humans are preceded by preclinical experiments based on animal models; this is also true for ASCs. For example, in a trial of ASC-derived hepatocytes transplanted into mice with liver pathology, not only did the ASCs differentiate into hepatocytes, but they also restored liver function.
Other potential clinical uses of ASCs include the treatment of multiple sclerosis, Alzheimer’s disease, and neurologic disorders. Other ongoing preclinical trials are focusing on the treatment of diabetes and cirrhosis. Another trial has leveraged ASCs for the management of fistulas in relation to Crohn’s disease, where they control inflammation and improve healing.
In spite of such potential, a number of questions remain to be elucidated, including the cellular, molecular, and biological features of these ASCs. It is uncertain whether the therapeutic effects of these cells are related to the cells’ ability to differentiate or to paracrine activity. Additional in vivo investigation needs to take place to clarify these doubts.
Future of Regenerative Medicine
Regenerative medicine is in constant evolution, and therapies leveraging ASCs and adipose tissue hold great promise for future research and clinical applications in this field. In the past 10 years, preclinical data stemming from in vitro studies and animal models have supported the use of these therapies in clinical applications.
The enhancing effect of ASCs on autologous repair could certainly lead to improved clinical outcomes, and play a relevant role in the treatment and rejuvenation of damaged tissue. Additional data on the methods used, and on an optimal management conducive to promoting differentiation lineages, need to be gathered and tested. As research progresses, new strategies are being developed to overcome current shortcomings, boost future therapeutic implementation, and meet the challenges posed by regenerative medicine.
Morenike Trenou
Independent Scholar
See Also: Adipose: Cell Types Composing the Tissue; Adipose: Existing or Potential Regenerative Medicine Strategies; Breast Cancer; Cancer Stem Cells: Overview; Pluripotent Stem Cells, Embryonic.
Further Readings
Bunnell, B., et al. “Adipose-Derived Stem Cells for Regenerative Medicine.” Circulation Research (2007).
Hong, L., I. A. Peptan, A. Colpan, et al. “Adipose Tissue Engineering by Human Adipose-Derived Stromal Cells.” Cells Tissues Organs, v.183 (2006).
Locke, M., J. Windsor, and P. R. Dunbar. “Human Adipose-Derived Stem Cells: Isolation, Characterization and Applications in Surgery.” ANZ Journal of Surgery, v.79 (2009).
Seong, J. M., B. C. Kim, J. H. Park, et al. “Stem Cells in Bone Tissue Engineering.” Biomedical Materials, v.5/06 (2010).
Shiffman, M. A., and S. Mirrafati. “Fat Transfer Techniques: The Effect of Harvest and Transfer Methods on Adipocyte Viability and Review of the Literature.” Dermatologic Surgery, v.27 (2001).
Sterodimas, A., J. de Faria, B. Nicaretta, et al. “Tissue Engineering With Adipose-Derived Stem Cells (ADSCs): Current and Future Applications.” Journal of Plastic, Reconstructive and Aesthetic Surgery, v.63 (2010).
Yoshimura, K., et al. “Cell-Assisted Lipotransfer for Facial Lipoatrophy: Efficacy of Clinical Use of Adipose-Derived Cells.” Dermatologic Surgery, v.34 (2006).
Yoshimura, K., et al. “Cell-Assisted Lipotransfer for Cosmetic Breast Augmentation: Supportive Use of Adipose-Derived Stem/Stromal Cells.” Aesthetic Plastic Surgery, v.32/1 (2008).
Zuk, P. A., M. Zhu, H. Mizuno, et al. “Multilineage Cells From Human Adipose Tissue: Implications for Cell-Based Therapies.” Tissue Engineering, v.7 (2001).
Breast: Existing or Potential Regenerative Medicine Strategies
Breast: Existing or Potential Regenerative Medicine Strategies
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Breast: Existing or Potential Regenerative Medicine Strategies
One aspect of regenerative medicine strategies of the breast involves treatment of breast cancer patients. Treatment of breast cancer depends on the kind of breast cancer and how far it has spread. Breast cancer treatment usually involves surgical removal of the tumor itself along with all or part of the surrounding normal breast tissue. After the operation, the breast is usually treated with radiation, which can alter the architecture of the breast. Methods of reconstruction include breast prosthetics or autologous tissue flaps. The reconstruction can be performed immediately at the time of mastectomy or on a delayed basis.
Subpectoral tissue expanders prepare the breast for implantation with saline or silicone. Reconstruction with implants is common, as the recovery is rapid and there is no donor site morbidity. However, implants can have several complications. Plastic surgeons are able to reconstruct the breast using autologous tissue flaps such as the latissimus dorsi, transverse rectus abdominus myocutaneous (TRAM) flap, and various perforator flaps. These terms represent abdominal tissue and vascular supplies used to reconstruct the breast. Perforator flaps minimize donor site morbidity through the preservation of muscle.
The implants are linked with the problems of any large foreign mass in the body. They are particularly problematic after radiation treatment. Stem cell treatment of the breast poses the advantage of creating a natural regrowth of fat tissue within the breast, which will give it a soft, natural appearance. Using body fat stored in the woman’s hips or thighs, the fat can recreate a natural breast.
Breast Reconstruction With Fat Graft and Plasma
Fat grafting, also known as autologous fat transfer, is a reconstructive technique that involves taking fat from the patient’s body via liposuction, processing it, and then injecting the liquefied fat into another area of the body. An alternative form of fat grafting, called lipofilling, has been used for a number of years to treat minor shape, contour, or positioning issues of the reconstructed breast. Present research surrounding lipofilling involves reconstructing an entire breast using fat. One considerable limitation to this strategy is the variability in results due to resorption. Over time, this results in a variable reduction in volume. Some clinicians utilize a Brava device, which is an external tissue expander. In this fat grafting technique, the Brava device is worn for several weeks prior to and after the fat grafting. The Brava device is a bra shaped with plastic cones for cups. The cones put suction on the breast area to expand the tissue, creating a matrix for fat to reside and preventing deformation and a loss of volume.
Fat grafting is advantageous in that patients are able to use their own native tissue instead of an implant. The fat is often removed from an area where the patient does not want fat, such as the buttocks or thigh. The treatment involves local anesthetic. The recovery period for fat graft patients is much shorter and less disruptive than other techniques. Many women report that a fat-graft reconstructed breast provides a natural, soft feel similar to an unreconstructed breast. Disadvantages for fat grafting treatment include the prolonged use of the Brava device, which can provide discomfort for the patient. The injected fat may be reabsorbed by the body over time. Since some fat cells can stimulate cell growth, some clinicians are concerned that fat injected into the breast may cause dormant breast cancer cells to grow. Research has not been done to address
