Research Article
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Experimental study: effects of folic acid, vitamin C, and vitamin E on fat graft survival

Year 2023, , 561 - 565, 27.10.2023
https://doi.org/10.47582/jompac.1359372

Abstract

Aim: This study explores the potential of folic acid (vitamin B9), ascorbic acid (vitamin C), and α-tocopherol (vitamin E) to enhance fat graft survival.
Material and Method: The dorsal regions of the Sprague-Dawley rats (n=10) were divided into four quadrants as inguinal fat donor recipient sites. After incubation, fat grafts were placed into sites (0.9% NaCl-left cranial, vitamin B9-right cranial, vitamin C-left caudal, and vitamin E-right caudal). At the end of the third month, fat grafts were harvested. Fat grafts were evaluated immunohistochemically with perilipin to reveal viability.
Results: Folic acid, vitamin C, and vitamin E were shown improved fat graft survival rate with perilipin (p<0.001, p<0.001, p<0.001, respectively).
Conclusion: Effects of folic acid (vitamin B9) in promoting angiogenesis and collagen synthesis, vitamin C's antioxidant properties and involvement in collagen synthesis, vitamin E’s potent antioxidant capacity, appeared to protect grafted adipose tissue from oxidative stress and inflammation, facilitates graft vascularization and integration, leading to enhanced survival. As an inexpensive and easy-to-supply and apply agents, vitamins B9, C, and E were found to improve fat graft survival immunohistochemically in our study. Increased graft viability by these medicines may inspire future clinical studies and practice.

References

  • Trotzier C, Sequeira I, Auxenfans C, Mojallal AA. Fat graft retention: adipose tissue, adipose-derived stem cells, and aging. Plast Reconstr Surg. 2023;151(3):420e-431e.
  • Kelly KB, Kennelly JP, Ordonez M, et al. Excess folic acid increases lipid storage, weight gain, and adipose tissue inflammation in high fat diet-fed rats. Nutrients. 2016;8(10):594.
  • Lunger A, Ismail T, Todorov A, et al. Improved adipocyte viability in autologous fat grafting with ascorbic acid-supplemented tumescent solution. Ann Plast Surg. 2019;83(4):464-467.
  • Tanaka-Yachi R, Takahashi-Muto C, Adachi K, et al. Promoting effect of α-tocopherol on beige adipocyte differentiation in 3T3-L1 cells and rat white adipose tissue. J Oleo Sci. 2017;66(2):171-179. Erratum in: J Oleo Sci. 2019;68(8):809.
  • Okyay MF, Kömürcü H, Bağhaki S, Demiröz A, Aydın Ö, Arslan H. Effects of insulin, metoprolol and deferoxamine on fat graft survival. Aesthetic Plast Surg. 2019;43(3):845-852.
  • Pham NA, Morrison A, Schwock J, et al. Quantitative image analysis of immunohistochemical stains using a CMYK color model. Diagn Pathol. 2007;2(1):1-10.
  • Karakol P, Bozkurt M, Gelbal C, et al. Efficacy of stromal vascular fraction and enzyme-free mechanical isolation therapy in experimental full thickness burn wounds. J Plast Surg Hand Surg. 2023;57(1-6):78-94.
  • Lunger A, Ismail T, Todorov A, et al. Improved adipocyte viability in autologous fat grafting with ascorbic acid-supplemented tumescent solution. Ann Plast Surg. 2019;83(4):464-467.
  • Abbas DB, Lavin CV, Fahy EJ, et al. Fat grafts augmented with vitamin E improve volume retention and radiation-induced fibrosis. Aesthet Surg J. 2022;42(8):946-955.
  • Cinar F, Yalcin CE, Ayas G, et al. Increased total antioxidant capacity value improves survival of fat grafts in a rat model. Plast Reconstr Surg. 2023;10:1097. doi: 10.1097/PRS.0000000000010873
  • Nemir S, Hanson SE, Chu CK. Surgical decision making in autologous fat grafting: an evidence-based review of techniques to maximize fat survival. Aesthet Surg J. 2021;41(Suppl 1):S3-S15.
  • Pu LLQ. Fat Grafting for facial rejuvenation: my preferred approach. Clin Plast Surg. 2020;47(1):19-29.
  • Shih L, Davis MJ, Winocour SJ. The science of fat grafting. Semin Plast Surg. 2020;34(1):5-10.
  • Loder S, Wang S, Amurgis C, et al. Active vitamin D3 (calcitriol) increases adipose graft retention in a xenograft model. Aesthet Surg J. 2023;43(6):NP449-NP465.
  • Wu W, Bi X, Zhao J, et al. Ultra-condensed fat: a novel fat product for volume augmentation. Aesthetic Plast Surg. 2023;47(5):2074-2083.
  • Khouri RK Jr, Khouri RK. Current clinical applications of fat grafting. Plast Reconstr Surg. 2017;140(3):466e-486e.
  • Deptula P, Fox P. Autologous fat grafting in hand surgery. J Hand Surg Am. 2021;46(7):594-600.
  • Prescher H, Froimson JR, Hanson SE. Deconstructing fat to reverse radiation induced soft tissue fibrosis. Bioengineering (Basel). 2023;10(6):742.
  • Condé-Green A, Wu I, Graham I, et al. Comparison of 3 techniques of fat grafting and cell-supplemented lipotransfer in athymic rats: a pilot study. Aesthet Surg J. 2013;33(5):713-721.
  • Guerrerosantos J, Gonzalez-Mendoza A, Masmela Y, Gonzalez MA, Deos M, Diaz P. Long-term survival of free fat grafts in muscle: an experimental study in rats. Aesthetic Plast Surg. 1996;20(5):403-408.

