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Concise Review: Adipose Tissue-Derived Stromal CellsBasic and Clinical Implicati [复制链接]

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发表于 2009-3-5 00:56 |只看该作者 |倒序浏览 |打印
作者:Andreas Schffler, Christa Bchler作者单位:Department of Internal Medicine I, University of Regensburg, Regensburg, Germany
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          【摘要】9 q5 Z( m0 W3 f  W# r. i7 |
      Compared with bone marrow-derived mesenchymal stem cells, adipose tissue-derived stromal cells (ADSC) do have an equal potential to differentiate into cells and tissues of mesodermal origin, such as adipocytes, cartilage, bone, and skeletal muscle. However, the easy and repeatable access to subcutaneous adipose tissue and the simple isolation procedures provide a clear advantage. Since extensive reviews focusing exclusively on ADSC are rare, it is the aim of this review to describe the preparation and isolation procedures for ADSC, to summarize the molecular characterization of ADSC, to describe the differentiation capacity of ADSC, and to discuss the mechanisms and future role of ADSC in cell therapy and tissue engineering. An initial effort has also been made to differentiate ADSC into hepatocytes, endocrine pancreatic cells, neurons, cardiomyocytes, hepatocytes, and endothelial/vascular cells. Whereas the lineage-specific differentiation into cells of mesodermal origin is well understood on a molecular basis, the molecular key events and transcription factors that initially allocate the ADSC to a lineage-specific differentiation are almost completely unknown. Decoding these molecular mechanisms is a prerequisite for developing novel cell therapies.! W/ _' g4 \7 p7 O7 J

8 ~) w9 m+ Y' _( J2 bDisclosure of potential conflicts of interest is found at the end of this article.
) A( n4 Q1 [2 |# f' p- S* ?, @9 ]          【关键词】 Adipocyte Adipose tissue Mesenchymal stem cell Tissue engineering Cell therapy- D; p% s# G' M* f# V+ C% v$ Y
                  INTRODUCTION( q; `" }% S, x! D
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Multipotent human and mouse MSC have the ability  of pluripotent adipose tissue-derived stromal cells.: [# M5 K1 V8 T; \) z! D
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There is a confusing inconsistency in the literature when using terms describing multipotent precursor cells from adipose tissue stroma, such as processed lipoaspirate (PLA) cells, adipose tissue-derived stromal cells (ADSC), preadipocytes, adipose stroma vascular cell fraction, and others. The term SVF corresponds to ADSC and describes cells obtained immediately after collagenase digestion. The critical point is the absence of a detailed molecular and cellular characterization of multipotent stem cells within the adipose stroma. Accordingly, the term ADSC will be used throughout this review. However, considerable effort has been made to characterize cellular and molecular properties of ADSC. This is a critical point in the field, and to date, there is currently no review available interpreting the complex data on ADSC or adipose tissue-derived multipotential precursor cells. Recently, Rodriguez et al.  described the isolation and culture of adipose tissue-derived stem cells with multipotent differentiation capacity at the single cell level. These cells maintain their characteristics with long-term passaging and develop the unique features of human adipocytes. We decided to use the term ADSC in this review as a compromise and only for cells that were (a) passaged several times, (b) shown to exert multipotential differentiation capacity, and/or (c) molecularly characterized by using a multipanel of mesenchymal differentiation markers according to Table 1.; _: _: ~1 L1 j3 ~% w
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Table 1. Molecular phenotype of adipose tissue-derived stromal cells
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1 G/ w" a# a3 d8 e3 |8 }3 I  T% h3 KThe simple surgical procedure, the easy and repeatable access to the subcutaneous adipose tissue, and the uncomplicated enzyme-based isolation procedures make this tissue source for MSC most attractive for researchers and clinicians of nearly all medicinal subspecializations .0 \: K9 b8 C& I0 L" k$ @1 d; M3 s) f
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Table 2. Clinical implications of tissue engineering in relation to cell-specific differentiation programs of adipose tissue-derived stromal cells
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; b$ b8 c$ B$ z; ?5 J  DADSC can easily be isolated from human adipose tissue  differentiation. Moreover, an initial effort has been made regarding the differentiation of ADSC across the germ leaf-specific tissues into nonmesenchymal tissues ("cross-differentiation"), such as neurons or endocrine pancreatic cells.) v3 ^: o- x# e" @, {7 h$ i0 B
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The aims of this review are:
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0 q/ Y2 a  N) z& YTo describe the isolation procedures for ADSC,
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6 |* x4 K$ m8 w8 TTo summarize the molecular characterization of ADSC,
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/ b1 J  K3 O; M+ [; f0 {. D$ ETo describe the differentiation capacity of ADSC, and; U8 e3 e9 O6 q' D1 v  U# \

