Expanding Clinical Indications of Mechanically Isolated Stromal Vascular Fraction: A Systematic Review

Abstract

Background Mechanically isolated stromal vascular fraction (tSVF, tissue SVF) is a potent regenerative solution, increasingly used as a therapeutic modality for a variety of pathologies. With recent evidence conclusively favoring mechanical isolation over enzymatic alternatives, the therapeutic share and indications of tSVF are expected to grow even further. Objectives The aim of this study was to provide a systematic review of all studies reporting on the use of tSVF. Methods A systematic search was undertaken of the Embase, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials databases. Outcome measures included clinical indications, such as recipient area, adverse events, clinical results recipient area, method of application, follow-up duration and evaluation methods. Results Of the total of 4505 articles identified, 186 full-texts were screened. Thirty-four studies, reporting on 1443 patients were included. tSVF-based therapy was observed for 10 different pathologies, including aged skin (8 studies), scars (5), wounds (6), osteoarthritis (6), tendinopathy (2), temporomandibular joint disorders (1), androgenic alopecia (1), perianal fistula (3), migraine (1), and vocal fold scarring (1). Across all studies, tSVF-based therapy resulted in favorable clinical results. Overall, 50 (3.43%) minor and one (0.07%) major adverse events were observed, mainly related to the liposuction procedure. Conclusions tSVF offers a safe, easy and legal treatment modality for a range of indications. Future research is indicated to identify the optimal isolation protocol, dose and timing. In addition, basic research remains crucial to identify the mechanism of action of SVF within different pathologies. Level of Evidence: 4

Potential Using of Fat-derived Stromal Cells in the Treatment of Active Disease, and also, in Both Pre- and Post-Periods in COVID-19

“…Although SVF and TOST has many promising potential uses, its most important feature is that it is an immunomodulatory. The ability of these cells to suppress an immune response has obvious indications for autoimmune disorders, these anti-inflammatory effects have been exploited in studies of several pathologic processes, such as hemorrhagic stroke, reactive airway disease, multiple sclerosis, and rheumatoid arthritis [ 19 ].…”

Regenerative medicine approaches for the management of respiratory tract fistulas

“…Moreover, amplification in culture of MSC requires GMP conditions, is timeconsuming, and is associated with high cost and regulatory burden. Therefore, alternative, enzyme-free strategies to obtain a ready-to-use adipose tissue-derived material have been developed [95] and administration of mechanically isolated adipose tissue SVF has been performed for the treatment of different pathologies [96]. In particular, administration of homogenized adipose tissue has been recently proved effective in the treatment of perianal fistulas in patients with Crohn's disease [97][98][99], providing a suitable alternative to MSC administration [100].…”

Utilizing Adipose Tissue-Derived Stem Cell Strategies for Obtaining Regeneration of Respiratory Tract Fistulas-A Systematic Review

“…Furthermore, amplification in culture of MSC needs GMP situations, consumes time, along with correlation with heavy cost away controlling burden. Thus ready to use -ATobtained material have got formed away delivery of mechanically removed AT SVF has been done regards to treatment of various pathologies [93,94]. Specifically, delivery of homogenized AT has proven to be efficacious recently in the therapy of perianal fistulas in Crohn's disease patients giving a method that is proper alternative to MSCs delivery [95,96].…”