Kokai Lauren E, Sivak Wesley N, Schilling Benjamin K, Karunamurthy Arivarasan, Egro Francesco M, Schusterman M Asher, Minteer Danielle M, Simon Patsy, D'Amico Richard A, Rubin J Peter
Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa.
McGowan Institute for Regenerative Medicine, Pittsburgh, Pa.
Plast Reconstr Surg Glob Open. 2020 Jan 27;8(1):e2574. doi: 10.1097/GOX.0000000000002574. eCollection 2020 Jan.
Biomaterials derived from human adipose extracellular matrix have shown promise in vitro and in animal studies as an off-the-shelf adipogenic matrix for sustained volume replacement. Herein, we report the results of a randomized prospective study conducted with allograft adipose matrix (AAM) grafted into the pannus of presurgical abdominoplasty patients 3 or 6 months before scheduled surgery. This is the first report of a longitudinal histologic analysis of AAM in clinical use.
Ten healthy patients undergoing elective abdominoplasty were recruited to receive AAM before surgery. Enrolled subjects were randomized into either a 3-month follow-up cohort or a 6-month follow-up cohort. Subjects were monitored for adverse events associated with AAM grafting in addition to undergoing serial biopsy. Following surgical excision of the pannus, representative samples from the AAM surgical sites were stained and evaluated with hematoxylin and eosin for tissue morphology, Masson's trichrome for collagen, and perilipin for adipocytes.
All subjects tolerated AAM with no severe adverse events reported. At 3 months following implantation, AAM remained visible within the confines of the subjects' native surrounding adipose tissue with sparse adipocytes apparent within the matrix. By 6 months, AAM had remodeled and was primarily composed of perilipin-positive adipocytes. Histologic analysis confirmed tissue remodeling (hematoxylin and eosin), adipogenesis (perilipin), and angiogenesis (Masson's trichrome) occurred with the presence of AAM.
AAM is a safe, allogeneic, off-the-shelf regenerative matrix that is adipogenic and noninflammatory and promotes angiogenesis.
源自人脂肪细胞外基质的生物材料在体外和动物研究中已显示出作为现成的成脂基质用于持续容量替代的前景。在此,我们报告一项随机前瞻性研究的结果,该研究将同种异体脂肪基质(AAM)移植到择期腹部整形手术患者术前3或6个月的 pannus 中。这是关于临床使用中 AAM 的纵向组织学分析的首次报告。
招募10名接受择期腹部整形手术的健康患者在手术前接受 AAM。入组受试者被随机分为3个月随访队列或6个月随访队列。除了进行系列活检外,还对受试者监测与 AAM 移植相关的不良事件。在手术切除 pannus 后,对来自 AAM 手术部位的代表性样本进行苏木精和伊红染色以评估组织形态,用 Masson 三色染色法评估胶原蛋白,用 perilipin 评估脂肪细胞。
所有受试者均耐受 AAM,未报告严重不良事件。植入后3个月,AAM 在受试者天然周围脂肪组织范围内仍可见,基质内可见稀疏的脂肪细胞。到6个月时,AAM 已重塑,主要由 perilipin 阳性脂肪细胞组成。组织学分析证实,AAM 的存在导致了组织重塑(苏木精和伊红染色)、脂肪生成(perilipin)和血管生成(Masson 三色染色法)。
AAM 是一种安全、同种异体、现成的再生基质,具有成脂性、非炎性且能促进血管生成。