You are hereDecember 3, 2019
Fat Grafting Improves Range of Motion in Limbs Damaged by Radiation Therapy
DURHAM, N.C. DECEMBER 03, 2019 - A new study released today in STEM CELLS outlines how fat grafting – which previous studies have shown can reduce and even reverse fibrosis (scar tissue) buildup – also improves the range of motion of the affected limb. The study, conducted by researchers at Stanford University School of Medicine, was conducted on mice.
The tumor-destroying capabilities of radiation therapy can be a life saver for a person suffering from cancer. But it’s a therapy that has several unwanted side effects, too, including causing substantial damage not just to cancerous cells, but any healthy tissue in its path. Over time, fibrosis builds up in the treated area which, in the case of an arm, shoulder, or leg, for example, can lead to painful contractures that significantly limit extensibility and negatively impact the person’s quality of life.
The Stanford team irradiated the right hind legs of subject mice, which resulted in chronic fibrosis and limb contracture. Four weeks later, the irradiated limbs of one group of the mice were injected with fat enriched with stromal vascular cells (SVCs). These potent cells already naturally exist in fat, but supplementation of fat with additional SVCs enhances its regenerative capabilities. A second group was injected with fat only, a third group with saline and a fourth group received no injections, for comparison. The animals’ ability to extend their limb was then measured at baseline and every two weeks for a 12-week period. At the end of the 12 weeks, the hind limb skin underwent histological analysis and biomechanical strength testing.
“Each animal showed significant reduction in its limb extension ability due to the radiation, but this was progressively rescued by fat grafting,” reported corresponding author Derrick C. Wan, M.D., FACS. Fat grafting also reduced skin stiffness and reversed the radiation-induced histological changes in the skin.
“The greatest benefits were found in mice injected with fat enriched with SVCs,” Dr. Wan added. “SVCs are easily obtained through liposuction and can be coaxed into different tissue types, where they can support neovascularization, replace cells and repair injured issue.
“Our study showed the ability of fat to improve mobility as well as vascularity and appearance,” he continued. “We think this holds enormous clinical potential — especially given that adipose tissue is abundant and can be easily collected from the patients themselves — and underscores an attractive approach to address challenging soft tissue fibrosis in patients following radiation therapy.”
Furthermore, said co-author and world-renowned breast reconstructive expert Arash Momeni, M.D., FACS, “Our observations are potentially translatable to a variety of challenging clinical scenarios. Being able to reverse radiation-induced effects holds promise to substantially improve clinical outcomes in implant-based as well as autologous breast reconstruction. The study findings are indeed encouraging as they could offer patients novel treatment modalities for debility clinical conditions.
“Excessive scarring is a challenging problem that is associated with a variety of clinical conditions, such as burn injuries, tendon lacerations, etc. The potential to improve outcomes based on treatment modalities derived from our research is indeed exciting,” Dr. Momeni added.
"Skin and soft tissue scarring and fibrosis are well-established problems after radiation. The current study, showing that human fat grafting can normalize the collagen networks and improve tissue elasticity in immune deficient mice, provides molecular evidence for how fat grafting functions,” said Dr. Jan Nolta, Editor-in-Chief of STEM CELLS. “The studies indicate that, with the appropriate regulatory approvals, autologous fat grafting could potentially also help human patients recover from radiation-induced tissue fibrosis.”
The full article, “Fat grafting rescues radiation-induced joint contracture,” can be accessed at https://stemcellsjournals.onlinelibrary.wiley.com/doi/full/10.1002/stem.3115.
About the Journal: STEM CELLS, a peer reviewed journal published monthly, provides a forum for prompt publication of original investigative papers and concise reviews. The journal covers all aspects of stem cells: embryonic stem cells/induced pluripotent stem cells; tissue-specific stem cells; cancer stem cells; the stem cell niche; stem cell epigenetics, genomics and proteomics; and translational and clinical research. STEM CELLS is co-published by AlphaMed Press and Wiley.
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