Abstract
The stromal vascular fraction (SVF) is a heterogeneous population of stem/stromal cells isolated from perivascular and extracellular matrix (ECM) of adipose tissue complex (ATC). Administration of SVF holds a strong therapeutic potential for regenerative and wound healing medicine applications aimed at functional restoration of tissues damaged by injuries or chronic diseases. SVF is commonly divided into cellular stromal vascular fraction (cSVF) and tissue stromal vascular fraction (tSVF). Cellular SVF is obtained from ATC by collagenase digestion, incubation/isolation, and pelletized by centrifugation. Enzymatic disaggregation may alter the relevant biological characteristics of adipose tissue, while providing release of complex, multiattachment of cell‐to‐cell and cell‐to‐matrix, effectively eliminating the bioactive ECM and periadventitial attachments. In many countries, the isolation of cellular elements is considered as a “more than minimal” manipulation, and is most often limited to controlled clinical trials and subject to regulatory review. Several alternative, nonenzymatic methods of adipose tissue processing have been developed to obtain via minimal mechanical manipulation an autologous tSVF product intended for delivery, reducing the procedure duration, lowering production costs, decreasing regulatory burden, and shortening the translation into the clinical setting. Ideally, these procedures might allow for the integration of harvesting and processing of adipose tissue for ease of injection, in a single procedure utilizing a nonexpanded cellular product at the point of care, while permitting intraoperative autologous cellular and tissue‐based therapies. Here, we review and discuss the options, advantages, and limitations of the major strategies alternative to enzymatic processing currently developed for minimal manipulation of adipose tissue. stem cells translational medicine 2019;8:1265&1271
Highlights
In 2001, Zuk et al described in a seminal work the isolation of putative multipotent cells from lipoaspirates [1]
SVF is commonly divided into cellular stromal vascular fraction and tissue stromal vascular fraction
The tissue stromal vascular fraction is a heterogeneous cell population containing adipose-derived stem/stromal cells, isolated from adipose tissue using nonenzymatic dissociation, which has been successfully used in translational studies and clinical trials
Summary
The ease of harvest with minimal donor morbidity, and plentiful access, makes adipose tissue a convenient source for autologous cell- and tissue-based therapies for regenerative medical purposes. The tissue stromal vascular fraction is a heterogeneous cell population containing adipose-derived stem/stromal cells, isolated from adipose tissue using nonenzymatic dissociation, which has been successfully used in translational studies and clinical trials The aim of this narrative literature review is to describe and discuss the effective, alternative, recognized methods for obtaining cell- and tissue-therapy products with minimal manipulation. Optimization of these methods has the potential to offer unprecedented opportunities to further bring effective regenerative therapies at the point of care in a widely variable application group in wound, orthopedic, musculoskeletal, and plastic-reconstructive fields
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