Journal of Molecular Medicine

, Volume 97, Issue 6, pp 761–775 | Cite as

Regenerative potential of adipocytes in hypertrophic scars is mediated by myofibroblast reprogramming

  • Katharina Hoerst
  • Lenie van den Broek
  • Christoph Sachse
  • Oliver Klein
  • Uwe von Fritschen
  • Sue Gibbs
  • Sarah HedtrichEmail author
Original Article


Abnormal scarring is a major challenge in modern medicine. The central role of myofibroblasts and TGF-β signaling in scarring is widely accepted, but effective treatment options are missing. Autologous fat grafting is a novel approach that has led to significant improvements in the functionality and appearance of scar tissue. While the underlying mechanism is unknown, the potential role of paracrine effects of adipocytes has been discussed. Hence, with the aim of unraveling the regenerative potential of adipocytes, their effects on in vitro differentiated myofibroblasts and on fibroblasts from hypertrophic scars were investigated. Exposure to adipocyte-conditioned medium significantly decreased the expression of the myofibroblast marker α-SMA and ECM components, indicating the occurrence of myofibroblast reprogramming. Further analysis demonstrated that myofibroblast reprogramming was triggered by BMP-4 and activation of PPARγ signaling initiating tissue remodeling. These findings may pave the way for novel therapeutic strategies for the prevention or treatment of hypertrophic scars.

Key messages

  • Adipocytes induce distinct regenerative effects in hypertrophic scar tissue.

  • Adipocytes secrete several proteins which are involved in wound healing and regeneration.

  • Adipocytes secrete BMP-4 which activates myofibroblast reprogramming.

  • Mediators secreted by adipocytes directly and indirectly activate PPARγ which exerts distinct anti-fibrotic effects.

  • These findings may pave the way for novel therapeutic strategies for the prevention or treatment of hypertrophic scars.


Myofibroblast Wound healing Hypertrophic scar Adipocyte Bone morphogenetic protein 



The authors thank Patrick Graff and Maria Thon for technical assistance. Moreover, the authors would like to acknowledge the support of Anja Briese and Dr. Christoph Sachse (NMI TT Pharmaservices).

Author contributions

K.H., G.E., and O.K. performed experiments. S.H., L.v.B. (at VUmc), and S.G. (at VUmc) supervised the work. K.H. and S.H. designed the experiments, analyzed the data, and wrote the manuscript. All the authors provided critical review of the manuscript.

Funding information

This work was financially supported by the Einstein Center for Regenerative Therapies (ECRTs) and the Berlin-Brandenburg School for Regenerative Therapies (BSRT).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

109_2019_1772_MOESM1_ESM.xlsx (46 kb)
ESM 1 (XLSX 45 kb)
109_2019_1772_MOESM2_ESM.pdf (595 kb)
ESM 2 (PDF 595 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Pharmaceutical Sciences, Pharmacology and ToxicologyFreie Universität BerlinBerlinGermany
  2. 2.Department of DermatologyVU University Medical CenterAmsterdamThe Netherlands
  3. 3.NMI TT PharmaservicesBerlinGermany
  4. 4.Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität BerlinHumboldt-Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
  5. 5.Division of Plastic Surgery and Hand SurgeryHelios ClinicBerlinGermany
  6. 6.University of British Columbia, Faculty of Pharmaceutical SciencesVancouverCanada

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