Department of Plastic Surgery, Stemform, Gyngemose Parkvej 74, DK-2860, Copenhagen, Denmark.
Department of Plastic and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
Stem Cell Res Ther. 2021 Jan 19;12(1):68. doi: 10.1186/s13287-020-02132-5.
In recent years, adipose-derived stromal cells (ASCs) have been heavily studied for soft tissue regeneration, augmentation, and dermal wound healing.
In this review, we investigated the trends in injectable scaffolds for ASC delivery in the dermis, and injectable or implantable scaffolds for ASC delivery in the subcutis. A total of 547 articles were screened across three databases; of these, 22 studies were found to be eligible and were included. The scaffolds were subdivided and analyzed based on their tissue placement (dermis or subcutis), delivery method (injected or implanted), and by the origin of the materials (natural, synthetic, and combinatory).
ASCs embedded in scaffolds generally showed improved viability. Neovascularization in the transplanted tissue was greater when undifferentiated ASCs were embedded in a combinatory scaffold or if differentiated ASCs were embedded in a natural scaffold. ASCs embedded in natural materials underwent more adipogenic differentiation than ASCs embedded in synthetic scaffolds, indicating an etiologically unknown difference that has yet to be described. Increased mechanical strength of the scaffold material correlated with improved outcome measurements in the investigated studies. Wound healing studies reported reduced healing time in all except one article due to contraction of the control wounds.
In future clinical trials, we recommend embedding ASCs in injectable and implantable scaffolds for enhanced protection, retained viability, and improved therapeutic effects.
This review was registered with PROSPERO: ID=CRD42020171534 . The use of scaffolds as a vehicle for ASC delivery generally improved cell viability, angiogenesis, and wound healing in vivo compared to utilizing ASCs alone. ASCs embedded in natural materials induced more adipogenesis than ASCs embedded in synthetic materials. Adipogenic-induced ASCs further increased this effect. The included studies indicate that the seeded scaffold material influences the differentiation of ASCs in vivo. All studies investigating the mechanical strength of ASC scaffolds reported improved outcome measurements with improved mechanical strength. The results suggest that scaffolds, in general, are favorable for ASC delivery. We recommend initiating clinical studies using scaffolds based on mechanical properties and tunability to improve ASC viability. For fat regeneration, natural scaffolds are recommended.
近年来，脂肪来源的基质细胞（ASCs）在软组织再生、增强和皮肤伤口愈合方面受到了广泛的研究。
在本综述中，我们研究了用于真皮内 ASC 递送的可注射支架以及用于皮下 ASC 递送的可注射或可植入支架的趋势。总共在三个数据库中筛选了 547 篇文章；其中，有 22 项研究符合条件并被纳入。根据组织位置（真皮或皮下）、递送方法（注射或植入）以及材料来源（天然、合成和组合）对支架进行细分和分析。
嵌入支架中的 ASC 通常显示出更高的活力。当未分化的 ASC 嵌入组合支架中或分化的 ASC 嵌入天然支架中时，移植组织中的新生血管化更大。与嵌入合成支架中的 ASC 相比，嵌入天然材料中的 ASC 经历了更多的成脂分化，这表明存在一种尚未描述的、病因不明的差异。支架材料的机械强度增加与研究中改善的结果测量相关。伤口愈合研究报告说，除了一篇文章外，所有文章的愈合时间都因对照伤口的收缩而缩短。
在未来的临床试验中，我们建议将 ASC 嵌入可注射和可植入支架中，以增强保护、保持活力并提高治疗效果。
本综述已在 PROSPERO 上注册：ID=CRD42020171534。与单独使用 ASC 相比，将支架用作 ASC 递送的载体通常可提高细胞活力、血管生成和体内伤口愈合。嵌入天然材料中的 ASC 比嵌入合成材料中的 ASC 诱导更多的成脂分化。诱导的脂肪生成 ASC 进一步增加了这种效果。纳入的研究表明，接种的支架材料会影响 ASC 的体内分化。所有研究脂肪来源的基质细胞（ASCs）在软组织再生、增强和皮肤伤口愈合方面受到了广泛的研究。
在本综述中，我们研究了用于真皮内 ASC 递送的可注射支架以及用于皮下 ASC 递送的可注射或可植入支架的趋势。总共在三个数据库中筛选了 547 篇文章；其中，有 22 项研究符合条件并被纳入。根据组织位置（真皮或皮下）、递送方法（注射或植入）以及材料来源（天然、合成和组合）对支架进行细分和分析。
嵌入支架中的 ASC 通常显示出更高的活力。当未分化的 ASC 嵌入组合支架中或分化的 ASC 嵌入天然支架中时，移植组织中的新生血管化更大。与嵌入合成支架中的 ASC 相比，嵌入天然材料中的 ASC 经历了更多的成脂分化，这表明存在一种尚未描述的、病因不明的差异。支架材料的机械强度增加与研究中改善的结果测量相关。伤口愈合研究报告说，除了一篇文章外，所有文章的愈合时间都因对照伤口的收缩而缩短。
在未来的临床试验中，我们建议将 ASC 嵌入可注射和可植入支架中，以增强保护、保持活力并提高治疗效果。
本综述已在 PROSPERO 上注册：ID=CRD42020171534。与单独使用 ASC 相比，将支架用作 ASC 递送的载体通常可提高细胞活力、血管生成和体内伤口愈合。嵌入天然材料中的 ASC 比嵌入合成材料中的 ASC 诱导更多的成脂分化。诱导的脂肪生成 ASC 进一步增加了这种效果。纳入的研究表明，接种的支架材料会影响 ASC 的体内分化。所有研究调查了支架材料机械强度的研究报告称，随着机械强度的提高，测量结果得到了改善。结果表明，支架一般有利于 ASC 的递送。我们建议启动基于机械性能和可调节性的 ASC 支架临床试验，以提高 ASC 的活力。对于脂肪再生，建议使用天然支架。
