Department of Plastic Surgery, 66375Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Cell Transplant. 2021 Jan-Dec;30:963689721997799. doi: 10.1177/0963689721997799.
Autologous fat transplantation is widely regarded as an increasingly popular method for augmentation or reshaping applications in soft tissue defects. Although the fat transplantation is of simple applicability, low donor site morbidity and excellent biocompatibility, the clinical unpredictability and high resorption rates of the fat grafts remain an inevitable problem. In the sites of fat transplantation, the most essential components are the adipocyte and adipose-derived stem cells (ADSCs). The survival of adipocytes is the direct factor determining fat retention. The efficacy of fat transplantation is reduced by fat absorption and fibrosis due to the inadequate blood flow, adipocyte apoptosis and fat necrosis. ADSCs, a heterogeneous mixture of cells in adipose tissue, are closely related to tissue survival. ADSCs exhibit the ability of multilineage differentiation and remarkable paracrine activity, which is crucial for graft survival. This article will review the recent existing research on the mechanisms of adipocytes and ADSCs in fat transplantation, especially including adipocyte apoptosis, mature adipocyte dedifferentiation, adipocyte browning, ADSCs adipogenic differentiation and ADSCs angiogenesis. The in-depth understanding of the survival mechanism will be extremely valuable for achieving the desired filling effects.
自体脂肪移植被广泛认为是一种越来越受欢迎的软组织缺损填充或塑形的方法。尽管脂肪移植具有适用性简单、供区损伤小、生物相容性好等优点，但脂肪移植物的临床不可预测性和高吸收率仍然是一个不可避免的问题。在脂肪移植部位，最基本的成分是脂肪细胞和脂肪来源的干细胞（ADSCs）。脂肪细胞的存活是决定脂肪保留的直接因素。由于血流不足、脂肪细胞凋亡和脂肪坏死，脂肪吸收和纤维化会降低脂肪移植的效果。ADSCs 是脂肪组织中一种异质性细胞混合物，与组织存活密切相关。ADSCs 具有多向分化能力和显著的旁分泌活性，这对于移植物的存活至关重要。本文将综述脂肪移植中脂肪细胞和 ADSCs 的最新研究进展，特别是包括脂肪细胞凋亡、成熟脂肪细胞去分化、脂肪细胞棕色化、ADSCs 成脂分化和 ADSCs 血管生成。深入了解其存活机制对于实现理想的填充效果具有极其重要的价值。
