Transplantation of Adipose Stromal Cells Promotes Neovascularization of Random Skin Flaps

Abstract

The delivery of bone marrow-derived mononulear cells (BM-MNCs) has been proved to be effective at promoting neovascularization of ischemic skin flaps. However, the limited source of BM-MNCs restricts their clinical application. Stromal vascular fraction (SVF) contains a group of heterogeneous cells in the adipose tissue, including adipose tissue-derived stem cells, and it has abundant reserve in human body. In this study, we evaluated the therapeutic potential of SVF to promote neovascularization of random skin flaps. Female Wistar rats were randomly devided into three groups with 8 in each group and received allogeneic SVF, BM-MNCs and phosphate-buffered saline (PBS), respectively, before surgery. Two days after cell administration, a 10 × 3 cm random skin flap was elevated. Flap survival, blood flow perfusion and capillary density were examined 7 days after surgery, and the relevant mechanism was also explored. Results showed that SVF group and BM-MNCs group had higher survival percentage (72.2 ± 2.0% and 76.4 ± 3.1%, respectively) as compared with the control group (56.8 ± 4.6%, P < 0.05). Blood flow perfusion and capillary density of flap tissues in SVF and BM-MNCs groups were both improved. The expression levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were increased in flap tissues of SVF and BM-MNCs groups detected by ELISA. These results indicate that SVF could promote vascularization and increase flap survival probably by secreting VEGF and bFGF. The effect of transplantation of SVF on therapeutic angiogenesis of skin flaps is equivalent to that of BM-MNCs.

Autologous Stem Cell Transplantation Promotes Mechanical Stretch Induced Skin Regeneration: A Randomized Phase I/II Clinical Trial

“…Mechanical stretch during tissue expansion creates a unique microenvironment (Zollner et al, 2013, Zhou et al, 2013) for skin regeneration. With the assist of MNCs, stretched skins are endorsed accelerated angiogenesis (Sheng et al, 2011, Zhou et al, 2013, Sasaki et al, 2008) and growth factor secretion (Yang et al, 2011, Stappenbeck and Miyoshi, 2009). Histological results of the present trial showed that there was a durable increase in the number of proliferating cells in the expanded skin after MNC transplantation (p < 0.01).…”

Effects of Acellular Amniotic Membrane Matrix and Bone Marrow-Derived Mesenchymal Stem Cells in Improving Random Skin Flap Survival in Rats

“…In this regard, Sheng et al (2011) demonstrated that BM-MSC transplantation improves neovascularization by increasing capillary angiogenesis and blood flow perfusion (6). They showed that BM-MSCs, a heterogeneous population of cells, are more beneficial than homogenous compositions in therapeutic vascularization (6).…”

“…They showed that BM-MSCs, a heterogeneous population of cells, are more beneficial than homogenous compositions in therapeutic vascularization (6). The effects of BM-MSCs and adipose mesenchymal stem cells (AD-MSCs) on skin flap survival have often been studied in dorsal random skin flaps in rats (5).…”

“…Neovascularization of the skin flap is a complicated process that requires proliferation of endothelial cells and cooperation of various growth factors (6). With this in mind, cell therapy has been considered an important basis of treatment, due to the cells’ capacity to self-renew and differentiate into numerous specific cell lines, and the use of mesenchymal cells derived from bone marrow and soft-tissue reconstruction has increased dramatically (7).…”

Stem Cell Research: A New Era for Reconstructive Surgery

“…In the recent studies, both BM-MNCs and SVF, have been found to promote the survival of ischemic flaps. [47] With great progress in stem cell therapy, more optimal choices will appear for the treatment of ischemia flaps. But still what is known from these cells is not enough, lots of work have to be done to explore the mechanism of cell therapy, and to improve the survival of transplanted cells as well as their therapeutic effects.…”