Mesenchymale Stammzellen aus Fettgewebe (ASC) – Grundlagen und Anwendung in der HNO-Heilkunde

Zusammenfassung

Adulte mesenchymale Stammzellen aus Fettgewebe sind im Vergleich zu Knochenmarkstammzellen mit einer geringen Hebedefektmorbidität und in großer Menge zu gewinnen. Da sie wie Knochenmarkstammzellen ein Multidifferenzierungspotenzial in zahlreiche Zell- und Gewebetypen sowie immunmodulatorische und wundheilungsfördernde Eigenschaften besitzen, stellen Fettgewebsstammzellen eine viel versprechende Zellquelle für das „Tissue Engineering“ und die regenerative Medizin dar. Die Charakterisierung der Fettgewebsstammzellen erfolgt analog zu den publizierten Leitlinien der Internationalen Gesellschaft für Zelltherapie anhand der Expression ihrer spezifischen Oberflächenmarkerproteine, ihr Multidifferenzierungspotenzial wird qualitativ und quantitativ bemessen. Während bisherige Arbeiten mit Fettgewebsstammzellen zu therapeutischen Ansätzen im HNO-Gebiet auf präklinische Studien beschränkt waren, wurden in anderen Gebieten wie der Hämatoonkologie, der Gastroenterologie und der plastischen Chirurgie bereits zahlreiche Berichte über die klinische Anwendung von Fettgewebsstammzellen publiziert. Die Sicherheit und genomische Stabilität der Fettgewebsstammzellen sowie eine mögliche Transformation nach Implantation dieser Zellen ist bislang noch nicht eindeutig geklärt. In dieser Übersicht wird der aktuelle Stand der Literatur zur Charakterisierung und anatomischen Lokalisierung der Fettgewebsstammzellen zusammengefasst. Darüber hinaus werden präklinische Untersuchungen zur Anwendung in der HNO-Heilkunde sowie aktuelle klinische Therapieansätze sowie Behandlungsberichte vorgestellt und die Sicherheit der Fettgewebsstammzellen in der klinischen Anwendung diskutiert.

Abstract

Adipose-derived Stromal Cells (ASC) – Basics and Therapeutic Approaches in Otorhinolaryngology

Mesenchymal stem cells from adipose tissue can be easily harvested with less discomfort, low donor-site morbidity and high amount compared to bone marrow-derived stem cells. Due to their multilineage differentiation potential in various cell types, immunmodulatory properties and their capability to enhance wound healing, ASC are a promising cell source for tissue engineering approaches and regenerative medicine. They are characterized by the expression of specific surface marker proteins and their differentiation potential into the mesenchymal lineages. Whereas only preclinical studies are published for otorhinolaryngology-related therapeutic options using ASC, various diseases, for instance graft-versus-host disease, have already been treated with ASC in single cases or clinical trials. Safety and genomic stability of ASC as well as the risk of spontaneous malignant transformation are still disputed. This review summarizes the current literature on characterization and anatomic localization of ASC. In addition, beside the presentation of preclinical studies concerning therapeutic approaches in otorhinolaryngology as well as of current clinical applications, the issue of safety of ASC in human stem cell therapy is discussed.

Schlüsselwörter

mesenchymale Stammzellen - ASC - Fettgewebsstammzellen - Fettgewebe - HNO-Heilkunde

Key words

adipose-derived stromal cells - ASC - otorhinolaryngology - fat tissue - mesenchymal stem cells

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