Please note our latest publication in the Special Issue entitled “Advances in Regenerative Medicine and Tissue Engineering” by MDPI Processes magazine. In this last article, we characterized Lipocell from the cellular and histological point of view. The following paragraphs are technical hints dedicated to insiders; the general publican can jump to the conclusion of the article.
HOW MANY CELLS ARE THERE?
The mechanism of function of Lipocell technology is a dialysis membrane that separates the elements of a solution, in this case, lipoaspirate. The filter has a porosity equal to 50 µm that retains adipose tissue, but permeable to washing solution, blood, and excess oil. The mesenchymal stem cell (MSCs) count was performed by comparing the standard device with smaller filters (15 and 20 µm). Lipocell, on average, has 2-3 times more MSC than untreated fat. At the same time, no differences were found between the different filters, suggesting that a filter with lower porosity is not useful to retain more cells.
FROM RED TO YELLOW
Excess of blood and oil, in case of lipofilling (re-integration of adipose tissue into the patient for filling or regenerative purposes), can be a problem. These are waste residues, without recognized biological activity, which can cause inflammatory reactions. The 50 µm Lipocell filter can purify tissue from these elements more effectively and quickly than smaller filters or other methods.
A MORE CONSERVATIVE METHOD THAN CENTRIFUGATION
From a regulatory point of view, excessive manipulation of adipose tissue turns the product into an ATMP, which stands for Advanced Therapeutic Medicinal Product. Consequently, it should be subject to strict regulation that is not compatible with routine clinical practice. Cell culture, for example, substantially modifies the cellular product. The same can be said of enzymatic digestion or significant mechanical manipulation which, by altering the structure of the tissue, become more than minimal manipulation. In our article we have characterized the elements of the extracellular matrix through biochemical analysis and performed histologies to compare the Lipocell product with untreated and centrifuged fat. Lipocell maintains a tissue architecture fully comparable to native fat, while the centrifuged one shows a substantial alteration of the structure.
THE RINGER’S LACTATE
The procedure with Lipocell also involves the use of a washing solution. Results have shown that washing with Ringer’s Lactate (instead of saline) fully preserves the proliferative potential of MSCs. The mechanism of action behind this novelty requires further investigation. Still, a possible explanation may be that the adipose tissue cells, after liposuction, go into ischemic shock due to lack of oxygen (as they no longer have a vascular supply). In oxygen deficiency, the cells initiate anaerobic respiration, which is a less efficient way to produce energy, but the administration of lactate ion could compensate this reaction by restoring the Krebs cycle and thus improve cell survival.
REGENERATIVE MEDICINE FOR ALL
Lipocell is a medical device classified IIa for intra-operative processing of adipose tissue. The mechanism of function is based on a dialysis membrane, which, in combination with a washing step, can separate adipose tissue from waste elements such as excess wash solution, free oil, and blood. The final product is enriched with MSC with great regenerative potential (see our recent article: “Fat is beautiful”), with the advantage of being easily injectable and with a preserved tissue architecture that meets the most stringent regulatory requirements.