The clinical use of fat grafts for breast reconstruction post-mastectomy or radiotherapy has the disadvantages of limited retention and survival rates.To solve this problem,adipose-derived stem cells(ADSCs)have been s...The clinical use of fat grafts for breast reconstruction post-mastectomy or radiotherapy has the disadvantages of limited retention and survival rates.To solve this problem,adipose-derived stem cells(ADSCs)have been suggested as an alternative cell source for breast reconstruction,because they are simple to access,have low immunogenicity,and support the survival of mature adipose grafts.However,despite their outstanding properties,the use of ADSCs in patients with breast cancer is controversial,and the oncological safety of this method has been questioned.The biological effects of ADSCs on breast cancer are complex,and clinical research on ADSC-assisted fat grafting is limited.Here,we review the current experimental findings on the effects of ADSCs on breast cancer,mainly focusing on the role of ADSCs in breast cancer proliferation and growth processes,such as epithelial-mesenchymal transition(EMT)and angiogenesis.We also discuss the safety of ADSCs in clinical breast reconstruction.展开更多
Objective: Although research increasingly underlines the theoretical importance of adipose-derived stem cells (ASC) for successful fat transplantation, we could not prove this notion in cosmetic breast augmentation. S...Objective: Although research increasingly underlines the theoretical importance of adipose-derived stem cells (ASC) for successful fat transplantation, we could not prove this notion in cosmetic breast augmentation. Stem-cell-enriched breast fat transplantation did not yield better results than grafting based on the WAL (water-jet assisted liposuction) technique in terms of volume persistence. To overcome inter-individual variation, intra-individual comparison was performed. Material and Methods: Four women underwent breast augmentation utilizing WAL fat transplantation with and without ex-vivo ASC isolation performed with the Multistation System. All patients underwent two fat transplantations for breast augmentation. In the first procedure, the left breast was augmented with stem-cell-enriched fat grafts and the right with plain WAL fat grafts. In the second surgery, the lipofilling was performed the other way round to exclude intra-individual differences in fat cell persistence. Results: MRI volumetry revealed a mean volume survival of 56% of the whole (watery) graft in the breasts with WAL only and 56% in the breasts with WAL and stem cell enrichment. While centrifugation of the WAL grafts demonstrated an average adipose content of 68%, the average volume survival of the adipose tissue itself was 83% in the breasts augmented with WAL only and 83% in those with WAL with stem cell enrichment. Conclusion: Breast augmentation by means of lipofilling using WAL alone is faster and more inexpensive, carrying a lower risk of contamination and offering an equal take rate. We do not see any advantage in stem-cell-enrichment in cosmetic fat transplantation to the breast.展开更多
Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Vario...Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.展开更多
基金supported by the Key Clinical Projects of Peking University Third Hospital(grant no.BYSYZD2019013)。
文摘The clinical use of fat grafts for breast reconstruction post-mastectomy or radiotherapy has the disadvantages of limited retention and survival rates.To solve this problem,adipose-derived stem cells(ADSCs)have been suggested as an alternative cell source for breast reconstruction,because they are simple to access,have low immunogenicity,and support the survival of mature adipose grafts.However,despite their outstanding properties,the use of ADSCs in patients with breast cancer is controversial,and the oncological safety of this method has been questioned.The biological effects of ADSCs on breast cancer are complex,and clinical research on ADSC-assisted fat grafting is limited.Here,we review the current experimental findings on the effects of ADSCs on breast cancer,mainly focusing on the role of ADSCs in breast cancer proliferation and growth processes,such as epithelial-mesenchymal transition(EMT)and angiogenesis.We also discuss the safety of ADSCs in clinical breast reconstruction.
文摘Objective: Although research increasingly underlines the theoretical importance of adipose-derived stem cells (ASC) for successful fat transplantation, we could not prove this notion in cosmetic breast augmentation. Stem-cell-enriched breast fat transplantation did not yield better results than grafting based on the WAL (water-jet assisted liposuction) technique in terms of volume persistence. To overcome inter-individual variation, intra-individual comparison was performed. Material and Methods: Four women underwent breast augmentation utilizing WAL fat transplantation with and without ex-vivo ASC isolation performed with the Multistation System. All patients underwent two fat transplantations for breast augmentation. In the first procedure, the left breast was augmented with stem-cell-enriched fat grafts and the right with plain WAL fat grafts. In the second surgery, the lipofilling was performed the other way round to exclude intra-individual differences in fat cell persistence. Results: MRI volumetry revealed a mean volume survival of 56% of the whole (watery) graft in the breasts with WAL only and 56% in the breasts with WAL and stem cell enrichment. While centrifugation of the WAL grafts demonstrated an average adipose content of 68%, the average volume survival of the adipose tissue itself was 83% in the breasts augmented with WAL only and 83% in those with WAL with stem cell enrichment. Conclusion: Breast augmentation by means of lipofilling using WAL alone is faster and more inexpensive, carrying a lower risk of contamination and offering an equal take rate. We do not see any advantage in stem-cell-enrichment in cosmetic fat transplantation to the breast.
文摘Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.