Deneysel çalışma: yağ grefti sağ kalımında folik asit, vitamin C ve vitamin E etkilerinin araştırılması

Year 2023, , 561 - 565, 27.10.2023
https://doi.org/10.47582/jompac.1359372

Abstract

Öz Bu çalışma, folik asit (vitamin B9), askorbik asit (vitamin C) ve α-tocopherol (vitamin E)'nin yağ grefti sağ kalımını artırmadaki potansiyel etkilerini araştırmayı amaçlamaktadır.
Gereç ve Yöntem Sprague-Dawley sıçanlarının (n=10) sırt bölgeleri kasık yağı donörü alıcı bölgeleri olarak dört kadrana bölündü. İnkübasyondan sonra yağ greftleri bölgelere (%0,9 NaCl-sol kranyal, B9 vitamini-sağ kranyal, C vitamini-sol kaudal ve E vitamini-sağ kaudal) yerleştirildi. Üçüncü ayın sonunda yağ greftleri toplandı. Yağ greftleri canlılığını ortaya çıkarmak için perilipin ile immünohistokimyasal olarak değerlendirildi.
Sonuçlar Folik asit, C vitamini ve E vitamininin perilipin ile yağ grefti sağkalım oranını iyileştirdiği gösterilmiştir (sırasıyla p<0.001, p<0.001, p<0.001).
Sonuç Folik asidin (B9 vitamini) anjiyogenezi ve kollajen sentezini teşvik etmedeki etkilerinin, C vitamininin antioksidan özelliklerinin ve kollajen sentezine katılımının, E vitamininin güçlü antioksidan kapasitesinin, greft olarak kullanılan yağ dokusunu oksidatif stres ve inflamasyondan koruduğu, greftin vaskülarizasyonunu ve entegrasyonunu kolaylaştırdığı gösterilmiş, sağ kalımın artmasına yol açtığı görülmüştür. Ucuz ve temini ve uygulaması kolay bir ajan olan B9, C ve E vitaminlerinin, çalışmamızda immünohistokimyasal olarak yağ grefti sağ kalımını arttırdığı bulunmuştur. Bu ilaçlarla artan greft canlılığı gelecekteki klinik çalışmalara ve uygulamalara ilham verebilir.