  z* S: n0 ?* s+ R& rTo discuss the mechanisms and future role of ADSC in mesenchymal tissue repair and tissue engineering.) l$ [9 O: p1 B% t2 d9 a% E

& e) l* p! P: u8 q( IIt is not the aim of the present review to discuss the characteristics and differentiation processes of MSC derived from other commonly used tissues, such as bone marrow, umbilical cord blood, or fetal liver.4 U# b: w) i" j- S# s! C

# K/ q1 q: q# y0 R1 F) [# k# d) x! ^/ XPREPARATION AND MOLECULAR CHARACTERIZATION OF ADIPOSE TISSUE-DERIVED MESENCHYMAL STEM CELLS) `; e2 t, K! N( L  Z
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Fibroblast-like adipose tissue-derived mesenchymal stem cells (ATMSC) are morphologically similar to MSC obtained from other tissues during isolation and culturing . Factors such as donor age, type (white or brown adipose tissue), and localization (subcutaneous or visceral adipose tissue) of the adipose tissue, type of surgical procedure, culturing conditions, exposure to plastic, plating density, and media formulations might influence both proliferation rate and differentiation capacity of ADSC.( I% S3 h: @* s% ^. o
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Neither the type of surgical procedure nor the anatomical site of the adipose tissue affects the total number of viable cells that can be obtained from the SVF  reported on the significant enlargement of a pedicle flap of skin/adipose tissue transferred from the subcutaneous abdominal region to the patient's dorsum of hand (autologous fat grafting). This enlargement occurred in parallel to the abdominal weight gain of the patient over time. Accordingly, transferred adipocytes might retain the properties of their site of origin. Future studies have to clarify whether different anatomical sources of ADSC (subcutaneous-peripheral, subcutaneous-abdominal, and visceral/omental) exhibit a different metabolic and cellular behavior after cell therapy.
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The frequency of proliferating MSC and the population doubling time are dependent on the surgical procedure, with some advantages for resection and tumescent liposuction compared with ultrasound-assisted liposuction . Total adipose tissue obtained by surgery first has to be microdissected under sterile conditions to obtain small fat lobules (0.5¨C1 cm3). The basic steps and principles of ADSC preparation are depicted in Figure 1. However, it has to be considered that the isolation procedure can affect the cells. Not only can viability and differentiation capacity be affected but also different collagenase batches and centrifugation speeds can cause the isolation of different cell subsets. Thus, a detailed molecular characterization of the isolated cells has to be performed.+ |, l0 t% C( Y9 J% |9 K; l

5 g9 k0 _; J* T4 X; LFigure 1. Preparation procedure of adipose tissue-derived stromal cells. Adipose tissue can be easily obtained by surgical resection, tumescent lipoaspiration, or ultrasound-assisted lipoaspiration. The principal steps of mesenchymal stem cell preparation and culturing are depicted. Exact protocols can be obtained from the literature. Expanded stromal cells can be used for several lineage-specific differentiation protocols as a basis for tissue engineering. Note that this procedure is depicted for the illustration of the basic steps and thus cannot be generalized. Abbreviations: BSA, bovine serum albumin; DMEM-LG, Dulbecco's modified Eagle's medium, low glucose concentration; FBS, fetal bovine serum; min., minutes; PBS, phosphate-buffered saline.
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9 Z9 A: v% n- Y0 ~% KIsolated ADSC can be cryopreserved and expanded easily in vitro. Under the conditions commonly used, these cells develop a fibroblast-like morphology. The greatest number of adipocytes can be obtained from cultures plated at low density .& y% k8 O1 u$ B5 W; N

