Stem Cell and Research in Plastic Surgery: Review
Stem Cell and Research in Plastic Surgery: Review
Stem Cell and Research in Plastic Surgery: Review
cells, are potentially unlimited pool of cells, harvested by mini- tion (BMT) combined with immunosuppressive agent protocols
mally invasive procedure and has milti-differentiation poten- have proven to prolong organ transplant survival (18). Bone mar
tials (7, 8). Mesenchymal stem cells (MSCs) derived from bone row contains multipotent progenitor cells that can differentiate
marrow and adipose tissue are another useful source. Autolo- into various mesenchymal cell types. These cells have been char-
gous mesenchymal stem cells with scaffold system have shown acterized as marrow stromal cells, marrow progenitor cells, or
improved wound healing. ASCs can be harvested easily from bone marrow mesenchymal stem cells (MSCs). These stem cells
various human body using a lot of liposuction technique. Ad- can modulate the antiinflammatory cytokine expression and T-
ministration of adequate number of stem cells to the defect may cell subsets (19). MSC or ASC infusion in combination with tran-
trigger local regeneration and healing process (9). Finding ap- sient immunosuppression can induce immune tolerance, pro-
propriate scaffold for applying this cell-based strategy could be long allograft survival and facilitated long-term graft acceptance.
challenge. Scaffold can do functional role as promoting cell ad- (20, 21).
hesion, proliferation, differentiation and preventing the migra-
tion of implanted cells (10). FUTURE PERSPECTIVES
STEM CELLS INCRESE FAT GRAFT SURVIVAL During the last decade, patient’s own stem cells has been tested
and effectively utilized in the plastic surgical field. Overall, clini-
Aging process involves a number of different degenerative path- cal advances using various stem cells suggest a promising future
ways, specially a soft tissue volume loss. Owing to the aged pop- for opening a new cell therapeutic strategy in plastic surgery (22).
ulation, a desire to regain youthful looks, minimal-invasive sur- To make stem cell therapy more established standard treatment,
gery options, the demand for cosmetic procedures has been in- a larger number of upcoming clinical study is necessary. Fur-
creasing (11). Fat graft technique is one of the most common ther research about determining the fate of transplanted cells
anti-aging procedures in plastic surgery. It can help restore de- and numbering of cells required for definitive clinical effects
fect and augment the soft tissue. Using autologous tissue, there should be followed. The adverse effects of cell transplantation,
have been no specific side effects caused by immune responses possibility of tumor growth and long-term results of these cells
have been reported. However, simply grafted fat can be absorb should also be validated. Good manufacturing practice (GMP)
ed anytime, and the absorption level is very difficult to antici- facilities are mandatory for safe collection, testing and cryopre
pate (12). The survival rate of aspirated fat can be increased us- servation of customer’s cells (23).
ing cell-assisted lipotransfer (CAL). CAL is a technique that com-
bines concentrated ASCs with aspirated fat to make ASC-rich ORCID
fat grafts (13). This approach allows for marked survival rate im
provements implanted fat and decrease in adverse effects of fi- Seok-Chan Eun http://orcid.org/0000-0003-4372-6955
brosis and cyst formation (14). BSCs can make systemic contri-
bution to fat graft survival by new blood vessel sprouting. The REFERENCES
bone marrow–derived mesenchymal stem cells (BSC) and cir-
culating progenitor cells, up-regulates vasculogenic growth fac- 1. You HJ, Han SK. Cell therapy for wound healing. J Korean Med Sci 2014;
tor production, and increase the number of new blood vessels 29: 311-9.
formed in the grafted fat leading to improvement of graft sur- 2. Kim KS. Book review: advances in wound repair. Arch Plast Surg 2013;
vival (15). 40: 639-40.
3. Cherubino M, Rubin JP, Miljkovic N, Kelmendi-Doko A, Marra KG. Ad-
STEM CELLS PREVENT ALLOTRANPLANTATION ipose-derived stem cells for wound healing applications. Ann Plast Surg
2011; 66: 210-5.
