Autologous fat or adipose-derived stem cell grafting in systemic sclerosis treatment: a systematic review and meta-analysis

Clin Exp Rheumatol. 2023 Aug;41(8):1659-1669. doi: 10.55563/clinexprheumatol/ycy3k7. Epub 2023 Jun 29.

Abstract

Objectives: Systemic sclerosis (SSc) is characterised by vasculopathy and progressive fibrosis of the skin. The aim of this article is to analyse and summarise the efficacy and safety of autologous fat (AF), stromal vascular fraction (SVF) and adipose-derived stem cell (ADSC) grafting in the treatment of SSc, providing evidence for clinical application.

Methods: The research involves the efficacy and safety of AF, SVF and ADSC grafting in the treatment of patients with SSc. The studies were screened and selected independently by two authors based on pre-specified criteria. The data extraction and quality assessment were also performed independently by two authors.

Results: Fifteen studies were eligible for inclusion. Skin thickness reduced following SVF or AF therapy, but there was no significant difference. All measures used to assess fingertip symptoms revealed a significant improvement. Notably, SVF and AF were found to have the most impact on Raynaud's phenomenon improvement. The ADSC group improved the most in terms of finger pain alleviation. SVF reported the highest proportion of adverse events, accounting for approximately half of the cases.

Conclusions: AF, SVF, and ADSC all displayed therapeutic effects of improving SSc, but differences existed in the effects on different symptoms. Plastic surgeons should choose the most suitable treatment strategy after comprehensively evaluating the patient's clinical manifestations.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adipose Tissue / transplantation
  • Humans
  • Obesity
  • Scleroderma, Systemic* / therapy
  • Stem Cell Transplantation* / adverse effects