We wish to thank Professor Klinger and his collaborators for the information provided in their letter. The main element of their discussion is the concordance of our results, which highlighted a clinical improvement, both aesthetic and functional, after fat transplantation, and without complication. All these data seem to correlate with histologic findings.
Our series of clinical cases is smaller than the one reported by Klinger et al., because we focused on fat transplantation in the irradiated territories. Indeed, the radiation-induced injury process is quite particular and is characterized by a cellular apoptosis, a cicatricial fibrosis, and a vascular ischemia.1 Furthermore, we chose to present only clinical cases for which we have histologic studies.
There is a growing body of evidence that human adipose tissue contains an important source of mesenchymal stem cells. Our hypothesis is that mesenchymal stem cells play a role in this clinical improvement based on their propensity to differentiate into multiple lineages and promote angiogenesis2 and their implications in the natural processes of tissue repair.3 To demonstrate this theory, our research group is currently performing experimental studies on the beneficial effects of mesenchymal stem cells in the rehabilitation of tissues following radiation-induced injury.
Berengere Phulpin, D.D.S.
Centre Alexis Vautrin
Pierre Gangloff, D.D.S., Ph.D.
Nguyen Tran, Ph.D.
Faculty of Medicine
Pierre Bravetti, D.D.S., Ph.D.
Jean-Louis Merlin, Ph.D.
Gilles Dolivet, M.D., Ph.D.
Centre Alexis Vautrin
1. Stone HB, Coleman CN, Anscher MS, McBride WH. Effects of radiation on normal tissue: Consequences and mechanisms. Lancet Oncol
2. Iwase T, Nagaya N, Fujii T, et al. Comparison of angiogenic potency between mesenchymal stem cells and mononuclear cells in a rat model of hindlimb ischemia. Cardiovasc Res
3. Pittenger M, Mackay AM, Beck SC, et al. Multilineage potential of adult human mesenchymal stem cells. Science
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