Autologous Adipose Tissue-Derived Mesenchymal Stem Cell Therapy Improves Skin Photo-Ageing

The purpose of the present clinical study was to investigate the effects of ADSC therapeutic introduction into the facial skin of patients with overt photo-ageing,¹ with special attention to morphological modifications of the dermal extracellular matrix. The chosen strategy was to compare histology and histopathology of the treated and non-treated skin, harvested from patients that were going to be submitted to facial rejuvenation through surgical face-lifting.^2,3

This prospective, clinical, randomized study involved twenty healthy subjects, 4 males and 16 females, candidates for facial rejuvenation surgery (face lifting). They aged from 45 to 65 years. The study was done between September 2012 and June 2014. They were inhabitants of the northeast region of Brazil, where an extensive exposure to sun is expected, and they presented class IV (n= 9), and V (n= 11) Fitzpatrick’ s classification of the skin [21]. Patients were treated according to the ethical principles of the Declaration of Helsinki 2000, and the present study was approved by the Brazilian Medical Investigation Ethical Board (Protocol no. 28063) and the Brazilian Clinical Trials Registry (RBR-2nn9y2).

Mesenchymal stem cells were obtained from lipoaspirates, expanded in vitro⁴, and introduced into the facial skin of patients to be submitted after four months to a face-lifting surgery. The retrieved face skin was analyzed by immunocytochemistry for identification and quantification of the elastic matrix components, cathepsin-K, metalloelastase M-12, and macrophage M2 markers CD68, CD206 and heme-oxygenase-1.⁵

Results: A full de novo formation of oxytalan and elaunin fibers was observed in the sub-epidermal region, with full reconstitution of the papillary dermal-epidermal junction. Elastotic deposits in the deep dermis were substituted by a normal elastin fiber network. The coordinated removal of the pathologic deposits and their substitution by the normal ones was concomitant with activation of cathepsin-K and MPP12, and expansion of the M2 macrophage infiltration.

Conclusions: Adipose Derived Stem Cell  therapy of solar elastosis fully regenerates skin extracellular matrix, with restoration of a normal elastin network in the sub-epidermal zone and substitution of elastotic deposits by normal elastin fibers in the deep dermis. This may be a promising cell-therapy for sun-aged skin regeneration.

Reference:

1. Yarak S, Okamoto OK. Human adipose-derived stem cells: Current challenges and clinical perspectives. An Bras Dermatol. 2010;85:647-56.
2. Kim JH, Jung M, Kim YM, Choi EH. Adipose-derived stem cells as a new therapeutic modality for aging skin. Exp Dermatol. 2011;20:383-7.
3. Meruane MA, Rojas M, Marcelain K. The use of adipose tissue-derived stem cells within dermal substitutes improves skin regeneration by increasing neoangiogenesis and collagen synthesis. Plast Reconstruc Surg. 2012;130:53-63.
4. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7:2011-28.
5. Charles-de-Sá L, Gontijo-de-Amorim NF, Takiya CM, Borojevic R, Benati D, Bernardi P, et al. Antiaging treatment of the facial skin by fat graft and adipose-derived stem cells. Plast Reconstr Surg. 2015;135:999-1009.