背景:自体脂肪移植已成为整形外科中解决软组织缺陷并实现嫩肤的流行工具,但是移植后的体积损失仍然是一个令人不安的问题。近年来,一些新的策略在一定程度上改善了结果,但是脂肪移植物的保留仍然远非理想,因此,该领域仍有广阔的发展前景。巨噬细胞与局部微环境和组织再生密切相关,它们在脂肪嫁接中的作用日益凸显。
目的:本文旨在对其疗效进行综述,可能的机制,以及巨噬细胞调节在脂肪移植中的潜在应用,以及对这一领域的关注和未来观点。
方法:对已发表的数据进行回顾性回顾。
结果:大多数研究表明,在脂肪移植过程中上调M2巨噬细胞会通过促进新生血管形成来改善脂肪保留。M2巨噬细胞可以分泌几种促血管生成因子,加速细胞外基质(ECM)重塑,并直接作用于内皮细胞以促进血管扩张。此外,巨噬细胞可以影响增殖,凋亡,和前脂肪细胞的成脂分化。
结论:在自体脂肪移植过程中,适当调节巨噬细胞可能成为增加脂肪滞留的有前景的方法。然而,M2巨噬细胞极化剂,治疗机会,禁忌症需要进一步讨论。我们希望我们的工作能够促进这个领域更深入的研究,我们期待着在临床实践中的巨噬细胞治疗的标准程序。
BACKGROUND: Autologous fat grafting has become a popular tool in plastic surgery to solve soft tissue defects and achieve skin rejuvenation, but the volume loss after transplantation remains a disturbing problem. In recent years, some new strategies have improved the outcome to some extent, but the fat graft retention is still far from ideal, so there remains a wide development prospect in this field. Macrophages are closely related to the local microenvironment and tissue regeneration, and their role in fat grafting has been increasingly highlighted.
OBJECTIVE: This article was aimed to
review the efficacy, possible mechanisms, and potential application of macrophage regulation on fat grafting, as well as concerns and future perspectives of this filed.
METHODS: A retrospective
review of the published data was conducted.
RESULTS: Most studies indicated that up-regulating M2 macrophages during fat grafting would improve fat retention via promoting neovascularization. M2 macrophages could secrete several pro-angiogenic factors, accelerate extracellular matrix (ECM) remodeling, and directly function on endothelial cells to encourage vascular expansion. In addition, macrophages could influence the proliferation, apoptosis, and adipogenic differentiation of preadipocytes.
CONCLUSIONS: During autologous fat grafting, appropriately regulating macrophages may become a promising method to increase fat retention. Nevertheless, the M2 macrophage polarizing agents, treatment opportunity, and contraindications require further discussion. We hope our work could promote more in-depth studies in this field, and we are looking forward to a standard procedure for the macrophage therapy in clinical practice.