Banyard Derek A, Sarantopoulos Christos N, Borovikova Anna A, Qiu Xiaolong, Wirth Garrett A, Paydar Keyianoosh Z, Haun Jered B, Evans Gregory R D, Widgerow Alan D
Orange, Calif.
From the Center for Tissue Engineering, Department of Plastic Surgery; the Departments of Biomedical Engineering and Chemical Engineering and Materials Science; and the Chao Family Comprehensive Cancer Center, University of California, Irvine.
Plast Reconstr Surg. 2016 Aug;138(2):237e-247e. doi: 10.1097/PRS.0000000000002356.
Optimization of fat grafting continues to gain increasing attention in the field of regenerative medicine. "Nanofat grafting" implements mechanical emulsification and injection of standard lipoaspirate for the correction of superficial rhytides and skin discoloration; however, little is known about the cellular constituents of the graft. Based on recent evidence that various stressors can induce progenitor activity, the authors hypothesized that the shear forces used in common fat grafting techniques may impact their regenerative capacities.
Lipoaspirates were obtained from 10 patients undergoing elective procedures. Half of each sample was subjected to nanofat processing; the other half was left unchallenged. The viscosity of each sample was measured for computational analysis. The stromal vascular fraction of each sample was isolated, quantified, and analyzed by means of flow cytometry with two multicolor fluorescence antibody panels.
Standard lipoaspirate is ideally suited for mechanical stress induction. The mechanical emulsification involved in nanofat processing did not affect cell number; however, viability was greatly reduced when compared with the stromal vascular fraction of standard lipoaspirate. Interestingly, nanofat processing resulted in stress-induced stromal vascular fraction with a higher proportion of endothelial progenitor cells, mesenchymal stem cells, and multilineage differentiating stress-enduring cells. Single-parameter analysis also revealed significant increases in CD34, CD13, CD73, and CD146 of the stress-induced stromal vascular fraction, markers associated with mesenchymal stem cell activity.
Mechanical processing used in techniques such as nanofat grafting induces the up-regulation of progenitor phenotypes consistent with multipotency and pluripotency. These data provide a first step in characterizing the potential regenerative benefits realized through stress induction in fat grafting.
CLINCAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
脂肪移植的优化在再生医学领域越来越受到关注。“纳米脂肪移植”通过机械乳化和注射标准抽脂物来改善浅表皱纹和皮肤色素沉着；然而，对于移植组织的细胞成分了解甚少。基于近期各种应激源可诱导祖细胞活性的证据，作者推测常见脂肪移植技术中使用的剪切力可能会影响其再生能力。
从10例接受择期手术的患者身上获取抽脂物。每个样本的一半进行纳米脂肪处理；另一半不做处理。测量每个样本的粘度以进行计算分析。通过两个多色荧光抗体面板的流式细胞术分离、定量并分析每个样本的基质血管成分。
标准抽脂物非常适合诱导机械应激。纳米脂肪处理中涉及的机械乳化不影响细胞数量；然而，与标准抽脂物的基质血管成分相比，活力大大降低。有趣的是，纳米脂肪处理导致应激诱导的基质血管成分中内皮祖细胞、间充质干细胞和多谱系分化应激耐受细胞的比例更高。单参数分析还显示，应激诱导的基质血管成分中与间充质干细胞活性相关的标志物CD34、CD13、CD73和CD146显著增加。
纳米脂肪移植等技术中使用的机械处理可诱导与多能性和全能性一致的祖细胞表型上调。这些数据为表征通过脂肪移植中的应激诱导实现的潜在再生益处迈出了第一步。
临床问题/证据水平：治疗性，V级
