It’s been more than a decade and a half since plastic surgeon Sidney Coleman reported that a patient’s scar tissue began to disappear after he injected some of the patient’s own fat to correct her nose defect.
And it’s been almost as long since researchers discovered the reason why.
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Our fat contains loads of adult stems cells, which can repair damaged tissue such as scars.
Our fat contains loads of adult stems cells, which can repair damaged tissue such as scars.
In the intervening years, much research has gone into how to separate those stem cells from fat, so they can be used to fix everything from torn knee cartilage to multiple sclerosis.
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One big challenge has been resistance from the Food and Drug Administration, which has been fighting to stop doctors from separating stem cells from fat. The federal agency says the processes used — such as chemicals that break down the fat tissue, or centrifuges to pull the tissue apart — change the nature of the fat tissue and therefore produce ‘bio-drugs’ that come under FDA jurisdiction.
For that reason, a lot of the more radical or experimental treatments with fat-derived stem cells have taken place off shore, in clinics outside the FDA’s control.
That may be changing, however. The latest research announced at this year’s annual meeting of iFATS found you don’t need to separate the stems cells from the fat. In fact, it might be better to keep it all together.
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iFATS is not an Apple product, though it may sound like it is. The name stands for the International Federation for Adipose Therapeutics and Science (adipose is medical jargon for fat). The group researches how, and why, fat can be used to reconstruct defects, as well as produce therapeutic results like anti-inflammation for illnesses like Alzheimer’s.
In the past, many iFATS presentations have focused on those adipose-derived stem cells — aka mesenchymal stem cells (MSCs) — and their healing powers. At this year’s conference in New Orleans, however, the discussion was about keeping the fat intact.
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Dr. Ricardo Rodriguez, the incoming president of iFATS, told LifeZette that stem cells are accompanied by an array of other cellular material, including tiny chemical messengers, which may be responsible for many of the therapeutic benefits once thought to come from the stem cells themselves. If you separate stem cells from the fat “niche,” you lose the power of what researchers are now calling “the extra cellular matrix,” a stew of associated chemicals.
Some scientists are even postulating stem cells themselves might not to be doing the repair work, but are instead acting more like conductors, telling the damaged tissue, like heart muscles or neurons, how to repair itself.
This is good news, said Rodriguez, since the FDA doesn’t oppose the transfer of fat, especially for things like facial injections, which can regenerate the skin, or orthopedic procedures, which can repair damaged knees and shoulders.
Rodriguez points to some new products coming online, such as Lipogems, which cleans fat and breaks it into tiny spheres with bioactive surfaces that not only create capillaries so the fat can survive, but also release the “extra-cellular”’ repair messengers.
Not to be left behind, Coleman also announced his latest research at November’s iFATS conference. He has been working with fat tissue from cadavers, removing the fat cells, but preserving the collagen — the structural tissue — and the chemical growth factors, those “extra-cellular” messengers.
Working first with rats and now humans, Coleman has discovered that if you inject the collagen and growth factors, the body starts to produce its own fat cells that attach to the collagen, which acts like scaffolding.
“If we could create something that could reliably create fat and influence wound healing, then we would have an off-the-shelf product,” Coleman said.
That would go a long way toward bypassing FDA restrictions.
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