Guangzhou, Guangdong, People's Republic of China.
From the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University.
Plast Reconstr Surg. 2018 Feb;141(2):376-386. doi: 10.1097/PRS.0000000000004028.
Fat grafting is a popular soft-tissue filler method; however, its results are variable and technique-dependent. Macrophages are present in fat grafts and closely associated with tissue regeneration. The authors hypothesized that activation/depletion of early macrophages in transferred fat improves/impairs fat graft survival.
Mouse inguinal fat (approximately 150 mg) was transferred autologously. Fat grafting was first performed without other manipulations to obtain baseline information. Then, liposome-encapsulated clodronate and macrophage-colony stimulating factor were used in a mouse fat grafting model for local macrophage depletion or activation. The authors examined the graft stromal vascular fraction by fluorescence-activated cell sorting at 1, 2, 4, and 12 weeks after transplantation in manipulation and control groups. Graft weight, vascularization, and secreted factors were also compared.
Early depletion of macrophages resulted in incompetent angiogenesis, feeble Sca-1/CD45 stem cell recruitment, and eventually a poor retention rate (34 ± 6 mg versus control 84 ± 15 mg; p = 0.006), whereas up-regulated macrophages allowed better angiogenesis and survival (117 ± 12 mg versus control, 84 ± 15 mg; p = 0.043).
In fat grafting, macrophages and their polarization initiated changes in the levels of dominant secreted factors and influenced blood-derived stem cell infiltration, indicating that macrophages were crucial for tissue revascularization. The macrophage manipulation models described here show that graft macrophage number can profoundly influence graft survival.
脂肪移植是一种流行的软组织填充方法，但效果因技术而异。脂肪移植物中存在巨噬细胞，并且与组织再生密切相关。作者假设转移脂肪中早期巨噬细胞的激活/耗竭可以改善/损害脂肪移植的存活。
小鼠腹股沟脂肪（约 150mg）自体移植。首先不进行其他操作进行脂肪移植，以获得基线信息。然后，使用脂质体包裹的氯膦酸盐和巨噬细胞集落刺激因子在小鼠脂肪移植模型中进行局部巨噬细胞耗竭或激活。作者在移植后 1、2、4 和 12 周通过荧光激活细胞分选检查移植物基质血管部分在操作组和对照组。还比较了移植物的重量、血管生成和分泌因子。
早期巨噬细胞耗竭导致血管生成功能不全、Sca-1/CD45 干细胞募集微弱，最终保留率差（34±6mg 与对照组 84±15mg；p=0.006），而上调的巨噬细胞则允许更好的血管生成和存活（117±12mg 与对照组 84±15mg；p=0.043）。
在脂肪移植中，巨噬细胞及其极化改变了优势分泌因子的水平，并影响了血液来源的干细胞浸润，表明巨噬细胞对组织再血管化至关重要。这里描述的巨噬细胞操作模型表明，移植物巨噬细胞数量可以深刻影响移植物的存活。
