论文通信作者Stig-FrederikTrojahnK?lle博士解释道，“我们的研究结果提示着干细胞富集的脂肪移植可能是主要组织瓣手术或诸如癌症发生后利用同种异体材料进行乳房重建之类的主要组织填充术的一种有吸引力的替代性选择”。

    自体脂肪移植或者说脂肪注入法---收集一个人自己的脂肪并在他们体内的另一个区域中增加脂肪体积(volume offat)---日益增加地被用于整形外科手术之中。

    在这项研究中，研究人员在10名健康志愿者体内比较了利用体外扩大培养的脂肪干细胞富集的脂肪移植物和传统的未富集脂肪移植物(作为对照)的存活。

    这些志愿者接受抽脂术以便收集他们腹部一侧的脂肪组织。对每名志愿者而言，这两种纯化的脂肪移植物---一种是利用他们自己的干细胞富集的脂肪移植物，另一种是未富集的脂肪移植物---经制备出后被注射到他们的上臂中。在移植后立即利用核磁共振成像(MRI)对注射的脂肪移植物容量进行测量，以及在移植后121天在这些移植物被移除之前，也利用MRI进行测量。

    作为对照的未富集脂肪移植物只保持它们初始体积的16.3%，但相比之下，经过干细胞富集的脂肪移植物保持它们初始体积的80.9%，并且在移植4个月后，显着性的增高的脂肪组织及新形成的结缔组织的数量及成活率。

    这些研究结果显着性地增加了干细胞在临床中使用的前景，并证实脂肪干细胞富集可能使得抽脂术成为一种可靠的方法，这是因为人们能够预测移植物不能存活的比例、组织质量和安全性。干细胞疗法可能在癌症发生后的乳房重建和创伤后的畸形修复方面引发革命。

    推荐原文阅读：

    Lancet. 2013 Sep 28;382(9898):1113-20. doi: 10.1016/S0140-6736(13)61410-5.

    Enrichment of autologous fat grafts with ex-vivo expanded adipose tissue-derived stem cells for graft survival: arandomised placebo-controlled trial.

    Stig-FrederikTrojahnK?lle, Fischer-Nielsen A, Mathiasen AB, Elberg JJ, Oliveri RS, Glovinski PV, Kastrup J, Kirchhoff M, Rasmussen BS, Talman ML, Thomsen C, Dickmeiss E,Drzewiecki KT.

    SourceDepartment of Plastic Surgery, Breast Surgery and Burns, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. stigfrederik@gmail.comAbstract

    BACKGROUND:Autologous fat grafting is increasingly used in reconstructive surgery. However, resorption rates ranging from 25% to 80% have been reported. Therefore, methods to increase graft viability are needed. Here, we report the results of a triple-blind, placebo-controlled trial to compare thesurvival of fat grafts enriched with autologous adipose-derived stem cells (ASCs) versus non-enriched fat grafts.

    METHODS:Healthy participants underwent two liposuctions taken 14 days apart: one for ASC isolation and ex-vivo expansion, and another for the preparation of fat grafts. Two purified fat grafts (30 mL each) taken from the second liposuction were prepared for each participant. One graft was enriched with ASCs, and another graft without ASC enrichment served as a control. The fat grafts were injected subcutaneously as a bolus to the posterior part of the right and left upper arm according to the randomisation sequence. The volumes of injected fatgrafts were measured by MRI immediately after injection and after 121 days before surgical removal. The primary goal was to compare the residualgraft volumes of ASC-enriched grafts with those of control grafts. This study is registered at www.clinicaltrialsregister.eu, number 2010-023006-12.

    FINDINGS:13 participants were enrolled, three of whom were excluded. Compared with the control grafts, the ASC-enriched fat grafts had significantly higher residual volumes: 23·00 (95% CI 20·57-25·43) cm(3) versus 4·66 (3·16-6·16) cm(3) for the controls, corresponding to 80·9% (76·6-85·2) versus 16·3% (11·1-21·4) of the initial volumes, respectively (p<0·0001). The difference between the groups was 18·34 (95% CI 15·70-20·98) cm(3), equivalent to 64·6% (57·1-72·1; p<0·0001). No serious adverse events were noted.

    INTERPRETATION:The procedure of ASC-enriched fat grafting had excellent feasibility and safety. These promising results add significantly to the prospect of stem cell use in clinical settings, and indicate that ASC graft enrichment could render lipofilling a reliable alternative to major tissue augmentation, such as breast surgery, with allogeneic material or major flap surgery.

    FUNDING:Danish Cancer Society, Centre of Head and Orthopaedics Rigshospitalet, and Moalem Weitemeyer Bendtsen.