Dong Miao, Ma Xuan, Li Facheng
From the Department of Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Plast Reconstr Surg. 2025 Jul 1;156(1):73e-84e. doi: 10.1097/PRS.0000000000011989. Epub 2025 Jan 22.
BACKGROUND: Dedifferentiated fat cells (DFATs) are derived from mature adipocytes that undergo dedifferentiation and regain proliferative and differentiation potential. Acellular dermal matrix (ADM) is widely used in plastic and reconstructive medicine. The effects of ADM combined with DFATs in fat transplantation have not been studied. METHODS: The microstructure of ADM was tested in vitro. Adipogenic gene and angiogenic factors secreted by adipose-derived stem cells or DFATs seeded on ADM were measured. In vivo experiments involved preculturing DFATs on ADM and then mixing them with adipose tissue for transplantation into nude mice (1:2). Samples were collected at 4, 8, and 12 weeks for histologic analysis, quantitative reverse transcription polymerase chain reaction, enzyme-linked immunosorbent assay, and immunostaining. RESULTS: ADM demonstrated good biocompatibility, and quantitative reverse transcription polymerase chain reaction showed that in vitro preculture enhanced the expression of adipogenic-related genes (PPARγ and CEBPα) in DFATs and increased the secretion of vascular endothelial growth factor (P < 0.05). In the animal experiments, the fat grafts mixed with ADM exhibited better fat integrity and lower fibrosis levels, and enzyme-linked immunosorbent assay showed that interleukin-1β and tumor necrosis factor α levels were decreased. In the DFATs + ADM group, the numbers of CD31-positive cells and perilipin-positive cells within the ADM were the largest (P < 0.01). There was no significant difference in the expression of CD11b or inducible nitric oxide synthase/CD206 compared with the adipose-derived stem cells + ADM group. CONCLUSIONS: ADM, as a commercialized biomaterial, enhances the paracrine function of seeded cells. When cultured on ADM in assisted fat transplantation, DFATs can improve angiogenesis and fat survival. Clinical application of the cell-scaffold-fat transplantation model in the future is promising. CLINICAL RELEVANCE STATEMENT: The combined use of DFATs and ADM has been proven to promote angiogenesis and adipogenesis, which may serve as a promising strategy for soft-tissue reconstruction.
背景：去分化脂肪细胞（DFATs）源自成熟脂肪细胞，这些成熟脂肪细胞经历去分化并重新获得增殖和分化潜能。脱细胞真皮基质（ADM）在整形和重建医学中被广泛应用。ADM联合DFATs在脂肪移植中的效果尚未得到研究。 方法：在体外检测ADM的微观结构。测量接种于ADM上的脂肪干细胞或DFATs分泌的成脂基因和血管生成因子。体内实验包括先将DFATs在ADM上预培养，然后将其与脂肪组织混合后移植到裸鼠体内（1:2）。在4周、8周和12周时收集样本进行组织学分析、定量逆转录聚合酶链反应、酶联免疫吸附测定和免疫染色。 结果：ADM表现出良好的生物相容性，定量逆转录聚合酶链反应显示，体外预培养增强了DFATs中成脂相关基因（PPARγ和CEBPα）的表达，并增加了血管内皮生长因子的分泌（P < 0.05）。在动物实验中，与ADM混合的脂肪移植物表现出更好的脂肪完整性和更低的纤维化水平，酶联免疫吸附测定显示白细胞介素-1β和肿瘤坏死因子α水平降低。在DFATs + ADM组中，ADM内CD31阳性细胞和脂滴蛋白阳性细胞的数量最多（P < 0.01）。与脂肪干细胞 + ADM组相比，CD11b或诱导型一氧化氮合酶/CD206的表达没有显著差异。 结论：ADM作为一种商业化生物材料，可增强接种细胞的旁分泌功能。在辅助脂肪移植中，当在ADM上培养时，DFATs可改善血管生成和脂肪存活。细胞-支架-脂肪移植模型在未来的临床应用前景广阔。 临床相关性声明：DFATs与ADM联合使用已被证明可促进血管生成和脂肪生成，这可能是一种有前景的软组织重建策略。
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