延迟两步 PRP 注射策略可提高脂肪移植成活率并促进血管生成。
Delayed two steps PRP injection strategy for the improvement of fat graft survival with superior angiogenesis.
机构信息
Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
Department of Plastic Surgery, Wuhan Third Hospital (Tongren Hospital of WuHan University), Wuhan, 430060, China.
出版信息
Sci Rep. 2020 Mar 23;10(1):5231. doi: 10.1038/s41598-020-61891-6.
Platelet-rich plasma (PRP) has been widely used to improve the fat retention rate in autologous fat transplantation since it possesses a good angiogenesis capability in vivo. However, due to the short half-life of growth factors released from PRP and its uneven distribution in injected fat tissue, the strategy of PRP in fat transplantation needs further improvement. Since the capillaries started to grow into fat grafts in 1 week and vascular growth peaks in the second week after transplantation, we hypothesized that delayed two-steps PRP injection into the interior of grafts, accompanied with the extent of neovascularization might theoretically promote microvessel growth inside transplanted adipose tissue. 24 nude mice were divided into three groups: Blank group (0.35 mL fat mixed with 0.15 mL saline, N = 8), Single step group (0.35 mL fat mixed with 0.15 mLPRP, N = 8), and Two steps group (0.35 mL fat (day 0) + 0.075 mL PRP (day 7) + 0.075 mL PRP (day 14), N = 8). At 6 and 14 weeks post-transplantation, grafts were dissected, weighted, and assessed for histology, angiogenesis, fat regeneration and inflammation level. The weight and volume of the fat samples revealed no statistical difference among the three groups at 6 weeks after fat transplantation. The weight and volume of the Two steps group fat samples showed significantly higher compared to that in Blank and Single step groups at 14 weeks after fat transplantation (weight: 137.25 ± 5.60 mg versus 87.5 ± 3.90 mg,106.75 ± 2.94 mg, respectively; volume: 0.13 ± 0.01 mL versus 0.08 ± 0.01 mL, 0.09 ± 0.01 mL, respectively). Histological assessments indicated that delayed two-steps PRP injection strategy helps to improve adipose tissue content and reduce the composition of fibrous connective tissue at 14 weeks after fat transplantation. At 6 weeks and 14 weeks after transplantation, CD31 immunofluorescence indicated that delayed two-steps PRP injection strategy helps to improve angiogenesis and significantly higher compared to that in Blank and Single step groups (6 weeks: 28.75 ± 4.54 versus 10.50 ± 2.06, 21.75 ± 1.85; 14 weeks: 21.75 ± 2.86 versus 9.87 ± 2.08, 11.75 ± 1.47, respectively). Preadipocyte count indicated delayed two-steps PRP injection strategy might promote fat regeneration and significantly higher compared to that in Blank and Single step groups at 14 weeks (129.75 ± 6.57 versus 13.50 ± 3.50, 17.12 ± 6.23, respectively). In this study, we demonstrated that the novel delayed two-steps PRP injection strategy remarkably enhanced the long-term fat retention rate and improved the neovascularization extent in the interior of the fat graft. Platelet-rich plasma, Delayed two-steps injection, Angiogenesis, Fat transplantation.
富血小板血浆 (PRP) 因其在体内具有良好的血管生成能力,已被广泛用于提高自体脂肪移植中的脂肪保留率。然而,由于 PRP 释放的生长因子半衰期短且在注射的脂肪组织中分布不均匀,因此 PRP 在脂肪移植中的策略需要进一步改进。由于毛细血管在移植后 1 周开始生长到脂肪移植物中,并且血管生长在移植后第 2 周达到峰值,我们假设将 PRP 延迟两步注入移植物内部,同时伴随着新生血管化的程度,理论上可以促进移植脂肪组织内的微血管生长。24 只裸鼠被分为三组:空白组(0.35ml 脂肪混合 0.15ml 生理盐水,N=8)、单步组(0.35ml 脂肪混合 0.15mlPRP,N=8)和两步组(0.35ml 脂肪(第 0 天)+0.075ml PRP(第 7 天)+0.075ml PRP(第 14 天),N=8)。在移植后 6 和 14 周时,解剖、称重并进行组织学、血管生成、脂肪再生和炎症水平评估。脂肪样本的重量和体积在脂肪移植后 6 周时三组之间无统计学差异。脂肪移植后 14 周时,两步组脂肪样本的重量和体积明显高于空白组和单步组(重量:137.25±5.60mg 比 87.5±3.90mg、106.75±2.94mg,分别;体积:0.13±0.01ml 比 0.08±0.01ml、0.09±0.01ml)。组织学评估表明,延迟两步 PRP 注射策略有助于在脂肪移植后 14 周时提高脂肪组织含量并减少纤维结缔组织的组成。在移植后 6 周和 14 周时,CD31 免疫荧光表明,延迟两步 PRP 注射策略有助于改善血管生成,并明显高于空白组和单步组(6 周:28.75±4.54 比 10.50±2.06、21.75±1.85;14 周:21.75±2.86 比 9.87±2.08、11.75±1.47)。前脂肪细胞计数表明,延迟两步 PRP 注射策略可能会促进脂肪再生,并在脂肪移植后 14 周时明显高于空白组和单步组(129.75±6.57 比 13.50±3.50、17.12±6.23)。在这项研究中,我们证明了新型延迟两步 PRP 注射策略可显著提高脂肪的长期保留率,并改善脂肪移植物内部的新生血管化程度。富血小板血浆;延迟两步注射;血管生成;脂肪移植。