Because of their ease of isolation and relative abundance, adipose-derived mesenchymal stem cells (ASCs) are a particularly attractive autologous cell source for various therapeutic purposes. ASCs retain a high proliferation capacity in vitro and have the ability to undergo extensive differentiation into multiple cell lineages. Moreover, ASCs secrete a wide range of growth factors that can stimulate tissue regeneration.
Stem cells mainly used in orthopedics are the Mesenchymal stem cells (MSCs), collected by the iliac crest, the highest part of the pelvis, but in recent years Mesenchymal stem cells, or adult stem cells, contained in subcutaneous fat, are used and collected through an ordinary liposuction. After the isolation, the cells are injected directly in the joints injured, like a normal infiltration.
Stem cells produce an immediate anti-inflammatory effect, and continue their “work” repairing the damaged tissue (like cartilage) and regenerating loss tissue. However the capacity for stem cells to produce this effects is not the same for everyone.
The potential of ASCs differs depending on the donor’s medical condition. Recent studies demonstrated that ASCs from diabetic donors exhibit reduced proliferative potential and a smaller proportion of stem cell marker-positive cells. to ensure the success of regenerative medicine tissue engineering methods must be improved by the incorporation of factors that increase the proliferation and differentiation of stem/progenitor cells when autologous cells are used.
In recent years there have been many studies on growth factors. Platelets, of which prp is rich, release substances that allow the healing of tissue and affect the behavior of the other cells modulating the inflammation and the neoformation of blood vessels (neoangiogenesis). Platelets in fact have a fundamental role to mediate the healing of damage tissue thanks to their ability to release growth factors.
Recent reports suggested that certain growth factors, such as vascular VEGF, fibroblast growth factor (FGF)-2, FGF-4, FGF-6, FGF-7, FGF-9, FGF-17, transforming growth factor (TGF)-beta1, TGF-beta2, HGF, keratinocyte growth factor, platelet-derived growth factor AA, and IGF-1, regulate the maintenance of ASC stemness [37]. These factors affect a plethora of responses such as angiogenesis, cellular migration, apoptosis, proliferation, and differentiation [56–59]. In particular, the proliferation of ASCs is regulated by paracrine factors such as FGF-2, FGF-4, interleukin (IL)-6, and stromal-derived factor 1, whereas FGF-2, endothelial growth factor, TGF-beta, and other factors are involved in differentiation.
Several studies describe the potential benefits of using PRP in tissue regeneration; in particular, PRP therapy has been proposed in wound healing. Moreover, because PRP is able to stimulate proliferation of undifferentiated stem cells as well as cell differentiation, it might be used in conjunction with stem cell transplantation to promote tissue regeneration.
ASCs hold great potential for use in stem cell therapy. After being transplanted, however, ASCs face a complex and hostile environment in which local hypoxia, oxidative stress, and inflammation may lead to cell loss or death on a large scale. Insufficient retention and survival of transplanted ASCs can dramatically reduce their therapeutic effects. In this regard, PRP is an attractive cell-maintained biomaterial, and the activated PRP scaffold can enhance the stemness properties of ASCs, although further analysis and investigation are needed to establish novel cell therapies.
The evidence compiled to date suggests that this combination treatment represents a promising approach in various fields of medicine.
Because of their ease of isolation and relative abundance, adipose-derived mesenchymal stem cells (ASCs) are a particularly attractive autologous cell source for various therapeutic purposes. ASCs retain a high proliferation capacity in vitro and have the ability to undergo extensive differentiation into multiple cell lineages. Moreover, ASCs secrete a wide range of growth factors that can stimulate tissue regeneration.
Stem cells mainly used in orthopedics are the Mesenchymal stem cells (MSCs), collected by the iliac crest, the highest part of the pelvis, but in recent years Mesenchymal stem cells, or adult stem cells, contained in subcutaneous fat, are used and collected through an ordinary liposuction. After the isolation, the cells are injected directly in the joints injured, like a normal infiltration.
Stem cells produce an immediate anti-inflammatory effect, and continue their “work” repairing the damaged tissue (like cartilage) and regenerating loss tissue. However the capacity for stem cells to produce this effects is not the same for everyone.
The potential of ASCs differs depending on the donor’s medical condition. Recent studies demonstrated that ASCs from diabetic donors exhibit reduced proliferative potential and a smaller proportion of stem cell marker-positive cells. to ensure the success of regenerative medicine tissue engineering methods must be improved by the incorporation of factors that increase the proliferation and differentiation of stem/progenitor cells when autologous cells are used.
In recent years there have been many studies on growth factors. Platelets, of which prp is rich, release substances that allow the healing of tissue and affect the behavior of the other cells modulating the inflammation and the neoformation of blood vessels (neoangiogenesis). Platelets in fact have a fundamental role to mediate the healing of damage tissue thanks to their ability to release growth factors.
Recent reports suggested that certain growth factors, such as vascular VEGF, fibroblast growth factor (FGF)-2, FGF-4, FGF-6, FGF-7, FGF-9, FGF-17, transforming growth factor (TGF)-beta1, TGF-beta2, HGF, keratinocyte growth factor, platelet-derived growth factor AA, and IGF-1, regulate the maintenance of ASC stemness [37]. These factors affect a plethora of responses such as angiogenesis, cellular migration, apoptosis, proliferation, and differentiation [56–59]. In particular, the proliferation of ASCs is regulated by paracrine factors such as FGF-2, FGF-4, interleukin (IL)-6, and stromal-derived factor 1, whereas FGF-2, endothelial growth factor, TGF-beta, and other factors are involved in differentiation.
Several studies describe the potential benefits of using PRP in tissue regeneration; in particular, PRP therapy has been proposed in wound healing. Moreover, because PRP is able to stimulate proliferation of undifferentiated stem cells as well as cell differentiation, it might be used in conjunction with stem cell transplantation to promote tissue regeneration.
ASCs hold great potential for use in stem cell therapy. After being transplanted, however, ASCs face a complex and hostile environment in which local hypoxia, oxidative stress, and inflammation may lead to cell loss or death on a large scale. Insufficient retention and survival of transplanted ASCs can dramatically reduce their therapeutic effects. In this regard, PRP is an attractive cell-maintained biomaterial, and the activated PRP scaffold can enhance the stemness properties of ASCs, although further analysis and investigation are needed to establish novel cell therapies.
The evidence compiled to date suggests that this combination treatment represents a promising approach in various fields of medicine.
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