Department of Plastic and Reconstructive Surgery, Medical Centre of Postgraduate Education, Prof. W. Orlowski Memorial Hospital, Warsaw, Poland.
Laboratory of Center for Preclinical Research, Department of Methodology, Medical University of Warsaw, Stefana Banacha 1B, 02-097, Warsaw, Mazowieckie, Poland.
Aesthetic Plast Surg. 2021 Oct;45(5):2397-2405. doi: 10.1007/s00266-020-01633-1. Epub 2020 Mar 27.
Our goal was to determine whether N-acetylcysteine (NAC) administered to the tumescent solution can reduce oxidative stress and increase autologous fat graft (AFG) viability.
The study included 15 women with a mean age of 31.8 years (range 23-39 years) who underwent breast asymmetry correction with AFG harvested from both thighs. One thigh was infiltrated with a standard tumescent fluid (control graft) and other with a NAC-enriched tumescent fluid (NAC-treated graft). Each participant had breast MRI imaging before and 6 months after the procedure. Also, adipose tissue samples from each graft were subjected to biochemical analysis, flow cytometric assay and qRT-PCR to determine the markers of oxidative stress, angiogenesis and adipogenesis.
Concentration and activity of superoxide dismutase in the NAC-treated grafts turned out to be significantly higher than in the control grafts, in both fresh (p = 0.041 and p = 0.023, respectively) and frozen samples (p = 0.004 and p = 0.003, respectively). The level of nitric oxide in frozen samples from the control grafts was significantly higher than in the NAC-treated grafts (p = 0.009). iNOS was the only qRT-PCR target showing significant intergroup differences, with higher transcription levels observed in the control grafts (p = 0.027). Breast volumetric analysis demonstrated that the NAC-treated group had a 12.19% lower resorption rate than the control group, although it was found to be statistically insignificant (p = 0.149). No postoperative complications were observed during a 6-month follow-up.
Some results of this study are promising. Further studies on larger groups are needed to determine NAC impact on AFG.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
The Impact of N-Acetylcysteine on Volumetric Retention of Autologous Fat Graft for Breast Asymmetry Correction.
NCT03197103. URL FOR THE REGISTRY: https://clinicaltrials.gov/ct2/show/NCT03197103?term=acetylcysteine&rank=6.
我们的目标是确定在肿胀液中给予 N-乙酰半胱氨酸（NAC）是否可以减轻氧化应激并提高自体脂肪移植物（AFG）的存活率。
该研究纳入了 15 名平均年龄为 31.8 岁（23-39 岁）的女性，她们接受了双侧大腿脂肪移植矫正乳房不对称。一侧大腿用标准肿胀液浸润（对照移植物），另一侧大腿用富含 NAC 的肿胀液浸润（NAC 处理移植物）。每位参与者在手术前和手术后 6 个月都进行了乳房 MRI 成像。此外，还对每个移植物的脂肪组织样本进行了生化分析、流式细胞术检测和 qRT-PCR，以确定氧化应激、血管生成和脂肪生成的标志物。
NAC 处理移植物的超氧化物歧化酶浓度和活性明显高于对照移植物，无论是新鲜样本（p=0.041 和 p=0.023）还是冷冻样本（p=0.004 和 p=0.003）。对照移植物冷冻样本中的一氧化氮水平明显高于 NAC 处理移植物（p=0.009）。只有 iNOS 是 qRT-PCR 靶点显示出显著的组间差异，对照移植物的转录水平较高（p=0.027）。乳房体积分析表明，NAC 处理组的吸收率比对照组低 12.19%，尽管差异无统计学意义（p=0.149）。在 6 个月的随访期间，未观察到术后并发症。
本研究的一些结果是有希望的。需要进一步在更大的人群中进行研究，以确定 NAC 对 AFG 的影响。
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N-乙酰半胱氨酸对乳房不对称矫正自体脂肪移植物体积保留的影响。
NCT03197103。注册网址：https://clinicaltrials.gov/ct2/show/NCT03197103?term=acetylcysteine&rank=6.
