Fat is beautiful
If there is something underestimated in our body, that is undoubtedly the fat (medical term: adipose tissue).
Large hips, swollen belly: people would love to remove fat from their bodies. Yet, for thousands of years, being overweight was a reason for admiration, a sign of prosperity and fertility, but also a charm. Only in the contemporary age, the concept of beauty shifted to the thin, setting it as a model for the most disparate reasons including the appropriate medical notion that correlates obesity to several diseases.
Why does fat exist? From a biological point of view it is neither to make us beautiful, nor to make us ugly, but to perform some important tasks, such as protecting organs and tissues by acting as a mechanical barrier, preventing the dispersion of heat generated by our body and regulating the energy reserves (glucose and lipids) with accumulation and release when needed. Fat tissue regulates many important physiological functions, such as metabolism, fertility, coagulation, but the most surprising fact is the abundant presence of adult stem cells, which makes fat an attractive cellular source also because of the ease of its collection. The reason why this resource exists is not clear to researchers and, notably, stem cells were discovered in adipose tissue recently, in 2001.
However, already at the beginning of the 20th century, some people sensed that fat could be a special tissue. During the First World War, Dr. Hippolyte Morestin, a plastic surgeon pioneer, tried to perform the first facial reconstructions of wounded soldiers, using autologous human fat. And in even older times, during the American Revolution, pig fat was used to treat war burns. With the evolution of reconstructive surgery, fat has maintained its importance both for aesthetic reasons and for its volumetric capacity, to fill the large voids of tissue loss. The technique is called lipofilling and it consists of the suction of fat (liposuction) from the subcutaneous to re-inject it on the patient himself. Over the years, the procedure has evolved to obtain increasingly refined grafts, purified from residual oil that causes inflammatory reactions and reduced in size for better survival of the implant. It is with this progression that it has been understood that the adipose tissue is mostly a regenerative tool and not only a volumizer. Only later, researchers identified an abundant presence of mesenchymal stem cells in fat, able to differentiate in the cells of connective tissues (bone, cartilage, muscle, etc..), but especially to release molecules useful for tissue repair in case of damage.
Today, fat is back in fashion. At least in medicine. Many medical devices, such as Lipocell, can purify adipose tissue directly in the operating room, making it injectable and useful for the treatment of a wide range of diseases ranging from osteoarthritis to diabetic foot. However, biology is complex, men are mysterious machines and we do not know all the reasons why adipose tissue is so special and useful in medicine. Probably, this does not depend only on the regenerative and anti-inflammatory activity of stem cells. In our laboratory, we are analyzing the extracellular matrix components of adipose tissue and investigating the anti-oxidant power of lipids, which could have a great influence on the mechanisms of tissue regeneration. The goal is to understand what are the differences between individuals and how much diet and habits can affect the therapeutic potential of this tissue.
Anyway, we should not despair for those extra-pounds on the belly, because today we have a (scientific) excuse to say that “fat is beautiful”.
Omar Sabry
Sources:
Benmoussa N, Hansen K, Charlier P. Use of Fat Grafts in Facial Reconstruction on the Wounded Soldiers From the First World War (WWI) by Hippolyte Morestin (1869-1919). Ann Plast Surg. 2017 Nov;79(5):420-422. doi: 10.1097/SAP.0000000000001221.
Murray CK, Hinkle MK, Yun HC. History of infections associated with combat-related injuries. J Trauma. 2008 Mar;64(3 Suppl):S221-31. doi: 10.1097/TA.0b013e318163c40b.
Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001 Apr;7(2):211-28. doi: 10.1089/107632701300062859