Kesten Steven, Fraser John K
Cytori Therapeutics, Inc., San Diego, California.
Surg Technol Int. 2016 Oct 26;29:38-44.
Adipose derived regenerative cells (ADRCs) are a heterogeneous population of cells including multipotent adipose derived stems cells, other progenitor cells, fibroblasts, T-regulatory cells, and macrophages. Preclinical data exist supporting benefits that are predominantly through angiogenesis, modulation of inflammation, and wound remodeling. Such effects are likely paracrine in nature. The application of autologous ADRCs has been investigated across multiple therapeutic areas. While there are numerous publications, there is a relative lack of double-blind, well-controlled, randomized clinical trials in the literature. Nevertheless, a consistency in outcomes and a consistency with preclinical and laboratory studies suggests a true positive effect. The therapeutic areas reported include orthopedics, autoimmune disease, wounds and reconstruction, cardiology, peripheral vascular disease, genitourinary disorders, gastrointestinal fistulas, and neurology. Case reports have documented wound healing in otherwise intractable wounds such as ischemic- and radiation-related cutaneous ulcers and enterocutaneous fistulas. An open label, 12-patient-study indicated substantial improvement in hand manifestations of scleroderma across multiple endpoints. Post-radical prostatectomy urinary incontinence improved in a study of 11 patients with local delivery of ADRCs. Small studies of intramyocardial delivery have been associated with trends towards benefit. The studies also indicate that same day fat harvest through liposuction, cell processing, and cell delivery is feasible and can be performed with an acceptable safety profile. The objective of this review is to highlight the interest, potential, and trends that support the need to continue evaluation and exploration for the role of ADRCs as a therapeutic agent.
脂肪来源的再生细胞（ADRCs）是一群异质性细胞，包括多能脂肪来源干细胞、其他祖细胞、成纤维细胞、调节性T细胞和巨噬细胞。临床前数据表明其益处主要通过血管生成、炎症调节和伤口重塑实现。这些作用可能本质上是旁分泌的。自体ADRCs已在多个治疗领域进行了研究。虽然有大量出版物，但文献中相对缺乏双盲、严格对照的随机临床试验。然而，结果的一致性以及与临床前和实验室研究的一致性表明存在真正的积极效果。报告的治疗领域包括骨科、自身免疫性疾病、伤口与重建、心脏病学、外周血管疾病、泌尿生殖系统疾病、胃肠瘘和神经学。病例报告记录了在其他难以治愈的伤口，如缺血性和放射性皮肤溃疡以及肠皮肤瘘中的伤口愈合情况。一项开放标签的、纳入12名患者的研究表明，硬皮病手部表现的多个终点均有显著改善。在一项对11名局部递送ADRCs的患者进行的研究中，根治性前列腺切除术后的尿失禁情况有所改善。心肌内递送的小型研究显示有获益趋势。这些研究还表明，通过吸脂、细胞处理和细胞递送在同一天获取脂肪是可行的，并且可以在可接受的安全范围内进行。本综述的目的是强调支持继续评估和探索ADRCs作为治疗剂作用的兴趣、潜力和趋势。
