Stem Cells from Adipose Tissue Allow Challenging New Concepts for Regenerative Medicine

Abstract

The perspective of an innovative new concept integrating tissue-engineering techniques with an established surgical technique is described. The focus is primarily on a one-step surgical procedure using adipose tissue-derived mesenchymal stem cells, a calcium phosphate scaffold as a carrier, and a bioresorbable polymer cage to facilitate spinal interbody fusion. We address the harvesting and processing of clinically relevant quantities of adipose tissue-derived mesenchymal stem cells, triggering of these stem cells toward lineage-specific differentiation, seeding of the triggered stem cells on a bioresorbable scaffold, and implantation of the resulting tissue-engineered construct. The integrated steps can be accomplished within one surgical procedure in a surgical theater. Although the proposed concept has been developed for spinal fusion, potential application in other surgical disciplines is presumed realistic.

Tissue engineering and cartilage

“…Benefits of this tissue include easy accessibility, minimal morbidity upon harvest, and a clinically relevant number of stem cells can be obtained, limiting the need for expansion. 17 Another study has shown that the frequency of colony forming unit fibroblasts was three times greater in adipose tissue than in bone marrow. 18 There has been an attempt by Helder and colleagues to create a single surgical procedure where the stem cells can be harvested, directed to a certain lineage, chondrogenic via BMP-7, or osteogenic via BMP-2, then seeded on a scaffold and implanted.…”

“…This group found that stimulation with the growth factors for fifteen minutes yielded the same results as stimulation for four days. 17 This individual study may direct future research towards creating a one-step surgical procedure that includes harvesting cells, directing those cells toward a chondrogenic phenotype, seeding the cells on a scaffold, and then implanting that scaffold arthroscopically.…”

In vitro cardiomyogenic differentiation of adipose‐derived stromal cells using transforming growth factor‐β1

“…14,15 ADSCs have several advantages over other types of stem cells, such as easy accessibility, minimal morbidity upon harvest, and feasibility of extracting clinically relevant numbers of stem cells. 16 Importantly, transplanting CMCs differentiated from stem cells results in better myocardiac regeneration and higher cardiac functional improvement than transplanting undifferentiated stem cells. 2 Furthermore, undifferentiated stem cells may undergo unanticipated differentiation upon implantation.…”

Alginate cell encapsulation: new advances in reproduction and cartilage regenerative medicine

“…ADSCs regenerative therapy has also been implied for the treatment of IVD diseases (O'Halloran and Pandit 2007;Gaetani et al 2008;Helder et al 2007;Li et al 2005;Richardson et al 2006): in fact, chondrocytes could be retrieved, expanded in a 3D in vitro system consisting of alginate capsules, and finally re-implanted through a mini-invasive technique. Moreover it is now possible to regenerate or replace damaged IVDs through the implants of biodegradable scaffolds seeded with autologous ADSCs previously induced to differentiate to the chondrogenic phenotype (Helder et al 2007).…”

“…As a consequence, research on the role of adipose tissue in physiology and pathology has been relatively neglected until the discovery of leptin (Zhang et al 1994) and adiponectin (Scherer et al 1995); more recently, adipose tissue has been also identified as a source of mesenchymal stem cells (MSCs) able to differentiate into adipocytes, chondrocytes, osteoblasts, myocytes, cardiomyocytes, hepatocytes, and neuronal, epithelial and endothelial cells (Helder et al 2007;Romanov et al 2005;Dicker et al 2005). Adipose tissue is composed of two main populations, mature adipocytes and stromal vascular fraction (SVF): the latest is a heterogeneous population of cell including preadipocytes, endothelial cells, smooth muscle cells, pericytes, macrophage, fibroblasts (Mizuno and Hyakusoku 2003;Fraser et al 2006;Gomillion and Burg 2006) and adipose MSCs (Romanov et al 2005;Dicker et al 2005;Fraser et al 2006;Rydèn et al 2003;Rodriguez et al 2004Rodriguez et al , 2005Nakagami et al 2006;Strem et al 2005;Musina et al 2006;Guilak et al 2006;Mitchell et al 2006) that share many characteristics of bone marrow MSCs.…”