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      Autologous fat injection to face and neck: from soft tissue augmentation to regenerative medicine Translated title: Iniezione di grasso autologo nel distretto testa e collo: dall'incremento tissutale alla medicina rigenerativa

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          SUMMARY

          Minimally-invasive autologous fat injection of the head and neck region can be considered a valid alternative to major invasive surgical procedures both for aesthetic and functional purposes. The favourable outcomes of autologous fat injection in otolaryngological practice are due to the filling of soft tissue and, mainly, to the potential regenerative effect of adipose-derived mesenchymal stem cells. Herewith, some important biological preliminary remarks are described underlying the potential of autologous fat injection in regenerative medicine, and personal experience in using it for both consolidated clinical applications, such as fat grafting to the face and vocal fold augmentation in the treatment of glottic incompetence, and more recent applications including the treatment of post-parotidectomy Frey syndrome and velopharyngeal insufficiency.

          RIASSUNTO

          L'iniezione di grasso autologo del distretto testa e collo costituisce un trattamento mini-invasivo che può essere considerato una valida alternativa ad alcune procedure chirurgiche maggiori, sia per finalità estetiche che funzionali. L'efficacia dell'iniezione di grasso autologo nel trattamento di alcune patologie d'interesse otorinolaringoiatrico è dovuto, principalmente, al potenziale effetto rigenerativo intrinseco, ascrivibile alle cellule staminali adiposo-derivate. Nel presente lavoro verranno descritte le importanti premesse biologiche che sono alla base del potenziale impatto dell'iniezione di grasso autologo nella medicina rigenerativa e la nostra esperienza in questo ambito. Verranno in particolar modo discusse sia le applicazioni cliniche più consolidate, tra cui l'iniezione di grasso autologo nel distretto cutaneo cervico-facciale ed il trattamento dell'insufficienza glottica mediante iniezione di grasso autologo intra-cordale, sia quelle di più recente introduzione, quali l'iniezione di grasso autologo per il trattamento della sindrome di Frey post-parotidectomia e dell'insufficienza velofaringea.

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          Most cited references72

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          Developmental origin of fat: tracking obesity to its source.

          The development of obesity not only depends on the balance between food intake and caloric utilization but also on the balance between white adipose tissue, which is the primary site of energy storage, and brown adipose tissue, which is specialized for energy expenditure. In addition, some sites of white fat storage in the body are more closely linked than others to the metabolic complications of obesity, such as diabetes. In this Review, we consider how the developmental origins of fat contribute to its physiological, cellular, and molecular heterogeneity and explore how these factors may play a role in the growing epidemic of obesity.
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            Fibroblast precursors in normal and irradiated mouse hematopoietic organs.

            Using the in vitro colony assay, clonogenic fibroblast precursor cells (CFU-F) were detected in the bone marrow, spleen and thymus from adult mice. The survival curve for CFU-F of mouse bone marrow irradiated in vitro has a D0 of 220 r. Regeneration of bone marrow CFU-F after whole-body irradiation with 150 r is characterized by a marked secondary loss and post-irradiation lag and dip, lasting 6 days, followed by return to normal values by about the 25th day. This pattern of post-radiation recovery of CFU-F is similar to that of the CFU-s. In addition, during the first 6 hours following irradiation the number of CFU-F increased approximately twofold.
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              Spontaneous human adult stem cell transformation.

              Human adult stem cells are being evaluated widely for various therapeutic approaches. Several recent clinical trials have reported their safety, showing them to be highly resistant to transformation. The clear similarities between stem cell and cancer stem cell genetic programs are nonetheless the basis of a recent proposal that some cancer stem cells could derive from human adult stem cells. Here we show that although they can be managed safely during the standard ex vivo expansion period (6-8 weeks), human mesenchymal stem cells can undergo spontaneous transformation following long-term in vitro culture (4-5 months). This is the first report of spontaneous transformation of human adult stem cells, supporting the hypothesis of cancer stem cell origin. Our findings indicate the importance of biosafety studies of mesenchymal stem cell biology to efficiently exploit their full clinical therapeutic potential.
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                Author and article information

                Journal
                Acta Otorhinolaryngol Ital
                Pacini
                Acta Otorhinolaryngologica Italica
                Pacini Editore SpA
                0392-100X
                1827-675X
                April 2011
                : 31
                : 2
                : 59-69
                Affiliations
                Department of Specialist Surgical Sciences, IRCCS Ca' Granda Maggiore Foundation, Polyclinic Hospital, University of Milan, Milan;
                [1 ] Human Anatomy and Histology Section, University of Verona, Verona;
                [2 ] Cell Factory, Centre for Transfusion Medicine, Cell Therapy and Cryobiology, Department of Regenerative Medicine, IRCCS Ca' Granda Maggiore Foundation, Polyclinic Hospital, Milan, Italy
                Author notes
                Address for correspondence: Prof. L. Pignataro, Dipartimento di Scienze Chirurgiche, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milano, Italy. Fax: +39 02 50320248. E-mail: lorenzo.pignataro@ 123456unimi.it
                Article
                Pacini
                3203738
                22058586
                81a49a39-4cef-49a3-b43b-9f7332a5767a
                © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/

                History
                : 15 January 2011
                : 15 February 2011
                Categories
                Position Paper

                Otolaryngology
                fat grafting,head and neck,adipocytes,adipose-derived stem cells,autologous fat injection

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