São Paulo, Brazil From the Division of Plastic and Reconstructive Surgery, University of São Paulo School of Medicine; and the Human Genome Research Center, Institute of Biosciences, University of São Paulo.
Plast Reconstr Surg. 2013 Jul;132(1):141-152. doi: 10.1097/PRS.0b013e3182910a82.
Although first reports of the clinical use of adipose-derived stromal cells suggest that this approach may be feasible and effective for soft-tissue augmentation, there is a lack of randomized, controlled clinical trials in the literature. Thus, this study aimed to investigate whether a faster protocol for isolation of adipose-derived stromal cells and their use in combination with fat tissue improve the long-term retention of the grafts in patients with craniofacial microsomia.
Patients with craniofacial microsomia (n = 14) were grafted either with supplementation of adipose-derived stromal cells (experimental group) or without supplementation of adipose-derived stromal cells (control group). The number of viable cells isolated before and after the supplementation of the grafts was calculated, and these cells were examined for mesenchymal cell surface markers using flow cytometry. Computed tomography was performed to assess both hemifaces preoperatively and at 6 months postoperatively.
The average number of viable cells isolated before and after the supplementation of the grafts was 5.6 × 10 and 9.9 × 10 cells/ml of fat tissue (p = 0.015). Flow cytometric analysis revealed that the adipose-derived stromal cells were positive for mesenchymal cell markers (>95 percent for CD73 and CD105). Surviving fat volume at 6 months was 88 percent for the experimental group and 54 percent for the control group (p = 0.003).
These results suggest that this strategy for isolation and supplementation of adipose-derived stromal cells is effective, safe, and superior to conventional lipoinjection for facial recontouring in patients with craniofacial microsomia.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
虽然脂肪来源的基质细胞临床应用的最初报告表明，这种方法对于软组织填充可能是可行和有效的，但文献中缺乏随机对照临床试验。因此，本研究旨在探讨脂肪来源的基质细胞的更快分离方案及其与脂肪组织联合使用是否能提高面裂畸形患者移植物的长期存活率。
面裂畸形患者（n = 14）接受脂肪来源的基质细胞补充（实验组）或不补充脂肪来源的基质细胞（对照组）移植。计算移植前和移植后分离的活细胞数量，并使用流式细胞术检查这些细胞的间充质细胞表面标志物。在术前和术后 6 个月进行计算机断层扫描评估。
移植前和移植后活细胞的平均分离数量分别为 5.6×10 和 9.9×10 个细胞/ml 脂肪组织（p = 0.015）。流式细胞术分析显示脂肪来源的基质细胞对间充质细胞标志物呈阳性（>95%为 CD73 和 CD105）。实验组 6 个月时存活脂肪体积为 88%，对照组为 54%（p = 0.003）。
这些结果表明，这种分离和补充脂肪来源的基质细胞的策略是有效、安全的，优于传统的脂肪注射对面裂畸形患者的面部重塑。
临床问题/证据水平：治疗，II 级。
