Possibility of Injecting Adipose-Derived Stromal Vascular Fraction Cells to Accelerate Microcirculation in Ischemic Diabetic Feet: A Pilot Study

Abstract

Background and Objectives Beneficial effects of human adipose-derived stromal vascular fraction (SVF) cell injection on microcirculation have been recently reported in in vitro and in vivo studies. However, no clinical studies have reported its effect in diabetic patients who commonly experience compromised tissue perfusion, regardless of the status of intravascular blood flow. The present piloting study was designed to clinically examine the possibility of SVF cell injection to accelerate microcirculation, particularly in ischemic diabetic feet. Methods Ten diabetic feet were included to receive subcutaneous injection of SVF cells around wounds. Transcutaneous partial oxygen pressure (TcPO 2 ) and cutaneous microvascular blood flow were measured before and every four weeks after cell injection until the 12 th week visit. Results TcPO 2 values increased from 31.3±7.4 before injection to 46.4±8.2 mmHg at 12 weeks after SVF injection (1.5-fold, p<0.05). Cutaneous microvascular blood flow levels increased from 34.0±21.1 before injection to 76.1±32.5 perfusion unit at 12 weeks after SVF injection (2.2-fold, p<0.05). There were no adverse events related to SVF cell injection. Conclusions Results of this study demonstrate that adipose-derived SVF cell injection have the possibility to provide beneficial effects on microcirculation in ischemic diabetic feet.

Hopes and Limits of Adipose-Derived Stem Cells (ADSCs) and Mesenchymal Stem Cells (MSCs) in Wound Healing

“…Their use helped the emergence of a near-natural skin concept in terms of appearance, texture, color, and metabolic properties. Other investigations have used autologous or allogenic ADSCs in the treatment of Crohn's disease, critical limb ischemia, diabetic foot ulcers, and burns [63,[79][80][81][82]. In combination with fat or platelet-rich lysate, skin engraftment, and reconstitution have been improved in human and animal models [83][84][85].…”

Therapeutic application of adipose-derived stromal vascular fraction in diabetic foot

“…It has been used for clinic treatment of various conditions and shown good safety and healing effects. Moon and colleagues injected SVF cells into the affected area of diabetic foot patients, and the microvascular blood flow of the wound surface was found significantly increased with no adverse reactions [ 11 , 12 ]. Studies found that SVF could secrete a variety of cytokines, differentiate into various cells such as endothelial cells, and have the potential to participate in angiogenesis in vivo .…”

New Amphiphilic Squalene Derivative Improves Metabolism of Adipocytes Differentiated From Diabetic Adipose-Derived Stem Cells and Prevents Excessive Lipogenesis

“…A recent study revealed that subcutaneous transplantation of ASC sheet prepared from non-diabetic mice into diabetic mice improved glucose intolerance ( Ishida et al, 2020 ). Subcutaneous injection and local administration of human adipose-derived stromal vascular fraction cells showed a beneficial effect on microcirculation in ischemic diabetic feet and wound healing ( Nie et al, 2011 ; Moon et al, 2019 ). Moreover, its application in tissue engineering and fat grafting in reconstructive surgery is being extensively explored ( Naderi et al, 2014 , 2017 ).…”