, b. b! A; q9 \' g2 EBy using antioxidants, such as N-acetyl-L-cysteine and L-ascorbic acid-2-phosphate, and a low calcium concentration, growth rate and life span of ADSC can be increased . The increasing knowledge on the molecular mechanisms regulating ADSC proliferation might be useful for the improvement of isolation and culturing procedures.
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Knowledge of the global gene and protein expression profile of ADSC is a prerequisite both for culturing and lineage-specific differentiation and thus for a highly effective cell therapy. Although the surface marker protein expression profile (determined by fluorescence-activated cell sorting) and the gene expression profile of ADSC (determined by microarray experiments) seem to be similar to that of BMMSC .
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$ j# b7 j& [( X# |, uWagner et al. , less than 1% of genes are estimated to be differentially expressed between ADSC and BMMSC.. t0 \! G( y3 i1 ^- a
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Although BMMSC are phenotypically clearly described, the phenotypic characterization of ADSC still is in its infancy, and all attempts to establish an exact phenotypical definition of ATMSC and a clear discrimination between these cells and fibroblasts have been unsuccessful to date. Therefore, the Mesenchymal and Tissue Stem Cell Committee of the International Society for Cellular Therapy has proposed, most recently, a minimal set of four criteria to define human MSC :5 ]% v: W+ R2 y! h

! M+ q# b/ F" Q( D: |, }MSC have to be plastic-adherent when maintained under standard culture conditions.
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MSC must have the ability for osteogenic, adipogenic, and chondrogenic differentiation.6 ^9 @$ X& ]" M6 Q# E
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MSC must express CD73, CD90, and CD105 (Table 1).% L# z! Z+ P. X

! N$ |  v6 m: Z7 g# NMSC must lack expression of the hematopoietic lineage markers c-kit, CD14, CD11b, CD34, CD45, CD19, CD79, and human leukocyte antigen (HLA)-DR (Table 1).+ \  u* B. Z) C. N
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The known ADSC expression profile of surface markers and genes is summarized in Table 1 according to data derived from the literature , one has to be cautious when comparing mesenchymal stem cells with (multipotent) precursor cells isolated from adipose tissue stroma. When interpreting the expression data summarized in Table 2, it has to be considered that, for example, HLA-DR can be induced by interferon-. Similarly, CD34 expression can also be seen at least during the first passages. This problem cannot be satisfyingly solved at present, and more detailed molecular data are necessary before a real and multipotent adipose tissue-derived mesenchymal stem cell can be clearly characterized and distinguished from intrinsic, pluripotent, adipose tissue stromal cell precursors./ I) x' _/ h! E
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The lack of HLA-DR expression and the immunosuppressive properties of ADSC . These findings support the idea that ADSC share immunosuppressive properties with BM-MSC and therefore might represent an alternative source to BM-MSC.0 [3 ^4 y' u6 T/ e5 B( X' x
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DIFFERENTIATION CAPACITY OF ADIPOSE TISSUE-DERIVED MESENCHYMAL STEM CELLS( d  Q3 M5 h- ^$ e1 V
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Allocation and Differentiation& }( C4 l, S% i' r6 q  Z
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MSC have the ability to differentiate into mesodermal cells (Table 3), such as adipocytes, fibroblasts, myocytes, osteocytes, and cartilagocytes, processes named lineage-specific differentiation . Among these cell types of mesodermal origin, the differentiation process can be switched, for example, by overexpression of lineage-specific transcription factors. Thus, overexpression of peroxisome proliferator-activated receptor  (PPAR) in fibroblasts or myocytes results in adipogenic differentiation. This characteristic process (trans-germ plasticity) is termed trans-differentiation. Surprisingly, ADSC do not only have the potential to differentiate into cells and organs of mesodermal origin. There is increasing evidence for the ability of ADSC to differentiate into cells of nonmesodermal origin, such as neurons, endocrine pancreatic cells, hepatocytes, endothelial cells, and cardiomyocytes (Table 3). Accordingly, we suggest to describe this process by using the term "cross-differentiation" (cross-germ plasticity).2 J6 g) j$ n( j; p

$ m, y- k6 w) Y4 QTable 3. Experimentally used factors triggering the differentiation of adipose tissue-derived stromal cells4 m6 @5 o+ T+ j) z2 h

