Evans Brogan G A, Gronet Edward M, Saint-Cyr Michel H
Texas A&M Health Science Center, College of Medicine, Bryan, Tex.
Division of Plastic Surgery, Baylor Scott & White Health, Temple, Tex.
Plast Reconstr Surg Glob Open. 2020 Jul 14;8(7):e2705. doi: 10.1097/GOX.0000000000002705. eCollection 2020 Jul.
Fat grafting has been shown to improve diseased soft issue. Although the mechanism behind fat grafting's regenerative properties is currently debated, published studies agree that there is an associated vasculogenic effect. A systematic literature review was conducted to elucidate the biochemical pathways responsible for establishing neo-vasculature to grafted fat.
A systematic literature review was conducted by searching PubMed for current basic science and clinical research relating to fat grafting. In total, 144 of 269 (54%) articles met the inclusion criteria for our literature review. These 144 articles were summarized, with 86 of them (60%) used to construct this article at the authors' discretion.
Fat grafting-induced neovascularization can be divided into 3 parts. First, tissue trauma induced via fat injection activates a host inflammatory response necessary for cellular recruitment. Recruited cells promote the formation of connective tissue and neo-vasculature at the graft site. Second, cellular elements within the lipoaspirate contribute to neovascularization through a cytokine burst. Third, a synergistic relationship is established between recruited inflammatory cells and the cytokine burst of grafted fat. The end product of these processes is the differentiation of progenitor cells and the creation of neo-vasculature at the graft site.
Establishing neovasculature is paramount for the survival of grafted fat. Fat graft take can be divided into 2 steps: imbibition and neovascularization. We believe this process occurs through 3 distinct concepts: host inflammation via graft injection, hypoxic response of lipoaspirate-derived cellular elements, and a synergistic relationship between host inflammation and grafted fat.
脂肪移植已被证明可改善病变软组织。尽管目前关于脂肪移植再生特性背后的机制存在争议，但已发表的研究一致认为存在相关的血管生成效应。进行了一项系统的文献综述，以阐明负责为移植脂肪建立新血管的生化途径。
通过在PubMed上搜索与脂肪移植相关的当前基础科学和临床研究进行了一项系统的文献综述。在269篇文章中，共有144篇（54%）符合我们文献综述的纳入标准。对这144篇文章进行了总结，其中86篇（60%）由作者酌情用于撰写本文。
脂肪移植诱导的新生血管形成可分为三个部分。首先，通过脂肪注射诱导的组织创伤激活了细胞募集所需的宿主炎症反应。募集的细胞促进移植部位结缔组织和新血管的形成。其次，抽脂物中的细胞成分通过细胞因子爆发促进新生血管形成。第三，在募集的炎症细胞和移植脂肪的细胞因子爆发之间建立了协同关系。这些过程的最终产物是祖细胞的分化和移植部位新血管的形成。
建立新血管对移植脂肪的存活至关重要。脂肪移植的成活可分为两个步骤：吸收和新生血管形成。我们认为这个过程通过三个不同的概念发生：通过移植注射引起的宿主炎症、抽脂物来源的细胞成分的缺氧反应以及宿主炎症与移植脂肪之间的协同关系。
