Abstract
ABSTRACTPurpose:To assess the effects of adipocyte-derived stem cell (ASC)-injection on the survival of surgical flaps under ischemia in diabetic rats.Methods:Diabetes was induced in 30 male Wistar rats using streptozotocin (55 mg/kg). After eight weeks, epigastric flap (EF) surgery was performed. The animals were divided into control (CG), medium-solution (MG), and ASC groups. The outcomes were: the survival area (SA), the survival/total area rate (S/TR), and expression levels (EL) of genes: C5ar1, Icam1, Nos2, Vegf-a.Results:In the ASC group, compared to CG, we observed improved flap SA (CG-420 mm2 vs. ASC-720 mm2; p=0.003) was observed. The S/TR analysis was larger in the ASC group (78%) than the CG (45%). This study showed an increase in the Vegf-a EL in the ASC group (2.3) vs. CG (0.93, p=0.0008). The Nos2 EL increased four-fold in the ASC group compared to CG, and C5ar1 EL decreased almost two-fold in the ASC group vs. the CG (p=0.02). There was no difference among the groups regarding Icam1 EL. Compared to the MG, the ASC group had a bigger flap SA (720 mm2 vs. 301 mm2, respectively), a bigger S/TR (78% vs. 32%, p=0.06, respectively) and increased EL of Vegf-a (2.3 vs. 1.3, respectively). No difference between ASC-group and MG was seen regarding Nos2 (p=0.08) and C5ar1 (p=0.05).Conclusions:This study suggests that ASCs increase the survival of EF under IR in diabetic rats.
Highlights
Several strategies have been developed to increase flap survival in patients with diabetes, e.g., VEGF-a to stimulate neoangiogenesis[1], and vasodilators[2] and hyperbaric oxygen therapy to increase the oxygen supply[3]
This study showed an increase in the Vegf-a expression levels (EL) in the adipocyte-derived stem cell (ASC) group (2.3) vs. Control group (CG) (0.93, p=0.0008)
The ASC group showed a higher survival area compared to CG (720 mm[2] vs. 420 mm[2], p=0.02)
Summary
Several strategies have been developed to increase flap survival in patients with diabetes, e.g., VEGF-a to stimulate neoangiogenesis[1], and vasodilators[2] and hyperbaric oxygen therapy to increase the oxygen supply[3]. These therapies have shown uncertain outcomes, because the necrosis may have multifactorial origin[2,3]. Mesenchymal cells can modulate inflammation (paracrine effect) and promote cell proliferation in injured tissues[6]. There is a lack of data related to the effects of ASCs on IR-induced tissue damage in diabetes Adipocyte-derived stem cells (ASCs) appear most promising, due to their low invasive harvesting and the possibility of collecting these in large quantities of liposuction[6,7,8,9].
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