REJECTION
4. Choi J, Minn KW, Chang H. The efficacy and safety of platelet-rich plas-
ma and adipose-derived stem cells: an update. Arch Plast Surg 2012; 39:
Composite tissue allotransplantation (CTA) could be an ideal
585-92.
solution for the replacement of certain tissue defects after trau-
5. Shin HS, Oh HY. The effect of platelet-rich plasma on wounds of OLETF
ma, tumor ablation, congenital anomaly repairs, etc. Recently, rats using expression of matrix metalloproteinase-2 and -9 mRNA. Arch
several great advances have been made in this field and CTA Plast Surg 2012; 39: 106-12.
has gained much popularity as a viable alternative reconstruc- 6. Lorenz HP, Hedrick MH, Chang J, Mehrara BJ, Longaker MT. The im-
tive option. However, CTA has harmful adverse effects of im- pact of biomolecular medicine and tissue engineering on plastic surgery
munosuppressive agents (16, 17). Stem cells can contribute to in the 21st century. Plast Reconstr Surg 2000; 105: 2467-81.
establish life-long tolerance after transplantation avoiding im- 7. Sterodimas A, De Faria J, Correa WE, Pitanguy I. Tissue engineering in
munosuppressant systemic toxicity. Bone marrow transplanta- plastic surgery: an up-to-date review of the current literature. Ann Plast
S168
http://jkms.org http://dx.doi.org/10.3346/jkms.2014.29.S3.S167
Eun S-C • Stem Cell and Research in Plastic Surgery
Surg 2009; 62: 97-103. ment of fat graft survival by bone marrow-derived mesenchymal stem
8. Chim H, Schantz JT. Human circulating peripheral blood mononuclear cell therapy. Plast Reconstr Surg 2013; 132: 1149-57.
cells for calvarial bone tissue engineering. Plast Reconstr Surg 2006; 117: 16. Whitaker IS, Duggan EM, Alloway RR, Brown C, McGuire S, Woodle ES,
468-78. Hsiao EC, Maldonado C, Banis JC Jr, Barker JH. Composite tissue allo-
9. Nussenbaum B, Teknos TN, Chepeha DB. Tissue engineering: the cur- transplantation: a review of relevant immunological issues for plastic
rent status of this futuristic modality in head neck reconstruction. Curr surgeons. J Plast Reconstr Aesthet Surg 2008; 61: 481-92.
Opin Otolaryngol Head Neck Surg 2004; 12: 311-5. 17. Eun SC. Facial transplantation surgery. Arch Plast Surg 2014; 41: 174-80.
10. Lim EH, Sardinha JP, Myers S. Nanotechnology biomimetic cartilage re- 18. Cendales L, Hardy MA. Immunologic considerations in composite tissue
generative scaffolds. Arch Plast Surg 2014; 41: 231-40. transplantation: overview. Microsurgery 2000; 20: 412-9.
11. McArdle A, Senarath-Yapa K, Walmsley GG, Hu M, Atashroo DA, Tevlin 19. Kuo YR, Chen CC, Goto S, Lee IT, Huang CW, Tsai CC, Wang CT, Chen
R, Zielins E, Gurtner GC, Wan DC, Longaker MT. The role of stem cells CL. Modulation of immune response and T-cell regulation by donor adi-
in aesthetic surgery: fact or fiction? Plast Reconstr Surg 2014; 134: 193- pose-derived stem cells in a rodent hind-limb allotransplant model. Plast
200. Reconstr Surg 2011; 128: 661e-72e.
12. Butala P, Hazen A, Szpalski C, Sultan SM, Coleman SR, Warren SM. En- 20. Eun SC. Composite tissue allotransplantation immunology. Arch Plast
dogenous stem cell therapy enhances fat graft survival. Plast Reconstr Surg 2013; 40: 141-53.
Surg 2012; 130: 293-306. 21. Kuo YR, Goto S, Shih HS, Wang FS, Lin CC, Wang CT, Huang EY, Chen
13. Yoshimura K, Sato K, Aoi N, Kurita M, Hirohi T, Harii K. Cell-assisted li- CL, Wei FC, Zheng XX, et al. Mesenchymal stem cells prolong composite
potransfer for cosmetic breast augmentation: supportive use of adipose- tissue allotransplant survival in a swine model. Transplantation 2009;
derived stem/stromal cells. Aesthetic Plast Surg 2008; 32: 48-55; discus- 87: 1769-77.
sion 6-7. 22. Burd A. Past. Present. Future? J Plast Reconstr Aesthet Surg 2007; 60: 1081.
14. Lee SK, Kim DW, Dhong ES, Park SH, Yoon ES. Facial soft tissue aug- 23. West CC, Murray IR, ZN. G, Hindle P, Hay DC, Stewart KJ, Péault B. Eth-
mentation using autologous fat mixed with stromal vascular fraction. ical, legal and practical issues of establishing an adipose stem cell bank
Arch Plast Surg 2012; 39: 534-9. for research. J Plast Reconstr Aesthet Surg 2014; 67: 745-51.
15. Zhao J, Yi C, Zheng Y, Li L, Qiu X, Xia W, Su Y, Diao J, Guo S. Enhance-
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