) ^. e" y% r) @2 _2 a" AThe transcriptional and molecular events triggering the lineage-specific mesodermal differentiation into adipocytes . Widely yet unidentified molecular rheostats, most probably transcription factors, are discussed to cause the commitment of the MSC to a specific lineage (Fig. 2).
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Figure 2. Molecular regulation of proliferation, allocation, and differentiation of adipose tissue-derived mesenchymal stem cells. The processes of proliferation, allocation, and lineage-specific terminal differentiation are regulated by a complex interplay involving stem cell transcription factors (molecular rheostats), cell-specific transcription factors, and a wide variety of cellular kinases, growth factors, and receptors. Whereas the lineage-specific differentiation triggered by tissue-specific transcription factors is well understood, the allocation/commitment of the mesenchymal stem cell to a specific lineage is poorly understood. Thus, unknown stem cell transcription factors, such as TAZ, allocating the stem cell to a specific lineage still await discovery (molecular rheostats). Abbreviations: ADD1/SREBP1c, adipocyte determination- and differentiation-dependent factor-1/sterol regulatory element-binding protein-1; BMP, bone morphogenetic protein; C/EBP, CCAAT enhancer-binding protein; Dlx5, distal-less homeobox-5; ERK, extracellular signal-regulated kinase; FGF-2, fibroblast growth factor 2; FGF-2-R, fibroblast growth factor 2 receptor; JNK, c-jun N-terminal kinase; KLF, Kr¨¹ppel-like transcription factor; KROX-20, Krox-20 homolog Drosophila (previously); MEF2, MADS box transcription enhancer factor-2; MEK, microtubule-associated protein/extracellular signal-regulated kinase kinase; MRF4, muscle regulatory factor-4; Myf5, myogenic factor-5; MyoD, myogenic differentiation antigen; PPAR, peroxisome proliferator-activated receptor ; RXR, retinoid X receptor ; Shh, sonic hedgehog; STAT-1, signal transducer and activator of transcription-1; TAZ, transcriptional coactivator with PDZ-binding motif; TGF, transforming growth factor.9 b. s" X4 r7 D- N2 t
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In the case of adipocyte differentiation, although several transcriptional key events regulating the differentiation of preadipocytes into mature adipocytes have been identified in the last decade, master genes committing the multipotent mesenchymal stem cell to adipoblasts are still awaiting discovery. Recently, transcriptional coactivator with PDZ-binding motif (TAZ) was identified as an early "molecular rheostat" (Fig. 2) modulating mesenchymal stem cell differentiation .
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Adipogenic Differentiation
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! T0 A" E8 i  J5 D3 L/ ~  @( z$ `ADSC can be isolated from human subcutaneous adipose tissue and readily differentiated into cells of the adipocyte lineage. Most importantly, these ADSC-derived adipocytes develop important features known from mature adipocytes, such as lipolytic capacity upon catecholamine stimulation, anti-lipolytic activity mediated by 2-adrenoceptors, and the secretion of typical adipokines, such as adiponectin and leptin .
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3 a$ ?( _$ y7 O+ {% A! _To date, a human white adipocyte cell line is not commercially available. Thus, most researchers are currently using several rodent cell lines (e.g., mouse 3T3-L1 preadipocytes) or SVF prepared from total adipose tissue followed by hormonal differentiation programs. However, rodent adipocytes and human adipocytes demonstrate species-specific differences, and mature adipocytes differentiated from SVF cannot be expanded. Based on these limitations, ADSC can effectively serve as a source for human white fat cells, and donor-specific cell banks might be easy to establish. Soft tissue defects after trauma, burn injury, or surgery still remain a challenge in plastic and reconstructive surgery, and innovative therapies are needed. Adipose tissue engineering using ADSC subjected to adipogenic differentiation seems to be a highly promising approach  designed injectable poly-lactic-co-glycolic acid spheres, attached MSC after adipogenic differentiation on these spheres, and were successful in generating newly formed adipose tissue in nude mice.
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  ?; h! ], m- O3 j, R) CAutologous ADSC therapy might also be used for the treatment of fistulas in patients suffering from Crohn disease. In a pilot study  on five patients with Crohn disease, the external opening of six of eight fistulas could be closed by inoculation of the fistulas with autologous lipoaspirate-derived ADSC. The results of this uncontrolled phase I clinical trial do not allow the demonstration of effectiveness but might give motivation to undertake in vivo studies with autologous ADSC in patients suffering from wound healing defects and fistulas.* k( N7 U" `. @! z& I2 S* k$ R

