Abstract
Stromal vascular fraction (SVF) containing adipose stem cells (ASCs) has been used for many years in regenerative plastic surgery for autologous applications, without any focus on their potential allogenic role. Allogenic SVF transplants could be based on the possibility to use decellularized extracellular matrix (ECM) as a scaffold from a donor then re-cellularized by ASCs of the recipient, in order to develop the advanced therapy medicinal products (ATMP) in fully personalized clinical approaches. A systematic review of this field has been realized in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. Multistep research of the PubMed, Embase, MEDLINE, Pre-MEDLINE, PsycINFO, CINAHL, Clinicaltrials.gov, Scopus database, and Cochrane databases has been conducted to identify articles and investigations on human allogenic ASCs transplant for clinical use. Of the 341 articles identified, 313 were initially assessed for eligibility on the basis of the abstract. Of these, only 29 met all the predetermined criteria for inclusion according to the PICOS (patients, intervention, comparator, outcomes, and study design) approach, and 19 have been included in quantitative synthesis (meta-analysis). Ninety-one percent of the studies previously screened (284 papers) were focused on the in vitro results and pre-clinical experiments. The allogenic use regarded the treatment of perianal fistulas, diabetic foot ulcers, knee osteoarthritis, acute respiratory distress syndrome, refractory rheumatoid arthritis, pediatrics disease, fecal incontinence, ischemic heart disease, autoimmune encephalomyelitis, lateral epicondylitis, and soft tissue defects. The information analyzed suggested the safety and efficacy of allogenic ASCs and ECM transplants without major side effects.
Highlights
The Stromal Vascular Fraction Cells (SVFs) and Adipose Stem Cells (ASCs), both contained in the Stromal Vascular fraction (SVF) portion, meet the majority of the International Society for Cellular Therapy—ISCT’s criteria for Mesenchymal Stem Cells (MSCs) [1].The ISCT [1] suggested four parameters to define MSCs: 1. MSCs are disc-adherent in standard cultures; 2
The human clinical allogenic use regarded the treatment of complex perianal fistulas, diabetic foot ulcers, knee osteoarthritis, acute respiratory distress syndrome (ARDS), refractory rheumatoid arthritis, pediatrics disease, fecal incontinence, allogenic flap, ischemic heart disease, autoimmune encephalomyelitis, lateral epicondylitis, and soft tissue defects
It is fundamental that the implementation of adipose-derived stem cell therapy is based on the standard principles of Evidence-Based Medicine (EBM)
Summary
The Stromal Vascular Fraction Cells (SVFs) and Adipose Stem Cells (ASCs), both contained in the Stromal Vascular fraction (SVF) portion, meet the majority of the International Society for Cellular Therapy—ISCT’s criteria for Mesenchymal Stem Cells (MSCs) [1].The ISCT [1] suggested four parameters to define MSCs: 1. MSCs are disc-adherent in standard cultures; 2. The Stromal Vascular Fraction Cells (SVFs) and Adipose Stem Cells (ASCs), both contained in the Stromal Vascular fraction (SVF) portion, meet the majority of the International Society for Cellular Therapy—ISCT’s criteria for Mesenchymal Stem Cells (MSCs) [1]. MSCs express CD73, CD90, and CD105; 4. MSCs do not express CD11b, CD14, CD19, CD34, CD45, CD79, c-kit, and human leukocyte antigen-DR. The SVF offers a rich source of ASCs that may be gathered from human adipose tissue (HAT) [2]. Each mL of HAT offers 300,000 SVFs, of which 1–3% are represented by ASCs (3000–9000/mL) [3]. The anti-inflammatory and immunomodulatory activities of SVFs and ASCs make them considered as a potential cellular therapy in Coronavirus disease 2019 (COVID-19), as preliminarily displayed [4]
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