Is Fat Tissue a Suitable Source of Stem Cells for Musculoskeletal Regenerative Medicine Therapies: Literature Review

This review found that adipose-derived stem cells are suitable for treating osteoarthritis. Besides joint replacement the current treatments do not reverse the underlining pathology, whereas this therapy replaces lost or damaged tissue and could represent a cure. Bone marrow is the traditional source of stem cells, however adipose tissue is more appropriate because of ease of harvesting, abundance, the concentration of stem cells and potential cosmetic benefits. Subcutaneous fat-derived stem cells are more effective for treating osteoarthritis when compared to visceral fat-derived. Human and animal models have shown its efficacy but with limitations. It has been less successful in older and/or patients with greater joint degeneration. Its cost-effectiveness when compared to current treatment has not been shown. A gold standard production and implantation method have yet to be developed, meaning there are no guidelines for its use. Current studies aim to address these issues, with implementation on the horizon.

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P667 Combined therapy of perianal fistulas with autologous adipose-derived stem cells

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.795 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S548-S548

Author(s):

A Surowiecka ◽

M Łodyga ◽

M Durlik ◽

R Grażyna

Keyword(s):

Stem Cells ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Subcutaneous Fat ◽

Good Resolution ◽

Adipose Derived Stem Cells ◽

Fat Tissue ◽

Perianal Fistulas ◽

The Mean ◽

Subcutaneous Fat Tissue

Abstract Background Autologous adipose-derived stem cells (ADSCs) are pluripotent medical stimulatory cells. In damaged tissues, they activate regeneration by secretion of various growth factors, anti-inflammatory cytokines and migration factors. Autologous ADSCs are harvested from subcutaneous fat tissue. Methods The aim of our study was to create a protocol of combined surgical and biologic treatment of perianal fistulas followed with transfer of autologous ADSCs into fistulas. It was a prospective study. We selected patients diagnosed with Crohn’s disease with perianal fistulas, confirmed in MRI or transanal US, with no symptoms of abscess formation. In this protocol, we started from fistulas setoning. Afterwards, two courses of biologic agents were conducted. In the next step, autologous ADSCs were harvested from subcutaneous fat tissue and transferred to inactive fistulas. We used Arthrex®system to acquire ADSCs. Further courses with biologic agents followed the ADSCs transfer. To evaluate the outcomes we used Pikarky’s Perianal Crohn’s Disease Activity Index. A good resolution was defined as fistula closure, incomplete healing as partial resolution without complete closure and fistula reactivation as no resolution. Results In a preliminary study we collected data of 10 patients. The mean volume of lipoaspirate was 30 ml. The mean amount of ADSCs transferred was 4 ml. The mean operative time was 90 min. The early observation time varied from 1 to 3 months. In all cases, these were bifurcated complex and trans-sphincteric fistulas. There were no cases of no resolution. Early results were promising with almost all cases of good resolution. However, longer observation is required. Conclusion Autologous adipose-derived stem cells in combination with surgical setoning and biological agents are a good alternative for patients with perianal manifestation of Crohn’s disease.

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