Maxillofacial Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Aesthet Surg J. 2021 Jun 14;41(7):NP921-NP934. doi: 10.1093/asj/sjab055.
Platelet-rich fibrin (PRF) can promote fat graft survival, but the reported mixing ratio of PRF to fat ranges from 1:25 to 1:2, lacking a clear standard for clinical application.
The authors sought to explore the long-term effects of PRF on grafted fat and their optimal mixing ratio.
Nude mice were randomly divided into a control group (receiving subcutaneous injection of fat granules) and 4 PRF groups (receiving subcutaneous injection of PRF and fat granules at volume ratios of 1:5, 1:10, 1:15, and 1:20, respectively). The graft samples (n = 12) were obtained in weeks 4, 8, and 12 to (1) calculate retention rates; (2) evaluate gene and protein expression of vascular endothelial growth factor A (VEGF-A), peroxisome proliferator-activated receptor-γ (PPAR-γ), type I collagen A1 (COL1-A1), and B-cell lymphoma-2 associated X protein (BAX); (3) perform hematoxylin and eosin, Masson's trichrome, α-smooth muscle action, and periplipin-1 stainings; and (4) count the microvessels and viable adipocytes.
Compared with the control group, PRF groups had higher retention rates, a higher gene/protein expression of VEGF-A, a lower gene/protein expression of COL1-A1 and BAX, less fibrosis, and more microvessels and viable adipocytes. Group 1:10 was superior to other groups in terms of retention rates and other evaluation indexes. The expression of PPAR-γ did not significantly differ among groups.
PRF may not play a long-term effect on adipogenesis, but it can still promote fat graft survival through facilitating vascularization, regulating collagen production, and inhibiting apoptosis. PRF can achieve the best promoting effect when the mixing ratio of PRF to fat is 1:10, which is recommended as the optimal ratio for clinical application.
富血小板纤维蛋白（PRF）可促进脂肪移植物存活，但目前 PRF 与脂肪混合的报告比例为 1:25 至 1:2，缺乏明确的临床应用标准。
作者旨在探索 PRF 对移植脂肪的长期影响及其最佳混合比例。
将裸鼠随机分为对照组（接受脂肪颗粒皮下注射）和 4 个 PRF 组（分别以 PRF 与脂肪颗粒的体积比 1:5、1:10、1:15 和 1:20 进行皮下注射）。在第 4、8 和 12 周获取移植物样本（n=12），以（1）计算保留率；（2）评估血管内皮生长因子 A（VEGF-A）、过氧化物酶体增殖物激活受体-γ（PPAR-γ）、I 型胶原 A1（COL1-A1）和 B 细胞淋巴瘤-2 相关 X 蛋白（BAX）的基因和蛋白表达；（3）进行苏木精和伊红、马松三色、α-平滑肌肌动蛋白和脂联素-1 染色；和（4）计数微血管和有活力的脂肪细胞。
与对照组相比，PRF 组保留率更高，VEGF-A 的基因/蛋白表达更高，COL1-A1 和 BAX 的基因/蛋白表达更低，纤维化程度更低，微血管和有活力的脂肪细胞更多。在保留率和其他评价指标方面，1:10 组优于其他组。各组间 PPAR-γ 的表达无显著差异。
PRF 可能不会对脂肪生成产生长期影响，但它仍可通过促进血管生成、调节胶原生成和抑制细胞凋亡来促进脂肪移植物存活。当 PRF 与脂肪的混合比例为 1:10 时，可达到最佳促进效果，推荐作为临床应用的最佳比例。
