduced skin flap necrosis and increased survival, as demonstrated by macroscopic measurements and blood flow analysis. Histological analysis revealed that FE treatment increased the capillary density. CONCLUSIONS FE is a cell-free, easy-to-prepare, and growth-factor-enriched liquid derived from human adipose tissue that possesses proangiogenic activity and improves skin flap survival by accelerating blood vessel formation. FE may be potentially used for treating ischemic disorders.
Collapse
Affiliation(s)
- Yizuo Cai
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Ziyou Yu
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Qian Yu
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Hongjie Zheng
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Yuda Xu
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Mingwu Deng
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Xiangsheng Wang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Lu Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Wenjie Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| | - Wei Li
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, China
| |
Collapse
|
|
44
|
Chi H, Song X, Song C, Zhao W, Chen G, Jiang A, Wang X, Yu T, Zheng L, Yan J. Chitosan-Gelatin Scaffolds Incorporating Decellularized Platelet-Rich Fibrin Promote Bone Regeneration. ACS Biomater Sci Eng 2019; 5:5305-5315. [DOI: 10.1021/acsbiomaterials.9b00788] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Hui Chi
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150001, Heilongjiang, China
| | | | - Chengchao Song
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150001, Heilongjiang, China
| | | | - Guanghua Chen
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150001, Heilongjiang, China
| | - Anlong Jiang
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150001, Heilongjiang, China
| | - Xiaoyan Wang
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150001, Heilongjiang, China
| | - Tailong Yu
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150001, Heilongjiang, China
| | | | | |
Collapse
|
|
45
|
Protective Effect of Fat Extract on UVB-Induced Photoaging In Vitro and In Vivo. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6146942. [PMID: 31531185 PMCID: PMC6720842 DOI: 10.1155/2019/6146942] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 07/20/2019] [Indexed: 12/19/2022]
Abstract
Background Nanofat can protect against ultraviolet B- (UVB-) induced damage in nude mice. Fat extract (FE) is a cell-free fraction isolated from nanofat that is enriched with a variety of growth factors. Objective To determine whether FE can protect against UVB-induced photoaging in cultured dermal fibroblasts and in nude mice. Method For the in vitro study, human dermal skin fibroblasts were pretreated with FE 24 h prior to UVB irradiation. Generation of reactive oxygen species (ROS) was analyzed immediately following irradiation, while cell cycle analysis was performed 24 h after UVB irradiation. Senescence-associated β-galactosidase (SA-β-gal) expression, cell proliferation, and expression of glutathione peroxidase 1 (GPX-1), catalase, superoxide dismutase-1 (SOD-1), SOD-2, and collagen type 1 (COL-1) were investigated 72 h after UVB irradiation. For the in vivo study, the dorsal skin of nude mice was irradiated with UVB and mice were then treated with FE for 8 weeks. The thickness of the dermis, capillary density, and apoptotic cells in skin tissue sections were investigated after treatment. The expression of GPX-1, catalase, SOD-2, SOD-1, and COL-1 in the tissue was also measured. Result FE significantly increased cell proliferation and protected cells against UVB-induced cell death and cell cycle arrest. FE reduced ROS and the number of aged cells induced by UVB irradiation. FE promoted the expression of COL-1 and GPX-1 in cultured dermal fibroblasts. FE treatment of UVB-irradiated skin increased dermal thickness and capillary density, decreased the number of apoptotic cells, and promoted the expression of COL-1 and GPX-1. Conclusion FE protects human dermal fibroblasts and the skin of nude mice from UVB-induced photoaging through its antioxidant, antiapoptotic, and proangiogenic activities.
