Department of Burn and Plastic Surgery, Second People's Hospital of Shenzhen, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, 518000, Guangdong, China.
Yuanmei Cosmetic and Plastic Medical Center, Shenzhen, China.
Aesthetic Plast Surg. 2021 Oct;45(5):2426-2436. doi: 10.1007/s00266-021-02299-z. Epub 2021 May 6.
Autologous fat grafts have been widely in use for reconstruction, contour abnormalities, and cosmetic surgeries. However, the grafted fat one-year survival rate is unpredictable and always low (20%-80%). Standardizing the existing transplantation technology is difficult due to the limiting conditions. Scaffold materials or drugs are unsuitable to employ because of legal restrictions, complex production, and undetermined hazards. Therefore, a simpler and more effective approach to improve grafted fat survival rate is using commercial products as additives. Earlier studies proved that porcine acellular dermal matrix (PADM), a biomaterial clinically used for wound repair, could work as a scaffold for lipo-implantation. This study aimed at investigating the hitherto unclear effect of PADM on transplanted fat survival.
Thirty-two 8-week-old female nude mice were divided into two groups. Control mice received a 300 μl fat injection, while the PADM group mice were injected with a 300 μl PADM-fat mixture. After a 4-week treatment, fat weight and liquefaction ratio were assessed. Histological changes were quantified via hematoxylin & eosin (H&E) staining. Macrophage infiltration and vascular regeneration were revealed using an anti-CD34 antibody. Mouse and human mRNA expression levels were gauged via RNA-sequencing. On the third day post implantation, the mRNA expression levels of inflammatory genes Mcp-1 and Tnf-α were measured by qRT-PCR.
The weight of surviving grafted fat did not differ between the control and the PADM group. However, adding PADM significantly decreased fat liquefaction. H&E-stained sections showed that PADM decreased fat necrosis, increased fat tissue regeneration, and raised CD34 levels in the regenerated tissue. RNA-sequencing showed that, compared to controls, fats from PADM-added group expressed more mouse-related mRNA but less human-related mRNA. The following GO and KEGG analysis showed that added PADM increased extracellular matrix (ECM) genes expression levels. The qRT-PCR showed that adding PADM increased Mcp-1 and Tnf-α mRNA expression levels.
In summary, PADM addition increased fat survival rate by reducing fat liquefaction through an increased macrophage infiltration, ECM regeneration, and revascularization. Therefore, PADM addition is a workable application in autologous fat grafting.
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自体脂肪移植已广泛应用于重建、轮廓畸形和美容手术。然而，移植脂肪的一年存活率是不可预测的，且通常较低（20%-80%）。由于限制条件，标准化现有的移植技术是困难的。支架材料或药物由于法律限制、复杂的生产和不确定的危害而不适合使用。因此，采用商业产品作为添加剂，是提高移植脂肪存活率的一种更简单、更有效的方法。早期研究证实，临床用于伤口修复的生物材料猪去细胞真皮基质（PADM）可用作脂肪植入的支架。本研究旨在探讨 PADM 对移植脂肪存活的影响。
将 32 只 8 周龄雌性裸鼠分为两组。对照组小鼠接受 300μl 脂肪注射，而 PADM 组小鼠注射 300μl PADM-脂肪混合物。治疗 4 周后，评估脂肪重量和液化率。通过苏木精和伊红（H&E）染色定量评估组织学变化。使用抗 CD34 抗体显示巨噬细胞浸润和血管再生。通过 RNA 测序测量小鼠和人 mRNA 表达水平。植入后第 3 天，通过 qRT-PCR 测量炎性基因 Mcp-1 和 Tnf-α 的 mRNA 表达水平。
对照组和 PADM 组之间存活的移植脂肪重量没有差异。然而，添加 PADM 显著降低了脂肪液化。H&E 染色切片显示，PADM 减少了脂肪坏死，增加了脂肪组织再生，并提高了再生组织中的 CD34 水平。RNA 测序显示，与对照组相比，添加 PADM 的脂肪表达更多的小鼠相关 mRNA，但表达更少的人相关 mRNA。随后的 GO 和 KEGG 分析显示，添加 PADM 增加了细胞外基质（ECM）基因的表达水平。qRT-PCR 显示，添加 PADM 增加了 Mcp-1 和 Tnf-α mRNA 的表达水平。
总之，通过增加巨噬细胞浸润、ECM 再生和血管再生，添加 PADM 可通过减少脂肪液化来提高脂肪存活率。因此，在自体脂肪移植中，添加 PADM 是一种可行的应用。
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