The therapeutic effect of adipose-derived stem cells on soft tissue injury after radiotherapy and their value for breast reconstruction

Tang, Haojing; He, Yiting; Liang, Zhuokai; Li, Jian; Dong, Ziqing; Liao, Yunjun

doi:10.1186/s13287-022-02952-7

Cited by 8 publications

(5 citation statements)

References 111 publications

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“…Thus, although CAL was first proposed more than ten years ago, it has not been widely used in breast cancer patients until recently. As the safety of CAL in breast cancer reconstruction has gradually been confirmed, radiotherapy in breast reconstruction with CAL appears to be a diminishing relative contraindication [ 47 ]. In the present study, our results demonstrated that CAL did not increase recurrence risk; it was oncologically safe in breast cancer patients after radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Current perspectives on cell-assisted lipotransfer for breast cancer patients after radiotherapy

Chen

Peng

et al. 2023

World J Surg Onc

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Background Cell-assisted lipotransfer (CAL), a technique of autologous adipose transplantation enriched with adipose-derived stem cells (ADSCs), has the potential to improve cosmetic outcomes at irradiated sites. However, many concerns have been raised about the possibility of ADSCs increasing oncological risk in cancer patients. With the increasing demand for CAL reconstruction, there is an urgent need to determine whether CAL treatment could compromise oncological safety after radiotherapy, as well as to evaluate its efficacy in guiding clinical decisions. Methods A PRISMA-compliant systematic review of the safety and efficacy of CAL in breast cancer patients after radiotherapy was conducted. The PubMed, Ovid, Cochrane Library, and ClinicalTrials.gov databases were comprehensively searched from inception to 31 December 2021. Results The search initially yielded 1185 unique studies. Ultimately, seven studies were eligible. Based on the limited outcome evidence, CAL did not increase recurrence risk in breast cancer patients but presented aesthetic improvement and higher volumetric persistence in a long-term follow-up. Although breast reconstruction with CAL also had oncological safety after radiotherapy, these patients needed more adipose tissue and had relatively lower fat graft retention than the non-irradiated patients (P < 0.05). Conclusions CAL has oncological safety and does not increase recurrence risk in irradiated patients. Since CAL doubles the amount of adipose required without significantly improving volumetric persistence, clinical decisions for irradiated patients should be made more cautiously to account for the potential costs and aesthetic outcomes. There is limited evidence at present; thus, higher-quality, evidence-based studies are required to establish a consensus on breast reconstruction with CAL after radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Current perspectives on cell-assisted lipotransfer for breast cancer patients after radiotherapy

Chen

Peng

et al. 2023

World J Surg Onc

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“…ASCs are partially characterized by their multilineage differentiation capacity: some common differentiation lineages for therapeutic applications include adipogenic and osteogenic cell types 94,95 . This allows for potential application of ASCs to treat a variety of conditions, including bone fractures, osteoarthritis and osteoporosis, spinal fusions, craniofacial and soft tissue defects, and cosmetic defects requiring enhanced adipogenic tissue volume 70,[96][97][98][99][100][101][102] . Overall, the multilineage differentiation capacity in ASCs is a key contributor to their therapeutic potential.…”

Section: Differentiationmentioning

confidence: 99%

The tardigrade-derived mitochondrial abundant heat soluble protein improves adipose-derived stem cell survival against representative stressors

Rolsma,

Darch,

Higgins

et al. 2024

Sci Rep

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Human adipose-derived stem cell (ASC) grafts have emerged as a powerful tool in regenerative medicine. However, ASC therapeutic potential is hindered by stressors throughout their use. Here we demonstrate the transgenic expression of the tardigrade-derived mitochondrial abundant heat soluble (MAHS) protein for improved ASC resistance to metabolic, mitochondrial, and injection shear stress. In vitro, MAHS-expressing ASCs demonstrate up to 61% increased cell survival following 72 h of incubation in phosphate buffered saline containing 20% media. Following up to 3.5% DMSO exposure for up to 72 h, a 14–49% increase in MAHS-expressing ASC survival was observed. Further, MAHS expression in ASCs is associated with up to 39% improved cell viability following injection through clinically relevant 27-, 32-, and 34-gauge needles. Our results reveal that MAHS expression in ASCs supports survival in response to a variety of common stressors associated with regenerative therapies, thereby motivating further investigation into MAHS as an agent for stem cell stress resistance. However, differentiation capacity in MAHS-expressing ASCs appears to be skewed in favor of osteogenesis over adipogenesis. Specifically, activity of the early bone formation marker alkaline phosphatase is increased by 74% in MAHS-expressing ASCs following 14 days in osteogenic media. Conversely, positive area of the neutral lipid droplet marker BODIPY is decreased by up to 10% in MAHS-transgenic ASCs following 14 days in adipogenic media. Interestingly, media supplementation with up to 40 mM glucose is sufficient to restore adipogenic differentiation within 14 days, prompting further analysis of mechanisms underlying interference between MAHS and differentiation processes.

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“…Less research, however, focuses on complication or morbidity prediction. One study developed a protocol to investigate radiation-induced skin fibrosis resulting from breast cancer treatment, in an effort to derive an algorithm for personalized risk estimation [104] .…”

Section: Future Directionsmentioning

confidence: 99%

The radiated breast and autologous reconstruction: benefits and alternatives

Ewing,

Gala,

Lemdani

et al. 2024

Plast Aesthet Res

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Despite advancements in research and technology, breast cancer remains the second leading cause of cancer-related mortality affecting women worldwide. Radiation therapy is a widely recommended adjunct to surgery due to its significant role in reducing loco-regional recurrence. Its use, however, is not without consequences. Radiation triggers a series of pathophysiologic events leading to tissue injury; reactive oxygen species incites (1) vascular damage and chronic hypoxia; (2) an inflammatory response; and (3) activation of myofibroblasts to induce fibrosis. As a result, radiotherapy interferes with wound healing and negatively impacts the quality of the skin. These pathophysiologic consequences complicate the sequence of breast reconstruction and require surgeons to consider timing and the type of reconstruction (autologous vs. implant), with respect to radiotherapy to improve patient outcomes. In this article, we briefly review radiation-induced tissue effects and their impact on breast reconstruction. More specifically, we comment on the traditional use of autologous tissue, microsurgical technical pearls for irradiated fields, reconstructive timing paradigms, and lymphedema prevention. With continued progress, derivation, and innovation, plastic and reconstructive surgery has consistently advanced and revolutionized both medicine and surgery. This review considers the future implications of breast reconstruction and how it will impact patients, healthcare, and the field. While not an exhaustive review, we aim to provide a comprehensive discussion and insights. In summary, the authors discuss the possibilities of a paradigm shift in breast reconstruction, emphasizing the need for surgeons to have an armamentarium capable of all breast reconstruction options for the best possible patient outcomes.

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The therapeutic effect of adipose-derived stem cells on soft tissue injury after radiotherapy and their value for breast reconstruction

Cited by 8 publications

References 111 publications

Current perspectives on cell-assisted lipotransfer for breast cancer patients after radiotherapy

Current perspectives on cell-assisted lipotransfer for breast cancer patients after radiotherapy

The tardigrade-derived mitochondrial abundant heat soluble protein improves adipose-derived stem cell survival against representative stressors

The radiated breast and autologous reconstruction: benefits and alternatives

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