Safety of Technique and Procedure of Stromal Vascular Fraction Therapy: From Liposuction to Cell Administration.

BACKGROUND: Stromal vascular fraction (SVF) therapy has been performed over the past six years to treat 421 patients by our group in five clinical centers. Autologous SVF, which is a substance containing stem cells, was isolated from lipoaspirate, mixed with platelet-rich plasma (PRP), and administered to patients with degenerative diseases, autoimmune diseases, trauma, aging, and other diseases with unknown etiology. This study aimed to determine the safety of SVF and PRP that were given through infusion, spinal, and intra-articular injection. METHODS: The lipoaspirate was treated with a tissue-dissociating enzyme, and then, through centrifugation, SVF was isolated. In addition, blood was drawn from each patient, and PRP was isolated. Autologous PRP and SVF were administered to all subjects by intravenous (IV) injection. A minority group within the population received an additional spinal or intra-articular injection. The type of intervention was determined by each disease evaluation. The cell doses and adverse events for each patient were documented and analyzed. RESULTS: Cell dose that was considered to be safe was less than 10 billion SVF cells in 250 cc of normal saline, for IV injection, and less than 1 billion SVF, for intra-articular and spinal injection. Adverse events were not severe and were treated successfully. Any observed adverse events were identified as a result of spinal or intra-articular injections and were not related to SVF or PRP. CONCLUSIONS: Our results showed that administration of high dose of SVF until 10 billion cells in a majority of 421 patients through infusion, spinal, and intra-articular injection was feasible without causing major adverse events and should be further investigated in well-designed phase I-II clinical trial to address the safety and efficacy of therapy.

Apoptosis of Adipose-Derived Stem Cells Induced by Liposomal Soybean Phosphatidylcholine Extract.

BACKGROUND: Recently, Phosphatidylcholine (PC) has been used as an off-label treatment for lipolysis injection, which is associated with inflammatory reaction due to sodium deoxycholate, an emulsifier, so that inflammation as side effect occurs in those patients. Liposome formulation from soybean lipid was thought to be a better and safer alternative. This study aimed to analyze the mechanism of Liposomal Soybean Phosphatidylcholine (LSPC) extract from Indonesian soybeans (containing 26% PC) to induce Adipose-derived Stem Cells (ASCs) death in vitro. METHODS: Liposomes were prepared using thin film hydration method followed by a stepwise extrusion process to produce a small amount of 41.0-71.3 nm. Liposomal soybean phosphatidylcholine extract (LSPCE), liposomal purified PC (LPCC), and solution of PC+SD were used for comparison. Annexin V fluorescein Isothiocyanate/Propidium Iodide (FITC/PI) double staining by flow cytometry and also measurement of caspase-3 activity using ELISA were used to quantify the rate of apoptosis. ASCs viability was measured using MTT assay after induction with liposomes. Morphological changes were shown using a phase-contrast, inverted microscope and Transmission-Electron Microscope (TEM). RESULTS: The flow cytometry results showed that cells treated with both LSPCE and LPCC showed increase in early apoptosis beginning at 6 hr after incubation, which was confirmed by caspase 3 measurement. MTT assay showed that both LSPCE and LPCC could decrease viability of cells. Cells treated with LSPCE and LPCC showed some rounded cells, which was an early sign of cell death. Cells treated with SD showed extensive membrane damage with necrosis features using TEM. CONCLUSION: The results above demonstrated that LSPCE induced apoptosis of ASCs.

Dengue virus infection: predictors for severe dengue.

Dengue virus (DENV) infection is a mosquito born disease that is endemic in all WHO regions, except European region, and may present a broad range of severity. It may appear as an asymptomatic condition, dengue fever (DF), or life threatening forms, such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), or the currently defined severe dengue. Currently there are means to diagnose DENV infection, but there is no accurate means to early predict the progress into severe manifestations. Therefore, this article addresses the factors that might be used to predict the progress into severe dengue. Predictors for severe dengue are the previously established warning signs, and coexisting conditions, as is recommended by the WHO, in addition to Caucasian race, and people with AB blood group. In the future, viral load assessment, viral serotype testing, NS1, cytokine, elastase, hyaluronan, soluble thrombomodulin, and NO level, and circulating endothelial cell detection test are promising to be studied and developed as early predictors of severe dengue.

Weighting the potential of using tenascin C in diagnosis and therapy of atherosclerosis.

Tenascin is a protein family in the extra cellular matrix (ECM) that consists of four members: tenascin C, tenascin R, tenascin X, and tenascin W. Among the four tenascins, tenascin-C was the first identified and have been the most studied member of the family. In 2006, a patent was registered for a formula containing tenascin C, and the formula has been claimed to be beneficial in treating and preventing vascular diseases such as atherosclerosis. Therefore, this review discusses the structure of tenascin C molecule, its various functions, the possibility of imaging tenascin C expression for diagnosis, the prospect of tenascin C in the therapy of atherosclerosis, and suggestions for further research. This review discusses the structure of tenascin C molecule, its various functions, the potential of imaging tenascin C expression for diagnosis, weighing the prospect of using tenascin C in the therapy of atherosclerosis, and future research suggestions.