Tissue Regeneration PRP-FAT: Potential Applications and Legal Framework
HERSANT B | MENINGAUD JP
Seance of wednesday 29 january 2020 (Innovations en chirurgie plastique et médecine régénérative)
Abstract
Adipose tissue has the advantage of easy removal and the possibility of autografts. The interest of lipofilling has long been considered as volumizing but the discovery of its trophic character has made lipofilling the most used regenerative medicine treatment in the field of tissue regeneration.
Indeed, adipose tissue is a potential source of adult stem cells known as mesenchymal stem cells (MSC) with multiple differentiation potentials. MSCs are isolated from the culture of the stromal vascular fraction (SVF), a heterogeneous population of cells with regenerative properties. SVF is derived from enzymatic digestion or mechanical fractioned of adipose tissue. It is thus considered as an alternative cell product that allows to ovoid the culture and cell expansion stages of MSCs.
Unfortunately, in France, the use of MSCs and SVF must meet regulatory constraints as they are cell therapy products or "Medicinal Products for Innovative Therapy" MTI (European Directive 2009/12/EC), limiting their use by research teams for clinical validation. These limits have allowed the development of new adipose tissue transfer techniques without going through digestion or cell culture steps. Thus, the development of cannulas for the removal of "micro" adipose lobules has made it possible to use fat rich in stem cells. More recently, Tonnard et al (14). have described a mechanical technique for obtaining emulsified fat or "nanofat" from a micro-fat sample. According to the authors, this emulsified fat would be rich in progenitor cells.
These tools of regenerative medicine should be used and validated for precise indications in each surgical field.
Indeed, adipose tissue is a potential source of adult stem cells known as mesenchymal stem cells (MSC) with multiple differentiation potentials. MSCs are isolated from the culture of the stromal vascular fraction (SVF), a heterogeneous population of cells with regenerative properties. SVF is derived from enzymatic digestion or mechanical fractioned of adipose tissue. It is thus considered as an alternative cell product that allows to ovoid the culture and cell expansion stages of MSCs.
Unfortunately, in France, the use of MSCs and SVF must meet regulatory constraints as they are cell therapy products or "Medicinal Products for Innovative Therapy" MTI (European Directive 2009/12/EC), limiting their use by research teams for clinical validation. These limits have allowed the development of new adipose tissue transfer techniques without going through digestion or cell culture steps. Thus, the development of cannulas for the removal of "micro" adipose lobules has made it possible to use fat rich in stem cells. More recently, Tonnard et al (14). have described a mechanical technique for obtaining emulsified fat or "nanofat" from a micro-fat sample. According to the authors, this emulsified fat would be rich in progenitor cells.
These tools of regenerative medicine should be used and validated for precise indications in each surgical field.