Processed lipoaspirate cells for tissue engineering of the lower urinary tract: implications for the treatment of stress urinary incontinence and bladder reconstruction.
OBJECTIVE
We performed a pilot study to investigate the ability of human adipose derived, multipotent stem cells to be delivered to and survive within bladder and urethral smooth muscle.


METHODS
Lipoaspirate was acquired from female patients undergoing liposuction. The lipoaspirate was processed to yield a pluripotent population of processed lipoaspirate (PLA) cells. For tissue delivery PLA cells were fluorescent labeled and suspended in Hanks' balanced salt solution (Sigma Chemical Co., St. Louis, Missouri). To assess PLA viability in multiple animal models 8 Rnu athymic rats (Charles River, Wilmington, Massachusetts) and 6 SCID mice (Taconic Farms, Oxnard, California) underwent laparotomy and injection of PLA cells into the bladder and urethra. An additional 8 rats underwent sham injection of Hanks' balanced salt solution alone. Experimental and control animals were sacrificed 2, 4, 8 and 12 weeks after injection, and the bladders and urethras were analyzed.


RESULTS
Self-regenerating, pluripotent PLA cells were easily isolated from human adipose tissue. Evaluation 2, 4, 8 and 12 weeks after injection demonstrated PLA cell viability and incorporation into the recipient smooth muscle. Eight weeks following injection PLA cells demonstrated in vivo expression of alpha-smooth muscle actin, an early marker of smooth muscle differentiation.


CONCLUSIONS
PLA cells are an easily accessible source of pluripotent cells, making them ideal for tissue regeneration. PLA cells remain viable up to 12 weeks in the lower urinary tract. Human PLA cells injected into the urinary tract show morphological and phenotypic evidence of smooth muscle incorporation and differentiation with time. PLA cells may provide a feasible and cost-effective cell source for urinary tract reconstruction.
Jack
Gregory S
GS
Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Almeida
Fernando G
FG
Zhang
Rong
R
Alfonso
Zeni C
ZC
Zuk
Patricia A
PA
Rodríguez
Larissa V
LV
D000273:Adipose Tissue / Q000166:cytology; D000818:Animals; D002470:Cell Survival; D017690:Cell Transplantation; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051379:Mice; D008805:Mice, Inbred A; D016513:Mice, SCID; D008856:Microscopy, Fluorescence; D039902:Multipotent Stem Cells / Q000637:transplantation*; D009130:Muscle, Smooth / Q000473:pathology* / Q000502:physiology; D010865:Pilot Projects; D051381:Rats; D012680:Sensitivity and Specificity; D023822:Tissue Engineering / Q000379:methods*; D014521:Urethra / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology; D014550:Urinary Incontinence, Stress / Q000628:therapy*