Combined platelet-rich plasma and lipofilling treatment provides great improvement in facial skin-induced lesion regeneration for scleroderma patients

Abstract

BackgroundThe use of stem cells, including mesenchymal stem cells (MSCs), for regenerative medicine is gaining interest for the clinical benefits so far obtained in patients. This study investigates the use of adipose autologous tissue in combination with platelet-rich plasma (PRP) to improve the clinical outcome of patients affected by systemic sclerosis (SSc).MethodsAdipose-derived mesenchymal stem cells (AD-MSCs) and PRPs were purified from healthy donors and SSc patients. The multilineage differentiation potential of AD-MSCs and their genotypic–phenotypic features were investigated. A cytokine production profile was evaluated on AD-MSCs and PRPs from both healthy subjects and SSc patients. The adipose tissue-derived cell fraction, the so-called stromal vascular fraction (SVF), was coinjected with PRP in the perioral area of SSc patients.ResultsHistopathological and phenotypical analysis of adipose tissue from SSc patients revealed a disorganization of its distinct architecture coupled with an altered cell composition. Although AD-MSCs derived from SSc patients showed high multipotency, they failed to sustain a terminally differentiated progeny. Furthermore, SVFs derived from SSc patients differed from healthy donors in their MSC-like traits coupled with an aberrant cytokine production profile. Finally, the administration of PRP in combination with autologous SVF improved buccal’s rhyme, skin elasticity and vascularization for all of the SSc patients enrolled in this study.ConclusionsThis innovative regenerative therapy could be exploited for the treatment of chronic connective tissue diseases, including SSc.Electronic supplementary materialThe online version of this article (doi:10.1186/s13287-017-0690-3) contains supplementary material, which is available to authorized users.

Shockwave Therapy Combined with Autologous Adipose-Derived Mesenchymal Stem Cells Is Better than with Human Umbilical Cord Wharton’s Jelly-Derived Mesenchymal Stem Cells on Knee Osteoarthritis

“…Combinations of distinct regeneration therapies have been vigorously studied in musculoskeletal disorders [34][35][36][37][38]. Dr.…”

The use of fat grafting and platelet‐rich plasma for wound healing: A review of the current evidence

“…There have been several clinical studies that have shown a beneficial effect of PRP on the outcome of fat graft contouring procedures, skin rejuvenation and chronic connective tissue disorders . There have also been three‐small clinical studies that have shown a beneficial effect on wound healing .…”

“…There have been several clinical studies that have shown a beneficial effect of PRP on the outcome of fat graft contouring procedures, 65-69 skin rejuvenation 70 and chronic connective tissue disorders. 71 There have also been three-small clinical studies that have shown a beneficial effect on wound healing. 40,72,73 Although these clinical benefits have suggested improved patient satisfaction, 74 the scientific evidence for the mechanistic relationship between fat and PRP is limited.…”

Could autologous adipose-derived stromal vascular fraction turn out an unwanted source of profibrotic myofibroblasts in systemic sclerosis?

“…In this regard, I believe that some additional cues are worth considering. First, another study has previously analysed the ADSVF from patients with diffuse cutaneous SSc and reported somehow different results 5. In fact, Virzì et al 5 have shown that SSc-ADSVF displays an altered cell composition characterised by a reduced number of cells with a stem-like phenotype, as well as a high content of proinflammatory cytokines and a shortage of angiogenic factors.…”

“…First, another study has previously analysed the ADSVF from patients with diffuse cutaneous SSc and reported somehow different results 5. In fact, Virzì et al 5 have shown that SSc-ADSVF displays an altered cell composition characterised by a reduced number of cells with a stem-like phenotype, as well as a high content of proinflammatory cytokines and a shortage of angiogenic factors. Moreover, at variance with an earlier study showing that isolated SSc-ADSC exhibit similar biological properties (ie, surface antigenic profile, proliferation and differentiation potentials, immunosuppressive properties and capacity to support endothelial cell tube formation) compared with HD-ADSC,6 Virzì et al 5 found that SSc-ADSC may retain high multipotency but fail to sustain terminally differentiated adipocyte, osteocyte and chondrocyte progenies.…”