title: New insights into lidocaine and adrenaline effects on human adipose stem cells.
abstract: BACKGROUND
  Adipose stem cells have gained great interest in plastic and reconstructive surgery with their ability to improve engraftment after fat transfer for soft tissue filling. It is therefore essential to know the effect of the drugs commonly used during the lipoaspiration procedure, such as lidocaine and adrenaline. Indeed, these drugs are infiltrated at the fat donor site for local anesthesia and for reduction of bleeding. This study analyzed the effects of these drugs on the viability of adipose-derived stem cells and on their inflammatory status.
  
  
  METHODS
  Adipose-derived stem cells from lipoaspirates were grown in culture before being treated with different clinical doses of lidocaine at different times of exposure (1-24 h), and with adrenaline (1 μg/mL). Cytotoxicity was measured by lactate dehydrogenase assay and by flow cytometry with annexin V/propidium iodide staining. In parallel, the secretion of the proinflammatory cytokines tumor necrosis factor-alpha (TNFα), interleukin-6 (IL-6), and monocyte chemotactic protein-1 (MCP-1) was tested by enzyme-linked immunoassay.
  
  
  RESULTS
  Lidocaine affected cell viability after 24 h, even when the cells were exposed for only 1 or 2 h. Apoptosis was not involved in lidocaine cytotoxicity. Regarding inflammation, no TNFα was produced, and lidocaine decreased the levels of IL-6 and MCP-1 in a dose-dependent manner. In contrast, adrenaline did not influence cell viability or cytokine secretions.
  
  
  CONCLUSIONS
  Adipose tissue should be handled appropriately to remove lidocaine and adrenaline, with such procedures as washing and centrifugation. This study provides new insights into the use of lidocaine and adrenaline for fat transfer or stem cell isolation from lipoaspirates.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors                      www.springer.com/00266                                        .
authors.affiliation: ADIP'sculpt, Plateforme CYROI, 2 rue Maxime Rivière, Sainte Clotilde, 97490, Reunion Island, France. ac.girard@adipsculpt.com
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Girard
authors.forename: Michael
authors.initials: M
authors.lastname: Atlan
authors.forename: Karima
authors.initials: K
authors.lastname: Bencharif
authors.forename: Manoj Kumar
authors.initials: MK
authors.lastname: Gunasekaran
authors.forename: Pierre
authors.initials: P
authors.lastname: Delarue
authors.forename: Olivier
authors.initials: O
authors.lastname: Hulard
authors.forename: Christian
authors.initials: C
authors.lastname: Lefebvre-d'Hellencourt
authors.forename: Regis
authors.initials: R
authors.lastname: Roche
authors.forename: Laurence
authors.initials: L
authors.lastname: Hoareau
authors.forename: Franck
authors.initials: F
authors.lastname: Festy
mesh_terms: D017667:Adipocytes / Q000187:drug effects*; D000273:Adipose Tissue / Q000166:cytology*; D000328:Adult; D000779:Anesthetics, Local / Q000494:pharmacology*; D002478:Cells, Cultured; D004837:Epinephrine / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000494:pharmacology*; D008875:Middle Aged; D013234:Stem Cells / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine