Adipose stem cells have gained great interest in plastic and reconstructive surgery with their ability to improve engraftment after fat transfer for soft tissue filling. It is therefore essential to know the effect of the drugs commonly used during the lipoaspiration procedure, such as lidocaine and adrenaline. Indeed, these drugs are infiltrated at the fat donor site for local anesthesia and for reduction of bleeding. This study analyzed the effects of these drugs on the viability of adipose-derived stem cells and on their inflammatory status.
Adipose-derived stem cells from lipoaspirates were grown in culture before being treated with different clinical doses of lidocaine at different times of exposure (1–24 h), and with adrenaline (1 μg/mL). Cytotoxicity was measured by lactate dehydrogenase assay and by flow cytometry with annexin V/propidium iodide staining. In parallel, the secretion of the proinflammatory cytokines tumor necrosis factor-alpha (TNFα), interleukin-6 (IL-6), and monocyte chemotactic protein-1 (MCP-1) was tested by enzyme-linked immunoassay.
Lidocaine affected cell viability after 24 h, even when the cells were exposed for only 1 or 2 h. Apoptosis was not involved in lidocaine cytotoxicity. Regarding inflammation, no TNFα was produced, and lidocaine decreased the levels of IL-6 and MCP-1 in a dose-dependent manner. In contrast, adrenaline did not influence cell viability or cytokine secretions.
Adipose tissue should be handled appropriately to remove lidocaine and adrenaline, with such procedures as washing and centrifugation. This study provides new insights into the use of lidocaine and adrenaline for fat transfer or stem cell isolation from lipoaspirates.
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This work has been financially supported by the Ministère de l’Enseignement Supérieur et de la Recherche, by the Association Nationale de la Recherche et de la Technologie, and by the University of Reunion Island. We are grateful to plastic surgeons Delarue P. and Hulard O. who took part in this study and allowed the collection of subcutaneous adipose tissue samples, to the group Clinifutur, to the entire team of the Biochemistry Department of the Félix Guyon Hospital, Reunion island, and to the French Ministry of National Education and Research and the Association Nationale de la Recherche et de la Technologie (ANRT) for their financial support. Finally, we thank all the patients who consented to the collection of tissue samples and thus made this study possible.
Anne-Claire Girard, Michael Atlan, Laurence Hoareau, Franck Festy contributed equally to this work.
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Girard, AC., Atlan, M., Bencharif, K. et al. New Insights into Lidocaine and Adrenaline Effects on Human Adipose Stem Cells. Aesth Plast Surg 37, 144–152 (2013). https://doi.org/10.1007/s00266-012-9988-9
- Adipose stem cells
- Fat grafting