| Objective:Analysis of factors related to lipotransfer for localized scleroderma,to explore the feasibility of the treatment of cell-assisted lipotransfer for localized scleroderma.Methods:(1)21 cases of abdomen fat samples were taken from patients:6 cases of localized scleroderma patients(without hormone therapy),5 cases of localized scleroderma patients(with hormone therapy),10 cases of normal liposuction patients.Extract the stem cells from adipose tissue,and Compare the quantity,morphology,proliferation and the ability of fat.(2)Blood flow in localized scleroderma lesions and normal contralateral parts of 8 cases localized scleroderma patients was measured by laser speckle contrast imaging.Blood flow in 6 cases of bleomycin-induced scleroderma model nude mice and 6 cases of normal nude mice was measured by laser speckle contrast imaging.(3)2 cases of localized scleroderma skin lesions and 2 cases of non scleroderma skin lesions.The fibroblasts were cultured and mixed with fat particles and then transplanted into nude mice to observe the survival of the fat in the human body.(4)18 cases of bleomycin-induced scleroderma model nude mice and 18 cases of normal nude mice,each of them were divided into three groups:control group,lipotransfer group,cell-assisted lipotransfer group.Fat weight was measured and TGF-?1 and type? collagen in the injected skin of nude mice were determined by immunohistochemistry at postoperation of 4 weeks.Results:(1)There were no differences in the morphology and adipogenic differentiation capacity of these 21 cases stem cells.The surface markers of the third generation ADSCs such as CD44+ was more than 90%,and no significant difference was detected of these 21 cases stem cells.But the stem cell number of the localized scleroderma patients with hormone treatment was significantly reduced than normal patient and the localized scleroderma patients without hormone treatment,the cell growth curve was significantly delay.(2)Mean blood perfusion in localized scleroderma lesions was 92.69 ±22.04,compared to 95.70 ±20.43 in normal contralateral side,no significant difference between the localized scleroderma lesions and contralateral normal side.The blood perfusion of normal nude mice was 251.72 ±43.82,and The blood perfusion of scleroderma nude mice was 241.89 ±22.76,There was no statistical significant difference in two type nude mice.(3)In localized scleroderma patients,the fat weight was about 68.24±19.20mg after the transplantation of fibroblasts and fat,and the fat weight was about ± 20.15mg in localized scleroderma patients.(4)Survival fat weight of normal nude mice lipotransfer group was 102.97± 17.87mg,and the cell-assisted lipotransfer group was 135.05 ±27.28 mg.Survival fat weight of scleroderma nude mice lipotransfer group was 77.54± 12.40mg,and the cell-assisted lipotransfer group was 102.48 ±23.16 mg.weather normal nude mice or with scleroderma nude mice,the survival rate of fat transplantation with adipose derived stem cells(ADSCs)was higher than that of simple fat transplantation.(4)To normal nude mice,the TGF-?1 was 939.34 1±216.92 in control group,974.98 ±470.18 in lipotransfer group,967.66 ±448.74 in cell-assisted lipotransfer group;and the type III collagen was 623.85±113.84 in control group,605.73 ±217.17 in lipotransfer group,599.34±89.39 in cell-assisted lipotransfer group.To scleroderma nude mice,the TGF-?1 was 1945.95 ±330.77 in control group,1418.86 ±376.82 in lipotransfer group,1132.12±190.69 in cell-assisted lipotransfer group;and the type ? collagen was 2629.39±746.62 in control group,1531.74±836.41 in lipotransfer group,946.92±448.90 in cell-assisted lipotransfer group.To normal nude mice,there was no significant changes in TGF-?1 and type ? collagen after lipotransfer or cell-assisted lipotransfer.But to scleroderma nude mice,lipotransfer or cell-assisted lipotransfer can reduced TGF-?1 and type ? collagen,and the effect of cell-assisted lipotransfer was more significant.Conclusions:(1)The pattern of fat transplantation in localized scleroderma patients is different from in normal patients.For localized scleroderma patients,fewer ADSCs,due to a history of hormone therapy and a local inflammatory microenvironment,are more important factors,while blood supply showed no significant change.(2)Cell-assisted lipotransfer not only improves the survival rate of transplanted fat,but also reduces collagen deposition in scleroderma nude mice. |
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