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使用新鲜分离的自体脂肪组织基质血管成分联合磷酸钙陶瓷进行骨再生

Bone Regeneration Using the Freshly Isolated Autologous Stromal Vascular Fraction of Adipose Tissue in Combination With Calcium Phosphate Ceramics.

作者信息

Prins Henk-Jan, Schulten Engelbert A J M, Ten Bruggenkate Christiaan M, Klein-Nulend Jenneke, Helder Marco N

机构信息

Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands Department of Oral and Maxillofacial Surgery, MOVE Research Institute Amsterdam, VU University Medical Center/ACTA, Amsterdam, The Netherlands.

Department of Oral and Maxillofacial Surgery, MOVE Research Institute Amsterdam, VU University Medical Center/ACTA, Amsterdam, The Netherlands.

出版信息

Stem Cells Transl Med. 2016 Oct;5(10):1362-1374. doi: 10.5966/sctm.2015-0369. Epub 2016 Jul 7.


DOI:10.5966/sctm.2015-0369
PMID:27388241
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5031181/
Abstract

UNLABELLED: : In patients undergoing maxillary sinus floor elevation (MSFE) for dental implant placement, bone substitutes are currently evaluated as alternatives for autologous bone. However, bone substitutes have only osteoconductive properties and lack osteoinductive potential. Therefore, this phase I study evaluated the potential additive effect on bone regeneration by the addition of freshly isolated, autologous but heterologous stromal vascular fraction (SVF), which is highly enriched with adipose stromal/stem cells when compared with native adipose tissue. From 10 patients, SVF was procured using automatic processing, seeded on either β-tricalcium phosphate (n = 5) or biphasic calcium phosphate carriers (n = 5), and used for MSFE in a one-step surgical procedure. Primary objectives were feasibility and safety. The secondary objective was efficacy, evaluated by using biopsies of the augmented area taken 6 months postoperatively, concomitant with dental implant placement. Biopsies were assessed for bone, graft, and osteoid volumes. No adverse effects were reported during the procedure or follow-up (≥3 years). Bone and osteoid percentages were higher in study biopsies (SVF supplemented) than in control biopsies (ceramic only on contralateral side), in particular in β-tricalcium phosphate-treated patients. Paired analysis on the six bilaterally treated patients revealed markedly higher bone and osteoid volumes using microcomputed tomography or histomorphometric evaluations, demonstrating an additive effect of SVF supplementation, independent of the bone substitute. This study demonstrated for the first time the feasibility, safety, and potential efficacy of SVF seeded on bone substitutes for MSFE, providing the first step toward a novel treatment concept that might offer broad potential for SVF-based regenerative medicine applications. SIGNIFICANCE: This is the first-in-human study using freshly isolated, autologous adipose stem cell preparations (the stromal vascular fraction [SVF] of adipose tissue) applied in a one-step surgical procedure with calcium phosphate ceramics (CaP) to increase maxillary bone height for dental implantations. All 10 patients received CaP plus SVF on one side, whereas bilaterally treated patients (6 of 10) received CaP only on the opposite side. This allowed intrapatient evaluation of the potential added value of SVF supplementation, assessed in biopsies obtained after 6 months. Feasibility, safety, and potential efficacy of SVF for bone regeneration were demonstrated, showing high potential for this novel concept.

摘要

未标注:在接受上颌窦底提升术(MSFE)以植入牙种植体的患者中,目前正在评估骨替代物作为自体骨替代品的可行性。然而,骨替代物仅具有骨传导特性,缺乏骨诱导潜能。因此,这项I期研究评估了添加新鲜分离的自体但异源的基质血管成分(SVF)对骨再生的潜在附加作用,与天然脂肪组织相比,SVF富含脂肪基质/干细胞。从10名患者中,通过自动处理获取SVF,将其接种在β-磷酸三钙(n = 5)或双相磷酸钙载体(n = 5)上,并在一步手术中用于MSFE。主要目标是可行性和安全性。次要目标是疗效,通过术后6个月在植入牙种植体时对增大区域进行活检来评估。对活检样本的骨、移植物和类骨质体积进行评估。在手术过程或随访(≥3年)期间未报告不良反应。研究活检样本(补充SVF)中的骨和类骨质百分比高于对照活检样本(仅对侧使用陶瓷),特别是在β-磷酸三钙治疗的患者中。对6名双侧治疗患者的配对分析显示,使用微型计算机断层扫描或组织形态计量学评估,骨和类骨质体积明显更高,证明补充SVF具有附加作用,与骨替代物无关。这项研究首次证明了接种在骨替代物上的SVF用于MSFE的可行性、安全性和潜在疗效,为一种新的治疗概念迈出了第一步,该概念可能为基于SVF的再生医学应用提供广阔前景。 意义:这是第一项在人体中使用新鲜分离的自体脂肪干细胞制剂(脂肪组织的基质血管成分[SVF])的研究,该制剂在一步手术中与磷酸钙陶瓷(CaP)一起应用,以增加上颌骨高度用于牙种植。所有10名患者一侧接受CaP加SVF,而双侧治疗患者(10名中的6名)另一侧仅接受CaP。这允许在患者体内评估补充SVF的潜在附加值,在6个月后获得的活检样本中进行评估。证明了SVF用于骨再生的可行性、安全性和潜在疗效,显示了这一新概念的巨大潜力。

