脱细胞脂肪组织制备：能否成为异体注射或原位成脂的软组织填充物

Acellular adipose tissue preparation: a soft-tissue filler allowing for allogeneic injection or in situ adipogenesis?

背景:通过脱细胞脂肪组织构建无种子细胞的组织工程脂肪为当前软组织填充的研究热点。目的:探讨近年来脱细胞脂肪组织的制备方法对其移植后诱导脂肪再生效果的影响,并展望其临床应用前景。方法:检索1971年1月至2018年12月PubMed数据、Elsevier数据库相关文献,英文检索词为“adipose tissue engineering;adipose tissue extracellular matrix;soft tissue repair;angiogenesis;adipogenic induction”。阅读近年国内外与脱细胞脂肪组织制备和移植相关的文献,从脱细胞脂肪组织制备方法的改良,交联细胞因子和生物材料等方面进行总结归纳。结果与结论:当前研究表明,脂肪组织细胞外基质可作为软组织填充的理想支架材料,植入皮下可募集宿主干细胞并诱导期增殖和成脂分化。但现有的脱细胞方案会导致细胞外基质蛋白和结构的损失,这极大的影响了脱细胞脂肪组织植入体内的脂肪再生能力,但通过超临界二氧化碳设备脱油、机械力预处理、交联细胞因子或生物材料等手段可以减少脱细胞脂肪组织制备过程中细胞外基质蛋白的损失和或补充具有促进组织再生功能的蛋白,最终提高脱细胞脂肪组织移植后的血管和脂肪新生能力。脱细胞脂肪组织由于其天然的成脂诱导能力,在脂肪组织工程中具有强大的应用前景,若能克服其制备流程中细胞外基质蛋白损耗或在安全可控的前提下,有望成为可异体注射并原位成脂的理想软组织填充物。

BACKGROUND:Construction of seedless tissue-engineered adipose tissue from acellular adipose tissue is a hot research topic in soft tissue filling.OBJECTIVE:To investigate the effects of preparation methods of acellular adipose tissue on the induction of adipose regeneration after transplantation in recent years,and to look forward to its clinical application prospects.METHODS:A computer-based online search of PubMed and Elsevier databases was performed to retrieve papers regarding acellular adipose tissue preparation and transplantation published between January 1971 and December 2018 with the search terms“adipose tissue engineering;adipose tissue extracellular matrix;soft tissue repair;angiogenesis;adipogenic induction”.The retrieved papers were summarized from the perspectives of improvement in preparation methods of acellular adipose tissue,cross-linking cytokines and biomaterials.RESULTS AND CONCLUSION:Retrieved studies have shown that extracellular matrix of adipose tissue can act as an ideal scaffold material for soft tissue filling.Subcutaneous implantation of extracellular matrix of adipose tissue can recruit host stem cells and induce their proliferation and adipogenesis.However,existing acellular schemes can lead to the loss of extracellular matrix proteins and structures.This greatly affects the fat regeneration ability of acellular adipose tissue implanted in vivo.However,supercritical carbon dioxide deoiling,mechanical pretreatment,cross-linking cytokines or biomaterials can reduce the loss of extracellular matrix proteins and supplement the proteins that promote tissue regeneration during the preparation of acellular adipose tissue.This can ultimately enhance the angiogenesis and adipogenesis of acellular adipose tissue after transplantation.Acellular adipose tissue has strong application prospects in adipose tissue engineering because of its natural adipogenic induction ability.If the loss of extracellular matrix protein can be overcome during preparation of acellular adipose tissue or under the premise of safety and controllability,acellular adipose tissue is expected to become a suitable soft tissue filler that allows allogeneic injection and in situ adipogenesis.