Adding Nanofat to Fat Grafting to Treat Velar Scarring in Velopharyngeal Incompetence

Protein profiling of mechanically processed lipoaspirates: discovering wound healing and anti-fibrotic biomarkers in nanofat

BACKGROUND

Nanofat is an injectable oily emulsion, rich in adipose derived stem cells (ADSCs) and growth factors. It is prepared from lipoaspirates through mechanical emulsification and filtration. Despite being successfully used in several procedures in regenerative medicine such as scar attenuation, skin rejuvenation and treatment of chronic wounds, little is known about exactly how nanofat induces regeneration in treated skin at the molecular level.

METHODS

Microfat and nanofat samples were isolated from 18 healthy patients. Proteomic profiling was performed through untargeted mass spectrometry proteomics and multiplex antibody arrays. Pathway enrichment analysis of differentially expressed proteins between microfat and nanofat was performed using Gene Ontology, Reactome and KEGG as reference databases.

RESULTS

Untargeted proteomics showed that upregulated genes in nanofat are involved in innate immunity responses, coagulation and wound healing, while downregulated genes were linked to cellular migration and extracellular matrix (ECM) production. Secretome array screening of microfat and nanofat samples showed no significantly different expression, which strongly suggests that the mechanical emulsification step does not affect the concentration of tissue regeneration biomarkers. The identified proteins are involved in wound healing, cellular migration, extracellular matrix remodelling, angiogenesis, stress response and immune response.

CONCLUSIONS

Mechanical processing of lipoaspirates into nanofat significantly influences the proteome profile by enhancing inflammation, antimicrobial and wound healing pathways. Nanofat is extremely rich in tissue repair and tissue remodelling factors.

CLINICAL RELEVANCE STATEMENT

This study shows that the effects of Micro- and Nanofat treatment are based on upregulated inflammation, antimicrobial and wound healing pathways. Mechanical emulsification does not alter the concentration of tissue regeneration biomarkers.

Tissue Engineering in Stomatology: A Review of Potential Approaches for Oral Disease Treatments

Tissue engineering is an emerging discipline that combines engineering and life sciences. It can construct functional biological structures in vivo or in vitro to replace native tissues or organs and minimize serious shortages of donor organs during tissue and organ reconstruction or transplantation. Organ transplantation has achieved success by using the tissue-engineered heart, liver, kidney, and other artificial organs, and the emergence of tissue-engineered bone also provides a new approach for the healing of human bone defects. In recent years, tissue engineering technology has gradually become an important technical method for dentistry research, and its application in stomatology-related research has also obtained impressive achievements. The purpose of this review is to summarize the research advances of tissue engineering and its application in stomatology. These aspects include tooth, periodontal, dental implant, cleft palate, oral and maxillofacial skin or mucosa, and oral and maxillofacial bone tissue engineering. In addition, this article also summarizes the commonly used cells, scaffolds, and growth factors in stomatology and discusses the limitations of tissue engineering in stomatology from the perspective of cells, scaffolds, and clinical applications.

The Effect of Different Diameters of Fat Converters on Adipose Tissue and Its Cellular Components: Selection for Preparation of Nanofat

BACKGROUND

Nanofat is an autologous product prepared mechanically from harvested fat. In nanofat grafting, converters are employed for mechanical emulsification to facilitate fat injection. To date, the study of different converters has received scant attention regarding whether they affect the characteristics of nanofat in terms of the practical applications and indications.

OBJECTIVES

The authors set out to investigate the influence of different internal diameters of converters on biological functionality of nanofat during shuffling.

METHODS

The 3-dimensional finite element method was employed to simulate the process of mechanical emulsification of fat and to research the stress with 5 different converters (3.76 mm, 2.00 mm, 1.20 mm, 1.00 mm, 0.80 mm). An assessment of the morphology of emulsified fat was conducted. Isolated stromal vascular fraction (SVF) was analyzed for cellular components, number, and viability through flowcytometry and live/ dead staining. Adipocytic and angiogenic differentiation assay allowed assessment of differentiation capacity of the SVF.

RESULTS

The smaller the aperture of the converter, the greater the mechanical force on adipose tissue during mechanical emulsification, showing the different macroscopic and microscopic structure of the emulsified fat. No difference in viability or ratio of endothelial progenitor cells and other cells was found. Angiogenic and adipogenic differentiation capacity of the SVF significantly changed in 5 different converters.

CONCLUSIONS

The mechanical emulsification from different apertures of converters exerts different effects of adipose tissue structure, cell content, and multipotency differentiation but not its viability. Converters with different apertures can be selected according to clinical needs.

Autologous Fat Grafting in Velopharyngeal Insufficiency Gives Complete and Stable Speech Recovery in Patient Under 7 years

ABSTRACT

The authorspresent a retrospective observational cohort study of 47 French speaking consecutive patients treated with retropharyngeal wall filling with autologous fat graft from 2006 to 2019 in a single tertiary center, to assess with a long-term follow-up, the best tailored treatment to recovery speech for velopharyngeal insufficiency, and to stress the importance of early treatment with minimally invasive procedure with retropharyngeal wall fat grafting. In preoperative setting, a clinical and instrumental evaluation with aerophonoscope is completed by a palatal closure assessment with nasal endoscopy. All patients were classified according with Borel Maisonny score pre- and post-operatively. Sixty three fat injections were performed. In 4 cases a pharyngeal flap was performed after fat graft for an insufficient speech result. The authors had no complications. Patients with less than 7 years of age obtained a complete recovery of their velopharyngeal incompetence (P = 0.03) compared to older patients. In conclusion, the authors can state that this tailored surgical technique needs a multidisciplinary approach. Many variables can affect postoperative results: fat reabsorption, concurrently performed surgery, pattern of pharyngeal closure, hearing impairment. None of these factors affected our result. Early treatment plays a crucial role to achieve better results. Patients with less of 7 years showed a better result in this functional treatment.