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J Urol. 2016 Sep;196(3):934-42. doi: 10.1016/j.juro.2016.04.099. Epub 2016 Jun 2.

Histological and Urodynamic Effects of Autologous Stromal Vascular Fraction Extracted from Fat Tissue with Minimal Ex Vivo Manipulation in a Porcine Model of Intrinsic Sphincter Deficiency.

Author information

1
Aix-Marseille University, 13284, Marseille, France; Department of Urology and Kidney Transplantation, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France. Electronic address: romain.boissier@ap-hm.fr.
2
Institut national de la santé et de la recherche médicale Unités mixtes de recherche 1076, Aix-Marseille University, 13284, Marseille, France; Department of Cell Therapy, Institut national de la santé et de la recherche médicale Unités mixtes de recherche 1076, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France; Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France.
3
Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France.
4
Aix-Marseille University, 13284, Marseille, France; Center for Research and Cliniques en biothérapies 1409, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France; Department of Pathology, 13015, Assistance Publique Hôpitaux de Marseille, Nord University Hospital, Marseille, France.
5
Aix-Marseille University, 13284, Marseille, France.
6
Department of Biology and Hematology, 13285, Assistance Publique Hôpitaux de Marseille, Hospital Conception, Marseille, France.
7
Aix-Marseille University, 13284, Marseille, France; Department of Plastic and Reconstructive Surgery, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France.
8
Aix-Marseille University, 13284, Marseille, France; Department of Urology and Kidney Transplantation, 13285, Assistance Publique Hôpitaux de Marseille, Marseille, France.
9
Center for Research and Teaching in Surgery, Aix-Marseille University, 13284, Marseille, France; Aix-Marseille University, 13284, Marseille, France.

Abstract

PURPOSE:

To evaluate the healing abilities of autologous stem cell therapy (stromal vascular fraction) prepared from adipose tissue we used an automated system without an ex vivo culture phase in a pig model of intrinsic sphincteric deficiency.

MATERIALS AND METHODS:

A total of 15 pigs underwent endoscopic section of the urethral sphincter. Animals were then randomly assigned to 3 groups, including 1) controls without stromal vascular fraction injection, 2) early injection with stromal vascular fraction 2 to 3 days after section and 3) late stromal vascular fraction injection delivery 30 days after injury. Extraction and stromal vascular fraction injection were performed as a single procedure. The stromal vascular fraction was characterized by flow cytometry. Mesenchymal stem cell-like cells were enumerated by clonogenicity (cfu fibroblast) assay. Study end points included histological assessment of the urethral injury surface and urodynamics to determine maximum urethral pressure.

RESULTS:

Flow cytometry analysis revealed a mesenchymal stem cell-like phenotype in a mean ± SD of 47.3% ± 11.8% of stromal vascular fraction cells. The cfu fibroblast frequency was 1.3 to 6.6/100 stromal vascular fraction cells (1.3% to 6.6%). Stromal vascular fraction injection was associated with a reduction of the urethral injury surface in the early and late injection groups compared with the respective controls (7% vs 17% and 1% vs 13%, p = 0.050 and 0.029, respectively). On day 30 after injection maximum urethral pressure was significantly higher in the injected groups than in the control group, that is 64% vs 50% of maximum urethral pressure on day 0 (p = 0.04).

CONCLUSIONS:

These data demonstrate the ability of an autologous stromal vascular fraction to improve the urethral healing process in a large animal model of intrinsic sphincteric deficiency.

KEYWORDS:

adipose tissue; cell- and tissue-based therapy; stem cells; urethra; urinary incontinence

PMID:
27265221
DOI:
10.1016/j.juro.2016.04.099
[Indexed for MEDLINE]

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