相似文献

[1]
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[3]
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[5]
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[6]
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[7]
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引用本文的文献

[1]
Preclinical Evaluation and Advancements in Vascularized Bone Tissue Engineering.

Biomimetics (Basel). 2025-6-20

[2]
New bone formation of biphasic calcium phosphate bone substitute material: a systematic review and network meta-analysis of randomized controlled trials (RCTs).

Int J Implant Dent. 2025-7-15

[3]
Engineered stromal vascular fraction for tissue regeneration.

Front Pharmacol. 2025-3-13

[4]
The effect of autologous platelet concentrates as solely grafting material or with bone graft materials in maxillary sinus augmentation: a meta-analysis of randomized controlled trials.

Clin Oral Investig. 2025-2-7

[5]
Local Application of Minimally Manipulated Autologous Stromal Vascular Fraction (SVF) Reduces Inflammation and Improves Bilio-Biliary Anastomosis Integrity.

Int J Mol Sci. 2024-12-30

[6]
Effect of Stromal Vascular Fraction in the Rat Model of Pharyngocutaneous Fistulas.

Cureus. 2024-9-10

[7]
Role of Adipose-Derived Mesenchymal Stem Cells in Bone Regeneration.

Int J Mol Sci. 2024-6-20

[8]
The Role of Bioceramics for Bone Regeneration: History, Mechanisms, and Future Perspectives.

Biomimetics (Basel). 2024-4-12

[9]
Bone Regeneration with Mesenchymal Stem Cells in Scaffolds: Systematic Review of Human Clinical Trials.

Stem Cell Rev Rep. 2024-5

[10]
Retrospective study on the effect of adipose stem cell transplantation on jaw bone regeneration.

Int J Implant Dent. 2024-2-5

本文引用的文献

[1]
Bone Engineering of Maxillary Sinus Bone Deficiencies Using Enriched CD90+ Stem Cell Therapy: A Randomized Clinical Trial.

J Bone Miner Res. 2015-7

[2]
Stromal cells and stem cells in clinical bone regeneration.

Nat Rev Endocrinol. 2015-3

[3]
Spinal fusion using adipose stem cells seeded on a radiolucent cage filler: a feasibility study of a single surgical procedure in goats.

Eur Spine J. 2015-5

[4]
Adipose stem cells used to reconstruct 13 cases with cranio-maxillofacial hard-tissue defects.

Stem Cells Transl Med. 2014-2-20

[5]
GMP-level adipose stem cells combined with computer-aided manufacturing to reconstruct mandibular ameloblastoma resection defects: Experience with three cases.

Ann Maxillofac Surg. 2013-7

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Growth factor gene expression profiles of bone morphogenetic protein-2-treated human adipose stem cells seeded on calcium phosphate scaffolds in vitro.

Biochimie. 2013-9-9

[7]
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Acta Biomater. 2013-6-19

[8]
Stromal cells from the adipose tissue-derived stromal vascular fraction and culture expanded adipose tissue-derived stromal/stem cells: a joint statement of the International Federation for Adipose Therapeutics and Science (IFATS) and the International Society for Cellular Therapy (ISCT).

Cytotherapy. 2013-4-6

[9]
A novel approach revealing the effect of a collagenous membrane on osteoconduction in maxillary sinus floor elevation with β-tricalcium phosphate.

Eur Cell Mater. 2013-3-25

[10]
Tissue engineering of bone: Clinical observations with adipose-derived stem cells, resorbable scaffolds, and growth factors.

Ann Maxillofac Surg. 2012-1

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