Willemsen Joep C N, Spiekman Maroesjka, Stevens H P Jeroen, van der Lei Berend, Harmsen Martin C
Groningen, The Hague, and Heerenveen, The Netherlands From the Departments of Pathology and Medical Biology and Plastic Surgery, University of Groningen, University Medical Centre Groningen; and Bergman Clinics.
Plast Reconstr Surg. 2016 Mar;137(3):554e-565e. doi: 10.1097/01.prs.0000479995.04255.bb.
Lipofilling is a treatment modality to restore tissue volume. Both platelet-rich plasma and adipose-derived stromal cells have been reported to augment the efficacy of lipofilling, yet results are not conclusive. The authors hypothesized that the variation reported in literature is caused by a dose-dependent influence of platelet-rich plasma on adipose-derived stromal cells.
Whole blood (n = 3) was used to generate platelet-rich plasma, which was diluted with Dulbecco's Modified Eagle Medium to 15%, 5%, and 1.7%, with 15% platelet-poor plasma and 10% fetal calf serum as controls. Pooled adipose-derived stromal cells (n = 3) were cultured in these media. Gene expression was assessed, along with angiogenic sprouting of endothelial cells by conditioned medium and platelet-rich plasma.
platelet-rich plasma in culture medium affected the expression of genes in a dose-dependent manner. The 15% concentration stimulated proliferation almost eightfold. Mesenchymal markers were unaffected. Interestingly, expression of collagens type 1 and 3 increased at lower concentrations, whereas transforming growth factor-β showed reduced expression in lower concentrations. Proangiogenic gene expression was unaltered or strongly reduced in a dose-dependent manner. platelet-rich plasma promoted endothelial sprouting and survival in a dose-dependent manner; however, conditioned medium from adipose-derived stromal cells exposed to platelet-rich plasma blocked endothelial sprouting capabilities.
The dose-dependent influence of platelet-rich plasma on the therapeutic capacity of adipose-derived stromal cells conditioned medium in vitro warrants caution in clinical trials.
脂肪填充是一种恢复组织体积的治疗方式。据报道，富含血小板血浆和脂肪来源的基质细胞均可增强脂肪填充的效果，但结果尚无定论。作者推测，文献中报道的差异是由富含血小板血浆对脂肪来源基质细胞的剂量依赖性影响所致。
使用全血（n = 3）制备富含血小板血浆，将其用杜氏改良伊格尔培养基分别稀释至15%、5%和1.7%，以15%的贫血小板血浆和10%的胎牛血清作为对照。将汇集的脂肪来源基质细胞（n = 3）在这些培养基中培养。评估基因表达，并通过条件培养基和富含血小板血浆检测内皮细胞的血管生成芽生情况。
培养基中的富含血小板血浆以剂量依赖性方式影响基因表达。15%的浓度刺激增殖近8倍。间充质标志物未受影响。有趣的是，1型和3型胶原蛋白的表达在较低浓度时增加，而转化生长因子-β在较低浓度时表达降低。促血管生成基因表达未改变或呈剂量依赖性强烈降低。富含血小板血浆以剂量依赖性方式促进内皮细胞芽生和存活；然而，暴露于富含血小板血浆的脂肪来源基质细胞的条件培养基会阻断内皮细胞的芽生能力。
富含血小板血浆对脂肪来源基质细胞条件培养基体外治疗能力的剂量依赖性影响，在临床试验中值得谨慎对待。