References

  • Trotzier C, Sequeira I, Auxenfans C, Mojallal AA. Fat graft retention: adipose tissue, adipose-derived stem cells, and aging. Plast Reconstr Surg. 2023;151(3):420e-431e.
  • Kelly KB, Kennelly JP, Ordonez M, et al. Excess folic acid increases lipid storage, weight gain, and adipose tissue inflammation in high fat diet-fed rats. Nutrients. 2016;8(10):594.
  • Lunger A, Ismail T, Todorov A, et al. Improved adipocyte viability in autologous fat grafting with ascorbic acid-supplemented tumescent solution. Ann Plast Surg. 2019;83(4):464-467.
  • Tanaka-Yachi R, Takahashi-Muto C, Adachi K, et al. Promoting effect of α-tocopherol on beige adipocyte differentiation in 3T3-L1 cells and rat white adipose tissue. J Oleo Sci. 2017;66(2):171-179. Erratum in: J Oleo Sci. 2019;68(8):809.
  • Okyay MF, Kömürcü H, Bağhaki S, Demiröz A, Aydın Ö, Arslan H. Effects of insulin, metoprolol and deferoxamine on fat graft survival. Aesthetic Plast Surg. 2019;43(3):845-852.
  • Pham NA, Morrison A, Schwock J, et al. Quantitative image analysis of immunohistochemical stains using a CMYK color model. Diagn Pathol. 2007;2(1):1-10.
  • Karakol P, Bozkurt M, Gelbal C, et al. Efficacy of stromal vascular fraction and enzyme-free mechanical isolation therapy in experimental full thickness burn wounds. J Plast Surg Hand Surg. 2023;57(1-6):78-94.
  • Lunger A, Ismail T, Todorov A, et al. Improved adipocyte viability in autologous fat grafting with ascorbic acid-supplemented tumescent solution. Ann Plast Surg. 2019;83(4):464-467.
  • Abbas DB, Lavin CV, Fahy EJ, et al. Fat grafts augmented with vitamin E improve volume retention and radiation-induced fibrosis. Aesthet Surg J. 2022;42(8):946-955.
  • Cinar F, Yalcin CE, Ayas G, et al. Increased total antioxidant capacity value improves survival of fat grafts in a rat model. Plast Reconstr Surg. 2023;10:1097. doi: 10.1097/PRS.0000000000010873
  • Nemir S, Hanson SE, Chu CK. Surgical decision making in autologous fat grafting: an evidence-based review of techniques to maximize fat survival. Aesthet Surg J. 2021;41(Suppl 1):S3-S15.
  • Pu LLQ. Fat Grafting for facial rejuvenation: my preferred approach. Clin Plast Surg. 2020;47(1):19-29.
  • Shih L, Davis MJ, Winocour SJ. The science of fat grafting. Semin Plast Surg. 2020;34(1):5-10.
  • Loder S, Wang S, Amurgis C, et al. Active vitamin D3 (calcitriol) increases adipose graft retention in a xenograft model. Aesthet Surg J. 2023;43(6):NP449-NP465.
  • Wu W, Bi X, Zhao J, et al. Ultra-condensed fat: a novel fat product for volume augmentation. Aesthetic Plast Surg. 2023;47(5):2074-2083.
  • Khouri RK Jr, Khouri RK. Current clinical applications of fat grafting. Plast Reconstr Surg. 2017;140(3):466e-486e.
  • Deptula P, Fox P. Autologous fat grafting in hand surgery. J Hand Surg Am. 2021;46(7):594-600.
  • Prescher H, Froimson JR, Hanson SE. Deconstructing fat to reverse radiation induced soft tissue fibrosis. Bioengineering (Basel). 2023;10(6):742.
  • Condé-Green A, Wu I, Graham I, et al. Comparison of 3 techniques of fat grafting and cell-supplemented lipotransfer in athymic rats: a pilot study. Aesthet Surg J. 2013;33(5):713-721.
  • Guerrerosantos J, Gonzalez-Mendoza A, Masmela Y, Gonzalez MA, Deos M, Diaz P. Long-term survival of free fat grafts in muscle: an experimental study in rats. Aesthetic Plast Surg. 1996;20(5):403-408.
There are 20 citations in total.

Details

Primary Language English
Subjects Plastic Reconstructive and Aesthetic Surgery
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Mehmet Fatih Okyay 0000-0002-7174-0917

Early Pub Date October 26, 2023
Publication Date October 27, 2023
Published in Issue Year 2023

Cite

AMA Okyay MF. Experimental study: effects of folic acid, vitamin C, and vitamin E on fat graft survival. J Med Palliat Care / JOMPAC / Jompac. October 2023;4(5):561-565. doi:10.47582/jompac.1359372

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