Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Jul 26, 2020; 12(7): 585-603
Published online Jul 26, 2020. doi: 10.4252/wjsc.v12.i7.585
Decellularized adipose matrix provides an inductive microenvironment for stem cells in tissue regeneration
Ji-Zhong Yang, Li-Hong Qiu, Shao-Heng Xiong, Juan-Li Dang, Xiang-Ke Rong, Meng-Meng Hou, Kai Wang, Zhou Yu, Cheng-Gang Yi
Ji-Zhong Yang, Li-Hong Qiu, Shao-Heng Xiong, Juan-Li Dang, Xiang-Ke Rong, Meng-Meng Hou, Kai Wang, Zhou Yu, Cheng-Gang Yi, Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
Author contributions: Yang JZ and Yi CG contributed to the conception and design of the review; Yang JZ, Qiu LH, Xiong SH, Dang JL, Rong XK, Hou MM, Wang K, and Yu Z performed the research; Yang JZ, Qiu LH, and Xiong SH collected the data; Yang JZ contributed to the writing of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Cheng-Gang Yi, MD, PhD, Professor, Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, No. 15, Changle West Road, Xi'an 710032, Shaanxi Province, China.
Received: December 31, 2019
Peer-review started: December 31, 2019
First decision: April 2, 2020
Revised: May 27, 2020
Accepted: May 29, 2020
Article in press: May 29, 2020
Published online: July 26, 2020

Stem cells play a key role in tissue regeneration due to their self-renewal and multidirectional differentiation, which are continuously regulated by signals from the extracellular matrix (ECM) microenvironment. Therefore, the unique biological and physical characteristics of the ECM are important determinants of stem cell behavior. Although the acellular ECM of specific tissues and organs (such as the skin, heart, cartilage, and lung) can mimic the natural microenvironment required for stem cell differentiation, the lack of donor sources restricts their development. With the rapid development of adipose tissue engineering, decellularized adipose matrix (DAM) has attracted much attention due to its wide range of sources and good regeneration capacity. Protocols for DAM preparation involve various physical, chemical, and biological methods. Different combinations of these methods may have different impacts on the structure and composition of DAM, which in turn interfere with the growth and differentiation of stem cells. This is a narrative review about DAM. We summarize the methods for decellularizing and sterilizing adipose tissue, and the impact of these methods on the biological and physical properties of DAM. In addition, we also analyze the application of different forms of DAM with or without stem cells in tissue regeneration (such as adipose tissue), repair (such as wounds, cartilage, bone, and nerves), in vitro bionic systems, clinical trials, and other disease research.

Keywords: Extracellular matrix, Decellularized adipose matrix, Decellularized adipose tissue, Adipose-derived extracellular matrix, Adipose tissue extracellular matrix, Adipose matrix, Stem cells, Soft tissue regeneration, Decellularization methods

Core tip: Decellularized adipose matrix (DAM) is widely used in soft tissue regeneration because it has unique biological and physical properties and can provide a natural microenvironment for the growth and differentiation of stem cells. There have been many studies on DAM, and our objective is to comprehensively describe the preparation, characterization and application of DAM from the perspective of stem cells. We also describe the problems that still need to be solved in DAM research and possible future developments.