Preparation, Characterization, and Clinical Implications of Human Decellularized Adipose Tissue Extracellular Matrix (hDAM): A Comprehensive Review

Abstract

Fat grafting is commonly employed by plastic and reconstructive surgeons to address contour abnormalities and soft-tissue defects; however, because retention rates and thus volume filling effects are unpredictable, there is a search for new and innovative approaches. Initial studies on the use of human decellularized adipose tissue extracellular matrix (hDAM) show promise for its use not only in tissue engineering, but also in fat grafting. In this review, we examine and analyze the literature for the preparation, characterization, and use of hDAM and its derivatives in tissue engineering and plastic surgery applications. All studies reviewed involve physical, chemical, and/or biological treatment stages for the preparation of hDAM; however a distinction should be made between detergent and nondetergent-based processing, the latter of which appears to preserve the native integrity of the hDAM while most-efficiently achieving complete decellularization. Methods of hDAM characterization vary among groups and included simple and immunohistochemical staining, biochemical assays, 3-dimensional (3D) imaging, and mechano-stress testing, all of which are necessary to achieve a comprehensive description of this novel tissue. Finally, we examine the various preclinical models utilized to optimize hDAM performance, which primarily include the addition of adipose-derived stem cells or cross-linking agents. Overall, hDAM appears to be a promising adjunct in fat-grafting applications or even possibly as a stand-alone soft-tissue filler with off-the-shelf potential for commercial applications.

MS in self-identified Hispanic/Latino individuals living in the US

“…Differences however have been noted when stratifying by place of birth where female predominance is increased in those who have immigrated to the US. 26 This difference is speculated to reflect migratory patterns in time where males make up a larger proportion. 27 …”

“…Immigrants to the US with MS reported more vascular risk factors, with hypercholesterolemia being the most common reported comorbid medical problem affecting them compared to US-born individuals ( p = 0.002). 26 A cross-sectional assessment of headache as comorbidity in individuals affected by MS found that chronic migraine was significantly more common among Hispanics (82%) than whites (18%; p = 0.012) and was noted to have significant impact on their daily life activities. 78 Differences in comorbid condition by immigration status in the US Hispanic MS population is expected to be the result of health care disparities that could reflect sociocultural and economic barriers that could have withstanding effects on disability.…”

Scarless Wound Healing: Looking for a Single Remedy With Multiple Targets

“…These cells show less potential than embryonic cells yet compared with bone marrow stem cells, they are easily harvested (55). Lipotransfer seems to improve the structural features of the extracellular matrix and increase its production (57). Histologic assessment after fat transfer revealed new collagen synthesis and dermal hyperplasia with hypervascularity, which was observed locally (55) and in a molecular study, results demonstrated downregulation of fibrotic markers along with upregulation of vasculogenic markers documented using both techniques (58).…”

Reply: Phenotypic Analysis of Stromal Vascular Fraction after Mechanical Shear Reveals Stress-Induced Progenitor Populations

“…There is currently a shift toward stromal vascular fraction as a therapeutic for regenerative applications, and we believe that a number of these subpopulations, in addition to the extracellular matrix, act synergistically for regenerative applications. 5,6 We are currently working in earnest to further characterize the differentiation capacity, transcriptional profile, secretome, and clonal properties of mechanically processed adipose-derived stem cells and other constituents of the stromal vascular fraction. We thank you for your letter and look forward to the growing body of knowledge regarding the mechanical processing of adipose tissue and its potential regenerative applications.…”