Regulatory, ethical, and technical considerations on regenerative technologies and adipose-derived mesenchymal stem cells
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Since the early days of molecular biology, organ and tissue regeneration represents a challenging medical goal. However, only recently the advances in the understanding of the cellular components have enabled the promise to become a reality. In this vast panorama of new technologies, stem cells have progressively established themselves as the most effective and user-friendly regenerative therapeutic tool. Scientific meetings, workshops, conferences, and forums focused on translational science of regenerative technologies are today blooming all over the world. The audience questions and, even more, the very often controversial and conflicting explanations highlight the great deal of confusion regarding this new discipline that should be considered today a real independent medical specialty, requiring long-term studies and dedication. All the technologies able to separate and concentrate the adipose tissue (AT) and the stromal vascular fraction (SVF) and their related clinical applications need to comply with a complex but still unclear regulatory frame, becoming everyday more severe and restrictive, this limiting their practical use. The aim of this manuscript is to overview the current status of the regulatory frame and few related ethical considerations and to describe the evolution in the way the adipose-derived stromal vascular fraction (SVF) is isolated, extracted, and concentrated, as well as, of the ongoing researches and related future perspectives. Considerations on the most controversial and still unclear points related to the regenerative medicine and surgery, seen from the perspective of a research group who dedicated their entire professional life to this field, are also provided.
Level of evidence: Not ratable.
KeywordsRegeneration Cell derivates PRP Adipose tissue (AT) Stromal vascular fraction (SVF) Mesenchymal stem cells (MSCs) Pericytes Growth factors (GFs) Minimal-grade manipulation (MGM) High-grade manipulation (HGM) Lipocondensation Sonication Bioactive composite grafts (BACG) Biocatalyzers MUSE cells Exosomes Photobiomodulation Acellular adipose matrix (AAM)
Compliance with ethical standards
No funds have been received.
Conflict of interest
Michele L. Zocchi, Vincenzo Vindigni, Andrea Pagani, Ortensia Pirr, Giamaica Contio, Andrea Sbarbati, and Franco Bassetto declare that they have no conflict of interest.
No need of any ethical approval because the topic of the article is mainly related to basic science behind regenerative surgery and no direct action on patients has been taken and referred in the article.
For the abovementioned reasons, no informed consent has been necessary.
- 2.Fournier P (1985) Microlipoextraction et microlipoinjection. Rev Chir Esthet Lang Franc 10:36–40Google Scholar
- 5.Wells HG (1940) Adipose tissue, a neglected subject. J Am Med Assoc 114(22):2177–2183Google Scholar
- 7.Lafontan M (2016) The adipose tissue: development, physiology and pathophysiology. Intern Stand Press Book Chapt. 6Google Scholar
- 11.Crisan M, Yap S, Casteilla L, Chen CW, Corselli M, Park TS, Andriolo G, Sun B, Zheng B, Zhang L, Norotte C, Teng PN, Traas J, Schugar R, Deasy BM, Badylak S, Bűhring HJ, Giacobino JP, Lazzari L, Huard J, Péault B (2008) A perivascular origin for mesenchymal stem cells in multiple human organs. Cell Stem Cell 3(3):301–313PubMedGoogle Scholar
- 15.von Heimburg D, Hemmrich K, Haydarlioglu S, Staiger H, Pallua N (2004) Comparison of viable cell yield from excised versus aspirated adipose tissue. Cells Tissues Organs 178(2):87–92Google Scholar
- 20.Zocchi M (1989) Remodelage facial complet par implants de collagene autologue. Revue Française de Chirurgie Esthétique 14:63Google Scholar
- 21.Zocchi M (1990) Méthode de production de collagène autologue par traitement du tissu graisseux. Journal de Médecine Esthétique et de Chirurgie Dermatologique 17(66):105–114Google Scholar
- 22.Zocchi M, Zuliani F (2008) Bicompartmental breast lipostructuring. Aesthet Plast Surg 32(2):313–328Google Scholar
- 23.Zocchi ML, Zocchi L (2017) Large-volume breast fat transfer: technical evolutions and safety aspects based on over 800 cases and 26 years of follow-up. Eur J Plast Surg 40(5):367–382Google Scholar
- 26.Zocchi M (1992) Ultrasonic liposculpturing. Aesthet Plast Surg 16(4):287–298Google Scholar
- 27.Zocchi M (1993) Clinical aspects of ultrasonic liposculpture. Perspect Plast Surg 7(02):153–172Google Scholar
- 28.Zocchi M (1995) The ultrasonic assisted lipectomy, instructional course. In: Annual meeting of the American Society for Aesthetic Plastic Surgery, San FranciscoGoogle Scholar
- 30.Zocchi M (1989) Les implants mixtes de collagène autologue dans le remodelage facial. Journal de Médecine Esthétique et de Chirurgie Dermatologique 16(63):191–201Google Scholar
- 31.Zocchi M (2006) New perspectives in plastic surgery: Adiposederived stem cells (ADSC.). In: Abstract Book of the ISAPS World Congress of Rio de Janeiro, AugustGoogle Scholar
- 32.Oberbauer E et al (2015) Enzymatic and non-enzymatic isolation systems for adipose tissue-derived cells: current state of the art. Cell Regen 4(1):7Google Scholar
- 35.Büntemeyer H, Lehmann J (2001) The role of vitamins in cell culture media. In: Animal cell technology: from target to market. Springer, Berlin, pp 204–206Google Scholar
- 38.Collino F, Pomatto M, Bruno S, Lindoso RS, Tapparo M, Sicheng W, Quesenberry P, Camussi G (2017) Exosome and microvesicle-enriched fractions isolated from mesenchymal stem cells by gradient separation showed different molecular signatures and functions on renal tubular epithelial cells. Stem Cell Rev Rep 13(2):226–243PubMedGoogle Scholar
- 51.Stahl PD, Barbieri MA (2002) Multivesicular bodies and multivesicular endosomes: the “ins and outs” of endosomal traffic. Sci Signal 2002(141):pe32Google Scholar
- 60.Illouz Y-GS, Stereodimas A (2011) Adipose stem cells and regenerative medicine. Springer, BerlinGoogle Scholar
- 63.Bao H (2009) Decellularized human amniotic membrane. J Biotech 7Google Scholar
- 64.Bao H (2014) Method of decellularization of porcine cancellous bone. Int J Life Sci Med Res 4:38–45Google Scholar
- 65.Bao H (2016) Decellularized porcine pericardium for clinical applications. Turk J Biol 10(3906):1510–1544Google Scholar