22 Oct ADIPOSE DERIVED STEM CELL THERAPY
Adipose tissue-derived stem cells (ADSCs) are mesenchymal cells that can differentiate into multiple lines of specialized cells, such as adipocytes, chondrocytes, myocytes, osteoblasts, and neurocytes, etc. Stem cells play a key role in reconstructive or tissue engineering medicine
Stem cells can be embryonic, fetal, adult or induced pluripotent. Human embryonic stem cells (ES cells) are derived from the inner layer of the blastocyst. Human fetal mesenchymal stem cells (hfMSCs) can be harvested from stem cells present in the amniotic fluid or the umbilical cord. There are difficulties in harvesting them due to their limited availability and also due to inherent ethical issues. The induced pluripotent stem cells (iPSCs) have the greatest difficulty in being differentiated into specific cells needed for the treatment of diseases.
Adipose tissue-derived stem cells (ADSCs) are easier to extract, give high yields (through SVF) and have uses in a wide range of diseases, such as diabetes mellitus, liver disease, corneal lesions, articular and cutaneous lesions, among others. The development of the use of ADSCs is based on cell transplantation, genetic manipulation, epigenetic modulation and the effect of secretomes correcting pathophysiological alterations.
ADSCs are harvested through subcutaneous lipoaspiration, which is a much less painful procedure than harvesting bone marrow stem cells, and has so ethical controversies unlike embryonic stem cells because they are harvested from autologous fat.
SVF is not only rich in ADSC but also has an abundance of adipocytokines, cytokines, transcriptional and growth factors, which helps it to perform as an energy reservoir, thermal insulator or mechanical buffer, and allows for a complex network of interactions with the endocrine, nervous and cardiovascular systems.
New research is being done to look into the possibilities of ADSC’s role in transgenesis and gene editing. They are purported to differentiate into different specific lineages according to therapeutic needs but also can be modified at the genetic level, so that cell therapy also becomes a gene therapy which can be used to correct genetic defects. Moreover, ADSC could function as vectors for the transduction of corrective genes.
In relation to cancer treatment, the cellular and biochemical components of ADSC-SVF can have beneficial effects in disrupting tumorigenesis, but it may conversely promote tumor progression as well, but there are low frequencies of loco-regional tumor recurrences reported in patients who underwent post-surgery breast cancer reconstruction. There is a great complexity and heterogeneity of the factors that can promote or antagonize the malignant transformation when ADSC is transplanted. More research is warranted in this space.
ADSCs are widely being used in experimental and human studies. They have been used in several small animal experiments for osteoporosis, muscle damage, autoimmune thyroiditis, rheumatoid arthritis, diabetes, etc, all with encouraging results. This research is now translating into clinical applications through robust clinical trials. Overall, ADSC’s not only had major potential application in regenerative medicine but also in medical genetics.