title: Ultrasound-Assisted Liposuction Does Not Compromise the Regenerative Potential of Adipose-Derived Stem Cells.
abstract: Human mesenchymal stem cells (MSCs) have recently become a focus of regenerative medicine, both for their multilineage differentiation capacity and their excretion of proregenerative cytokines. Adipose-derived mesenchymal stem cells (ASCs) are of particular interest because of their abundance in fat tissue and the ease of harvest via liposuction. However, little is known about the impact of different liposuction methods on the functionality of ASCs. Here we evaluate the regenerative abilities of ASCs harvested via a third-generation ultrasound-assisted liposuction (UAL) device versus ASCs obtained via standard suction-assisted lipoaspiration (SAL). Lipoaspirates were sorted using fluorescent assisted cell sorting based on an established surface-marker profile (CD34+/CD31-/CD45-), to obtain viable ASCs. Yield and viability were compared and the differentiation capacities of the ASCs were assessed. Finally, the regenerative potential of ASCs was examined using an in vivo model of tissue regeneration. UAL- and SAL-derived samples demonstrated equivalent ASC yield and viability, and UAL ASCs were not impaired in their osteogenic, adipogenic, or chondrogenic differentiation capacity. Equally, quantitative real-time polymerase chain reaction showed comparable expression of most osteogenic, adipogenic, and key regenerative genes between both ASC groups. Cutaneous regeneration and neovascularization were significantly enhanced in mice treated with ASCs obtained by either UAL or SAL compared with controls, but there were no significant differences in healing between cell-therapy groups. We conclude that UAL is a successful method of obtaining fully functional ASCs for regenerative medicine purposes. Cells harvested with this alternative approach to liposuction are suitable for cell therapy and tissue engineering applications. Significance: Adipose-derived mesenchymal stem cells (ASCs) are an appealing source of therapeutic progenitor cells because of their multipotency, diverse cytokine profile, and ease of harvest via liposuction. Alternative approaches to classical suction-assisted liposuction are gaining popularity; however, little evidence exists regarding the impact of different liposuction methods on the regenerative functionality of ASCs. Human ASC characteristics and regenerative capacity were assessed when harvested via ultrasound-assisted (UAL) versus standard suction-assisted liposuction. ASCs obtained via UAL were of equal quality when directly compared with the current gold standard harvest method. UAL is an adjunctive source of fully functional mesenchymal stem cells for applications in basic research and clinical therapy.
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Duscher
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: David
authors.initials: D
authors.lastname: Atashroo
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Zeshaan N
authors.initials: ZN
authors.lastname: Maan
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Luan
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Brett
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Janos
authors.initials: J
authors.lastname: Barrera
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Sacha M
authors.initials: SM
authors.lastname: Khong
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Zielins
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Whittam
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hu
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA Institute for Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Graham G
authors.initials: GG
authors.lastname: Walmsley
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Pollhammer
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Schmidt
authors.affiliation: Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany.
authors.forename: Arndt F
authors.initials: AF
authors.lastname: Schilling
authors.affiliation: Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany.
authors.forename: Hans-Günther
authors.initials: HG
authors.lastname: Machens
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria.
authors.forename: Georg M
authors.initials: GM
authors.lastname: Huemer
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Derrick C
authors.initials: DC
authors.lastname: Wan
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA Institute for Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Longaker
authors.affiliation: Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA ggurtner@stanford.edu.
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Gurtner
mesh_terms: D050153:Abdominal Fat / Q000166:cytology / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D017667:Adipocytes / Q000166:cytology* / Q000378:metabolism; D000328:Adult; D000818:Animals; D015703:Antigens, CD / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002454:Cell Differentiation; D002470:Cell Survival; D019902:Chondrocytes / Q000166:cytology / Q000378:metabolism; D017558:Elective Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D015187:Lipectomy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D059630:Mesenchymal Stem Cells / Q000166:cytology* / Q000378:metabolism; D051379:Mice; D008819:Mice, Nude; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D010006:Osteoblasts / Q000166:cytology / Q000378:metabolism; D014463:Ultrasonography; D014945:Wound Healing / Q000502:physiology
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins
keywords: Adipogenesis; Adipose-derived stem cells; Adult mesenchymal stem cells; Cell therapy; Fat harvest; Regenerative medicine; Ultrasound-assisted liposuction