1 p6 w) W& F9 U4 H# r1 ^; l2 B. STo date, artificial or biological implants suitable for the correction of soft tissue defects after trauma, tumor resection, or deep burns is lacking. In contrast to mature adipocytes, preadipocytes seem to have several characteristics that make them more suitable for this purpose than mature adipocytes. Morphologically, preadipocytes resemble fibroblasts, and they do not have large cytoplasmic lipid droplets. Since preadipocytes are smaller than mature adipocytes, they might allow a quicker revascularization after transplantation. Furthermore, transplanted preadipocytes maintain their ability to differentiate into mature adipose tissue in vivo, whereas the transplantation of mature adipocytes often gives poor results, such as oil cysts or transplant shrinkage. Preadipocytes have a significantly lower oxygen consumption than mature adipocytes , and this advantage in respiration and the better revascularization of undifferentiated adipose tissue cells might allow the future development of innovative transplants.
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8 S) K; I/ x. p4 i% Y0 `5 ]Chondrogenic/Osteogenic Differentiation
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Since bone and cartilage tissue engineering requires large amounts of osteogenic/chondrogenic precursor cells, new sources of progenitor cells are needed. Compared with BMMSC, ADSC have the same ability for osteogenic differentiation, and this ability is maintained with increasing donor age , ADSC also had a inferior ability in the treatment of partial growth arrest in a murine experimental model compared with MSC derived from bone marrow or periosteum.! Y3 B& y" n* ?8 O! R1 K5 Y* ?

: G5 {' N- M$ I" p3 I; BWhen ADSC were cultured in atelocollagen honeycomb-shaped scaffolds (three-dimensional culturing), osteogenic differentiation could be successfully triggered, as determined by alkaline phosphatase expression, osteocalcin secretion, and calcium phosphate deposition ., y7 i& q& W4 w  h
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Interestingly, MSC derived from synovial adipose tissue of joints exhibit a higher potential for chondrogenic differentiation (as determined by a higher STRO-1 and CD106 expression, a higher proliferation rate and colony-forming efficiency, and a higher amount of cartilage matrix production) than do MSC derived from subcutaneous adipose tissue . The molecular master regulators that allocate the ADSC to the chondrogenic lineage are widely unknown with a role for Brachyury, bone morphogenetic protein (BMP)-4, transforming growth factor ß3 (TGFß3), and Smad-1, -4, and -5.
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) X" _3 B8 t# m. g( s3 A/ qBMP-6 strongly upregulates the expression of aggrecan-1 and 1 chain of collagen II  by inducing the expression of N-cadherin, FGF-receptor-2, and the transcription factor Sox-9.
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  ]: s) Q# ~9 j, O: i' KHuman .: O7 X8 m. k  S4 N4 L

2 P6 q, l+ X: W( \# i8 NBMP-2 is known to stimulate osteogenic differentiation . Therefore, inhibitors of histone deacetylase might be of future interest in bone engineering.
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- l: p) {4 x* n$ ]4 T/ jHowever, in addition to the specific differentiation factors, both the artificial extracellular matrix substitutes and the three-dimensional environment used for cell culture are critical for a successful chondrogenic and osteogenic differentiation. Chitosan particle-agglomerated scaffolds, fibrin scaffolds, and ß-tricalcium phosphate scaffolds were reported to be suitable for ADSC-derived cartilage and osteochondral tissue engineering .
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Myogenic/Cardiomyogenic Differentiation3 C: ~: p- v9 q! y  {1 d

; A& i# P, V" WCultured adipose tissue SVF cells have the potential for differentiation into a cardiomyocyte-like phenotype with specific cardiac marker gene expression and pacemaker activity . However, these data were obtained exclusively from animal models of murine origin and cannot be transferred into the human system.
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Rodriguez et al. .1 \% h1 `( d1 \( D# Z1 G

. j5 J( P% ~1 X4 K4 bVascular/Endothelial Differentiation
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* {6 S! x- G6 [. ~, P4 |5 I2 g  x6 [Not only BMMSC but also ATMSC have the potential for endothelial differentiation  have already demonstrated an equal ability of ADSC compared with BMMSC in restoring the blood flow in these animals.
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3 I. X* `/ L# B. ^' ^& ?' Q' }Neurogenic Differentiation! k9 k0 Y$ _/ S. e

