Abstract
BackgroundOur previous study proved that nanofat could enhance fat graft survival by promoting neovascularization. Fat extract (FE), a cell-free component derived from nanofat, also possesses proangiogenic activity.ObjectivesThe aim of this study was to investigate whether FE could improve fat graft survival and whether FE and nanofat could work synergistically to promote fat graft survival. The underlying mechanism was also investigated.MethodsIn the first animal study, human macrofat from lipoaspirate was co-transplanted into nude mice with FE or nanofat. The grafts were evaluated at 2, 4 and 12 weeks post-transplantation. In the second animal study, nude mice were transplanted with a mixture of macrofat and nanofat, followed by intra-graft injection of FE at days 1, 7, 14, 21 and 28 post-transplantation. The grafts were evaluated at 12 weeks post-transplantation. To detect the mechanism by which FE impacts graft survival, the proangiogenic, anti-apoptotic and pro-proliferative activities of FE were analysed in grafts in vivo and in cultured human vascular endothelial cells (HUVECs), adipose-derived stem cells (ADSCs) and fat tissue in vitro.ResultsIn the first animal study, the weights of the fat grafts in the nanofat- and FE-treated groups were significantly higher than those of the fat grafts in the control group. In addition, higher fat integrity, more viable adipocytes, more CD31-positive blood vessels, fewer apoptotic cells and more Ki67-positive proliferating cells were observed in the nanofat- and FE-treated groups. In the second animal study, the weights of the fat grafts in the nanofat+FE group were significantly higher than those of the fat grafts in the control group. In vitro, FE showed proangiogenic effects on HUVECs, anti-apoptotic effects on fat tissue cultured under hypoxic conditions and an ability to promote ADSC proliferation and maintain their multiple differentiation capacity.ConclusionsFE could improve fat graft survival via proangiogenic, anti-apoptotic and pro-proliferative effects on ADSCs. FE plus nanofat-assisted fat grafting is a new strategy that could potentially be used in clinical applications.
Highlights
Our previous study proved that nanofat could enhance fat graft survival by promoting neovascularization
Fat extract (FE) showed proangiogenic effects on human vascular endothelial cells (HUVECs), anti-apoptotic effects on fat tissue cultured under hypoxic conditions and an ability to promote adipose-derived stem cells (ADSCs) proliferation and maintain their multiple differentiation capacity
FE plus nanofat-assisted fat grafting is a new strategy that could potentially be used in clinical applications
Summary
Our previous study proved that nanofat could enhance fat graft survival by promoting neovascularization. Fat extract (FE), a cell-free component derived from nanofat, possesses proangiogenic activity. Soft tissue defects caused by congenital defects, trauma, tumour resection and ageing are the most common problems in plastic and reconstructive surgery. Traditional repairs include filling with artificial fillers and autologous tissue transplantation. The potential rejection reactions induced by artificial fillers limit their clinical application. With biocompatibility and a wide range of sources, autologous fat grafting has become one of the most commonly used methods for the treatment of soft tissue defects. The highly unpredictable absorption rate of grafted fats after fat transplantation reduces the efficacy of this method. The retention rate of grafted fats is reported to range from 20 to 80% [1,2,3,4]
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