Background: Autologous fat grafting has become an essential procedure in breast reconstructive surgery. However, molecular knowledge of different adipose donor sites remains inadequate. Tissue regeneration studies have shown that it is essential to match the Hox code of transplanted cells and host tissues to achieve correct repair. This study aims to provide a better molecular understanding of adipose tissue.
Methods: Over the course of 1 year, the authors prospectively included 15 patients and studied seven adipose areas: chin, breast, arm, abdomen, thigh, hip, and knee. The first step consisted of the surgical harvesting of adipose tissue. RNA was then extracted and converted into cDNA to study gene expression levels of 10 targeted genes by real-time polymerase chain reaction.
Results: Forty samples from Caucasian women with a mean age of 48 years were studied. The expression of PAX3, a marker of neuroectodermal origin, was significantly higher in the breast, with a decreasing gradient from the upper to lower areas of the body. An inverse gradient was found for the expression of HOXC10. This expression profile was statistically significant for the areas of the thigh and knee compared with the breast (p < 0.0083).
Conclusions: Breast fat may have a specific embryologic origin compared with the knee and thigh. The reinjection of adipocytes from the infraumbilical area leads to the transfer of cells highly expressing HOXC10. This study raises questions about the safety of this procedure, and future studies will be required to examine molecular modifications of adipose cells transferred to a heterotopic location.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
From the Plastic and Reconstructive Surgery Unit, University Hospital of Nice; and the 2 iBV, Faculty of Medicine, University of Nice Sophia Antipolis.
Received for publication December 4, 2015; accepted June 22, 2016.
Disclosure: The authors have no financial interest to declare in relation to the content of this article.
Rémi Foissac, M.D., Hospital Pasteur 2, 30-voie romaine, Nice, France, firstname.lastname@example.org