" N- f2 r! f3 V- D3 zIncubation of ADSC under neuroinductive conditions can create a cell population expressing the neuronal differentiation marker type III ß-tubulin , genetically engineered ADSC might function as vehicles for future therapeutic gene transfer to the brain. Although these results are encouraging, more detailed and confirmatory studies are necessary before speculating on the future clinical implications.) _+ O; `" f8 o9 }% R3 b
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Pancreatic/Endocrine Differentiation! {# k% C% g! B
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Timper et al.  were successful in differentiating human ADSC into cells with a pancreatic endocrine phenotype using the differentiation factors activin-A, exendin-4, HGF, and pentagastrin. The proliferating MSC expressed the pancreatic endocrine transcription factor Isl-1 and the pancreatic developmental transcription factors Pax-6, Ipf-1, and Ngn-3. Most importantly, the differentiated cells expressed the endocrine pancreatic hormones insulin, glucagon, and somatostatin. These cells might be used to establish cell-based therapies for type 1 diabetes mellitus in the future. However, confirmatory and functional studies have to be performed, and conclusions from these preliminary data have to be drawn very cautiously.
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- D, v$ T6 H: Q; C* \& AHepatic Differentiation, E$ k& P, }( Q' x
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ADSC treated with HGF, oncostatin M (OSM), and dimethyl sulfoxide have the potential to develop a hepatocyte-like phenotype expressing albumin and -fetoprotein . Although the amount of available data is still low, these results should encourage basic research groups to extend these investigations.
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, h: C( M( C4 T3 D  {3 OHematopoietic Differentiation/ H. Q2 T# t: B% S% y
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Of course, ADSC cannot acquire the potential to undergo a complete hematopoietic differentiation program as do BMMSC. However, ADSC might support hematopoiesis in some way. Lethally irradiated mice can be reconstituted by cells isolated from adipose tissue .
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CONCLUSIONS" ?  h, X- g  p* U8 J) ?+ O7 L. Q

5 b  x1 ^& E+ e; M# E2 E- |. w# wThe easy and repeatable access to subcutaneous adipose tissue provides a clear advantage for the isolation of MSC, and both isolation and culture techniques are easy to perform. Compared with BMMSC, ADSC have an equal potential to differentiate into cells and tissues of mesodermal origin, such as adipocytes, cartilage, bone, and skeletal muscle. Based on this progress, several clinical implications for cell therapy and tissue engineering are highly promising. Although sparse data exist on ADSC differentiation into tissues of nonmesodermal origin, an initial effort has been made to differentiate ADSC into hepatocytes, endocrine pancreatic cells, neurons, cardiomyocytes, hepatocytes, and endothelial/vascular cells. Whereas the lineage-specific differentiation into cells of mesodermal origin is well understood on a molecular basis, the molecular key events and transcription factors that initially allocate the ADSC to a specific lineage are almost completely unknown. Decoding these molecular mechanisms is of great interest for a more effective development of novel cell therapies.2 `6 i4 W$ B8 {" n  k* U- m) a
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DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST
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4 z' e( V* ?+ y* W7 y2 KThe authors indicate no potential conflicts of interest.
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ACKNOWLEDGMENTS
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Review criteria: PubMed/Medline was searched for the terms and issues to be covered in this review. In addition, information from the Cochrane Library, National Center for Biotechnology Information nucleotide and protein database, Online Mendelian Inheritance in Man database, and patent specifications was used.; k7 V( ~  Y1 J9 O$ Y6 [
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发表于 2015-6-13 18:58 |只看该作者
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不错的东西  持续关注  

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发表于 2015-6-17 09:35 |只看该作者
今天临床的资料更新很多呀

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地板
发表于 2015-6-19 16:01 |只看该作者
哈哈 瞧你说的~~~  

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发表于 2015-6-27 12:27 |只看该作者
端粒酶研究

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发表于 2015-7-6 19:27 |只看该作者
你还想说什么啊....  

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发表于 2015-7-24 21:25 |只看该作者
慢慢来,呵呵  

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发表于 2015-8-1 15:36 |只看该作者
初来乍到,请多多关照。。。  
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