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Review
. 2017 Nov;11(11):3220-3235.
doi: 10.1002/term.2213. Epub 2017 Feb 3.

The power of fat and its adipose-derived stromal cells: emerging concepts for fibrotic scar treatment

Maroesjka Spiekman  1 , Joris A van Dongen  1   2 , Joep C Willemsen  1   2 , Delia L Hoppe  3 , Berend van der Lei  2 , Martin C Harmsen  1
Affiliations
Review

The power of fat and its adipose-derived stromal cells: emerging concepts for fibrotic scar treatment

Maroesjka Spiekman et al. J Tissue Eng Regen Med. 2017 Nov.

Abstract

Lipofilling or lipografting is a novel and promising treatment method for reduction or prevention of dermal scars after injury. Ample anecdotal evidence from case reports supports the scar-reducing properties of adipose tissue grafts. However, only a few properly controlled and designed clinical trials have been conducted thus far on this topic. Also, the underlying mechanism by which lipofilling improves scar aspect and reduces neuropathic scar pain remains largely undiscovered. Adipose-derived stromal or stem cells (ADSC) are often described to be responsible for this therapeutic effect of lipofilling. We review the recent literature and discuss anticipated mechanisms that govern anti-scarring capacity of adipose tissue and its ADSC. Both clinical and animal studies clearly demonstrated that lipofilling and ADSC influence processes associated with wound healing, including extracellular matrix remodelling, angiogenesis and modulation of inflammation in dermal scars. However, randomized clinical trials, providing sufficient level of evidence for lipofilling and/or ADSC as an anti-scarring treatment, are lacking yet warranted in the near future. © 2017 The Authors Journal of Tissue Engineering and Regenerative Medicine Published by John Wiley & Sons Ltd.

Keywords: adipose tissue; adipose-derived stromal/stem cells; dermal scar; lipofilling; scar treatment; stromal vascular fraction.

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Conflict of interest statement

The authors have no conflicts of interest to disclose in relation to the content of this work.

Figures

Figure 1
Figure 1
Schematic overview of dermal scar on tissue level, before and after treatment with lipofilling. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Summary of different fractions of adipose tissue before, during and after mechanical or enzymatic isolation of adipose‐derived stem or stromal cells (ADSC). Cell types and their cell surface markers are represented for all different fractions. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
Harnessing the power of fat for fibrotic scar treatment: as whole adipose tissue in lipofilling, or in loose components such as stromal vascular fraction (SVF), adipose‐derived stem or stromal cells (ADSC) or ADSC conditioned medium. As listed, we propose each form has its own ideal application. [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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