Collapse
|
|
46
|
Injectable Tissue Replacement and Regeneration: Anatomic Fat Grafting to Restore Decayed Facial Tissues. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2293. [PMID: 31592023 PMCID: PMC6756675 DOI: 10.1097/gox.0000000000002293] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/16/2019] [Indexed: 01/08/2023]
Abstract
Aging is a dynamic process that can be modeled and understood tissue by tissue and cell by cell. Numerous authors have helped us understand the anatomy of facial fat compartments and the effects of aging on our facial tissues such as skin, fat, bone and fibrous ligaments. Injectable tissue replacement and regeneration (ITR2) is a method to replace decayed tissues of the face using “like tissues” in an effort to delay or slow the rate of tissue decay seen in facial aging. Facial topography and proportion analysis are performed to diagnose individual-specific losses of facial fat. The degree of sun damage and skin thinning is noted as is the degree of loss in the superficial fat compartment. Deep compartment fat loss is evaluated as is pyriform aperture, orbital, mandibular ramus, mandibular body, and chin resorption. From this analysis, a detailed treatment plan is formulated. Using a mechanical device, 3 different fat grafts are created: 2 mm (millifat), 1 mm (microfat), and 500 microns (cell optimized, matrix rich nanofat); anatomic replacement of all areas of tissue loss is carried out. Millifat is used for deep compartment and bone losses, microfat for superficial fat losses above the facial musculature and nanofat is used intradermally and as a biological cream for topical application. The rationale behind this standardized approach is explained and the scientific foundations for the idea are presented. Reduction in tissue decay appears to be a valid observation, but awaits others confirmation.
Collapse
|
|
47
|
Abstract
Fat grafting was first described in the early 20th century but for many years remained a relatively underused technique due to the unreliability of long-term volume expansion. Significant improvements in reliability have been made in the last 2 decades and there is a large body of literature pertaining to extraction, processing and injection methods to obtain more lasting effects. However, volume loss and graft resorption remain a major challenge in the long term and lead to unpredictability in results. Enriching adipose graft with stromal vascular fraction, ex vivo cultured adipose stem cells and platelet-derived growth factor among others is one method under active investigation which may assist graft survival through a range of mechanisms including increased angiogenesis. Breaking adipose graft into smaller fragments such that engrafted cells have greater access to donor-site oxygenation and nutrition is another method which in theory may promote survival. Presently, adipose grafting in the face is usually for the addition of volume to fill defects. However, the stem-cell containing fraction of adipose grafting (stromal vascular fraction) appears to exert a rejuvenating effect on overlying skin and soft tissue when administered alone. The application of these low-volume injections represents a significant shift in thinking away from mere volume expansion. These techniques have been tested in a range of animal models and some human studies. In this review, the authors provide a broad overview of present research and highlight both limitations in previous research and current areas of investigation.
Collapse
|
|
48
|
Grünherz L, Sanchez-Macedo N, Frueh FS, McLuckie M, Lindenblatt N. Nanofat applications: from clinical esthetics to regenerative research. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2019. [DOI: 10.1016/j.cobme.2019.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
|
49
|
Chen L, Wang ZC, Ma JJ, Sun WJ, Wang SW, Gu ZC, Yang X. Autologous nanofat transplantation accelerates foot wound healing in diabetic rats. Regen Med 2019; 14:231-241. [PMID: 30810491 DOI: 10.2217/rme-2018-0169] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: This study explored the effects of local transplantation of autologous nanofat in the treatment of rats with diabetic foot wounds. Materials & methods: Nanofat was transplanted into the left foot wound of diabetic rats. Phosphate-buffered saline injection in the right served as control. We measured wound size, the extent of epithelization, microvessel density and the expression levels of cytokines at six different time-points postoperation. Results: Compared with the control feet, nanofat-treated feet had significantly smaller wound areas at 7 and 9 days after grafting and showed better re-epithelialization, a greater number of microvessels and higher levels of angiogenic factor expression. Conclusion: This research shows that autologous nanofat transplantation can promote diabetic foot wound healing in rats.
Collapse
Affiliation(s)
- Li Chen
- Department of Plastic & Reconstructive Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hang Zhou 310016, PR China
| | - Zheng-Cai Wang
- Department of Plastic & Reconstructive Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hang Zhou 310016, PR China
| | - Jing-Jing Ma
- Department of Plastic & Reconstructive Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hang Zhou 310016, PR China
| | - Wen-Jia Sun
- Department of Plastic & Reconstructive Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hang Zhou 310016, PR China
| | - Shao-Wen Wang
- Department of General Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hang Zhou 310016, PR China
| | - Zi-Chun Gu
- Department of Plastic & Reconstructive Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hang Zhou 310016, PR China
| | - Xuan Yang
- Department of Plastic & Reconstructive Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hang Zhou 310016, PR China
| |
Collapse
|