Abstract
In this thesis, we have investigated the anti-scarring effects of adipose tissue using a multi-disciplinary approach. Lipofilling is a safe and simple autologous treatment for dermal scars. Review of the available scientific literature revealed that the general consensus is that lipofilling improves scar appearance and relieves scar-related pain. Still, placebo controlled trials to definitively confirm effectivity of lipofilling for dermal scarring have yet to conducted.
In our own clinical trial, we demonstrated that lipofilling decreases severity of the scarring and normalized scar appearance towards normal skin. Moreover, analysis of scar tissues before and after lipofilling also demonstrated improvement of the scar tissues, pointing towards a regenerative effect.
In the laboratory, we showed that adipose tissue derived stem/stromal cells (ASC) could inhibit activation of dermal fibroblasts. Excessive activation of dermal fibroblasts leads to scarring. We have shown that growth factors produced by ASC inhibit this process and could thus be used as therapy for scarring.
However, obtaining large amounts of ASC that are needed for cell therapy in patients, remained a problem. In this thesis, we investigated different methods to obtain enough ASC for cell therapy. We showed that use of human platelet concentrates speeds up growth of ASC in the laboratory. Also, we compared different methods to isolate the stem/stromal cell fraction during surgery. Currently, we are testing one of these methods in a randomized, placebo-controlled patient study to investigate if injection of the stem/stromal cell fraction directly after surgery can prevent formation of pathological scars. The results of this study are still underway.
In conclusion, we have shown in this thesis that lipofilling and the stem/stromal cell fraction of adipose tissue are a promising treatment for treatment and prevention of dermal scars.
In our own clinical trial, we demonstrated that lipofilling decreases severity of the scarring and normalized scar appearance towards normal skin. Moreover, analysis of scar tissues before and after lipofilling also demonstrated improvement of the scar tissues, pointing towards a regenerative effect.
In the laboratory, we showed that adipose tissue derived stem/stromal cells (ASC) could inhibit activation of dermal fibroblasts. Excessive activation of dermal fibroblasts leads to scarring. We have shown that growth factors produced by ASC inhibit this process and could thus be used as therapy for scarring.
However, obtaining large amounts of ASC that are needed for cell therapy in patients, remained a problem. In this thesis, we investigated different methods to obtain enough ASC for cell therapy. We showed that use of human platelet concentrates speeds up growth of ASC in the laboratory. Also, we compared different methods to isolate the stem/stromal cell fraction during surgery. Currently, we are testing one of these methods in a randomized, placebo-controlled patient study to investigate if injection of the stem/stromal cell fraction directly after surgery can prevent formation of pathological scars. The results of this study are still underway.
In conclusion, we have shown in this thesis that lipofilling and the stem/stromal cell fraction of adipose tissue are a promising treatment for treatment and prevention of dermal scars.
| Original language | English |
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| Qualification | Doctor of Philosophy |
| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 20-Jun-2018 |
| Place of Publication | [Groningen] |
| Publisher | |
| Print ISBNs | 978-94-034-0664-0 |
| Electronic ISBNs | 978-94-034-0663-3 |
| Publication status | Published - 2018 |