Résumé
Le tissu adipeux (TA) est un organe endocrine impliqué dans la régulation de l’homéostasie énergétique en agissant au niveau du système nerveux central via les hormones qu’il sécrète telle que la leptine et au niveau locorégional. Le TA sous-cutané abdominal est devenu un des paramètres importants de la caractérisation des phénotypes des patients atteints d’obésité massive. Des anomalies morphologiques et fonctionnelles, telles que l’hypertrophie adipocytaire, l’inflammation ou la fibrose du tissu adipeux sont associées aux complications métaboliques liées à l’obésité. Ce tissu est facilement accessible à un prélèvement respectant plusieurs procédures. L’objectif de cet article est de présenter les différentes techniques de prélèvement du TA souscutané abdominal aujourd’hui développées en recherche clinique et leurs apports. Si l’aspiration de TA sous-cutané à l’aiguille est la technique la moins invasive, elle ne permet pas, en général, une bonne étude histologique car trop déstructurante pour le tissu. La biopsie chirurgicale qui nécessite une incision cutanée est plus invasive mais elle permet une étude histologique complète et de qualité, au prix d’une moindre quantité de TA en comparaison à l’aspiration.
Abstract
Adipose tissue (AT) is now well recognized as an endocrine organ involved in energy homeostasis regulation acting both on the central nervous system and at the local level via its hormonal secretion such as leptin. Recently, the abdominal subcutaneous AT, which is easily accessible by using several procedures, became one of the important parameters used to phenotype morbidly obese patients. Indeed, morphologic and functional modifications such as, adipocyte hypertrophia, inflammation and fibrosis are associated with obesity-related metabolic complications. The objectives of this article are to present the various techniques of abdominal subcutaneous AT biopsies, as well as further information which they can bring. The less morbid technique is the subcutaneous AT needle aspiration, which is currently used in several indications including morbidly obese patient phenotyping. However, it does not allow a complete histological study because it generally provides unstructured AT samples. Surgical AT biopsy, which requires a cutaneous section, is more invasive than the needle aspiration. However, it allows a good quality complete histological study, but with a lesser AT amount than the needle aspiration.
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Genser, L., Vatier, C., Keophyphath, M. et al. Le prélèvement de tissu adipeux: un acte médical pour la recherche clinique. Perspectives pour le soin courant. Obes 8, 222–227 (2013). https://doi.org/10.1007/s11690-013-0403-8
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DOI: https://doi.org/10.1007/s11690-013-0403-8