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Fat Grafting for the Treatment of Scleroderma
McDaniel JM, Alleyne B, Chim H, Guyuron B
University Hospitals Case Medical Center
2013-03-01
Presenter: Jarred McDaniel
Affidavit:
This work is entirely original work from the above resident and coauthors
Director Name: Hooman Soltanian, MD
Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Introduction: Cutaneous scleroderma is a progressive disorder with considerable morbidity. Despite advances in the understanding of scleroderma pathogenesis, treatments have not effectively reversed existing cutaneous pathology. This study evaluates the effectiveness of fat injection for the treatment of scleroderma in a murine model.
Methods: 45 female C3H mice underwent daily injection with 0.05mg of subcutaneous bleomycin for 4 weeks in order to create scleroderma. 25 control mice were injected daily with sterile saline. At the completion of the injections all mice underwent biopsy of the affected area for PCR and histological analysis. Experimental animals underwent fat injection from the inguinal fat pads of donor mice subcutaneously to the affected area. Half of the control and experimental mice were sacrificed 4 weeks after biopsy and fat injection. The dorsal skin of the animals was harvested and submitted for PCR and histological examination. The remainder of the animals were sacrificed 8-weeks post-surgery and the dorsal skin analyzed in the same fashion.
Results: Gross analysis of experimental animals showed improvement of scleroderma after fat injection. H&E and trichrome stains revealed changes consistent with scleroderma after injections with significant improvement in subcutaneous fat thickness, dermal thickness, and collagen deposition after fat grafting. PCR analysis demonstrated significant improvement in levels of TGF-B, cGTF, and HSP-47 at 4-weeks after fat injection and further improvement at 8-weeks.
Conclusions: Fat grafting is an effective treatment for cutaneous sclerosis in a murine model. Further studies must be conducted to ensure safety and effectiveness in human patients.
