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Stem Cell Scientists Boost Cell Survival in Adipose Tissue Transplantations

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A fat graft, also called an autologous adipose (fat) tissue transplantation, uses a patient’s own adipose tissue to increase the volume of fat in the subcutaneous area, which functions as the body’s major storage site for fat. The graft promotes three-dimensional reconstruction in patients who have undergone a traumatic or post-surgical event such as a mastectomy, or who suffer from a congenital or chronic debilitative condition.

However, the success of fat graft in clinical use has been limited by a variable but unpredictable low survival rate.

Human adipose-derived stem cells (ASCs) offer tremendous potential in fat grafting procedures due to their plasticity, abundance and easy accessibility. The Tor Vergata University team, led by Augusto Orlandi M.D., found that combining platelet-rich plasma (PRPs) and insulin greatly increases the proliferative rate and adipogenic differentiation of ASC through a complex intracellular Akt-regulated mechanism that is mediated from specific cell receptors. (Akt is a type of regulatory protein that plays a key role in multiple cellular functions.) They tested their theory on 39 patients who were undergoing reconstructive surgery for soft tissue defects and concluded that the clinical results “were very satisfactory.”

PRP already has been safely documented in many fields, including maxillofacial surgery and in treating problematic soft tissue ulcers. Other studies had demonstrated the ability of insulin to sustain the differentiation of adipocyte precursors and documented that slow insulin delivery in rats led to fat tissue generation.

However, insulin alone reduces ACS proliferation and, when used at higher doses, can even induce cell death.

“These data suggest that PRPs and insulin work synergistically and are able to sustain ASC proliferation, survival and their ability to develop into fat tissue,” Dr. Orlandi said. “The use of autologous PRP obtained by blood centrifugation is an alternative and easily controllable strategy for the local release of multiple endogenous growth factors for tissue regeneration.

“The amelioration of long-term fat graft maintenance in patients undergoing fat grafting procedures for soft tissue defects strongly supports that the positive synergistic effect of PRP and insulin on resident stem cells is maintained in vivo,” he added. “These findings suggest additional beneficial therapeutic opportunities of the association of PRP and insulin in other fields of regenerative medicine.”