Jin Ung Sik, Hong Ki Yong, Hwang Young-Il
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Dongguk University Medical Center, Dongguk University School of Medicine, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2017 Jun;70(6):806-813. doi: 10.1016/j.bjps.2017.02.016. Epub 2017 Feb 28.
Acellular dermal matrix (ADM) is frequently used in implant-based breast reconstruction. Although there are several advantages, ADM implantation also increases the risk of certain complications. Recently, ADM seeded with adipose-derived stem cells (ADSCs) were shown to induce angiogenesis and improve wound healing. This study aimed to investigate the effects of ADSCs on ADM engraftment in a rabbit model of implant-based breast reconstruction. Silicone implants were inserted to submuscular pocket of 16 female New Zealand rabbits using ADM with or without seeding of fluorescent PKH26-labelled rabbit ADSCs. The marginal and central ADMs in each group were evaluated at 1 and 3 months after insertion. We performed a histological analysis including the number of CD31 blood vessels, vimentin fibroblasts and lymphocytes; live/dead analysis; and gene expression analysis related to angiogenesis, inflammation and hypoxia. The implant was exposed in one rabbit with ADM without ADSCs during the study period. At 1 month, a histological analysis revealed more blood vessels and fibroblasts and reduced immune cell infiltration in marginal ADM with ADSCs. At 3 months, only angiogenesis was histologically different between groups. Conversely, cellularity was not significantly different in the central ADM between groups at month 1 or 3. ADSC supplementation increased the gene expression level associated with angiogenesis and inflammation, but not hypoxia. PKH26-labelled ADSCs were observed in both marginal and central ADMs at month 3. ADM seeded with ADSCs might be useful in promoting early incorporation with recipient tissue. This study supports the potential of ADM seeded with ADSCs as a reliable material for implant-based breast reconstruction.
脱细胞真皮基质（ADM）常用于基于植入物的乳房重建。尽管有几个优点，但ADM植入也会增加某些并发症的风险。最近，接种脂肪来源干细胞（ADSCs）的ADM被证明可诱导血管生成并改善伤口愈合。本研究旨在探讨ADSCs对基于植入物的乳房重建兔模型中ADM植入的影响。使用接种或未接种荧光PKH26标记兔ADSCs的ADM，将硅胶植入物插入16只雌性新西兰兔的肌下囊袋中。在植入后1个月和3个月对每组的边缘和中央ADM进行评估。我们进行了组织学分析，包括CD31血管数量、波形蛋白成纤维细胞和淋巴细胞数量；活/死分析；以及与血管生成、炎症和缺氧相关的基因表达分析。在研究期间，1只植入未接种ADSCs的ADM的兔子出现了植入物外露。在1个月时，组织学分析显示接种ADSCs的边缘ADM中有更多的血管和成纤维细胞，免疫细胞浸润减少。在3个月时，两组之间只有血管生成在组织学上存在差异。相反，在第1个月或第3个月时，两组中央ADM的细胞密度没有显著差异。补充ADSCs增加了与血管生成和炎症相关的基因表达水平，但与缺氧无关。在第3个月时，在边缘和中央ADM中均观察到PKH26标记的ADSCs。接种ADSCs的ADM可能有助于促进与受体组织的早期融合。本研究支持接种ADSCs的ADM作为基于植入物的乳房重建可靠材料的潜力。
