Adipose-Derived Stem Cells

Until recently bone marrow was perceived to be the only significant reservoir of stem cells in the body. However, it is now recognized that there are other and perhaps even more abundant sources, which include adipose tissue. Subcutaneous fat is readily available in most patients, and can easily be harvested in ample amounts. Therefore adipose-derived stem cells (ASCs), also known as the stromal vascular fraction, can easily be isolated in therapeutically relevant amounts from this fat tissue. This isolation can be performed in a matter of hours by simple enzymatic tissue digestion and centrifugation, which eliminates the need for cultivation and expansion in a Good Medical Practice (GMP)/ATMP clean room facility. This renders them as the ideal candidate for autologous (mesenchymal-like) stem cell transplantation in the acute phase of disease, including myocardial infarction. To date, ASCs have been used in a wide variety of disease, including systemic sclerosis, osteoarthritis, complex wound repair including partial mastectomy defects after breast cancer, facial lipoatrophy, and urinary incontinence. Here, ASC transplantation for acute and chronic cardiac disease will be reviewed, including the current harvesting methods, cell isolation techniques, immunophenotyping, suggested working mechanisms, and the first results from preclinical animal studies and clinical trials that have been collected to date.