Adipose Tissue: a valuable source of stem cells.
Thanks to its high vascularity, the Adipose Tissue (AT) has outstanding natural regenerative properties.  Surrounding the network of capillaries, there are lots of pericytes: precursors of Mesenchymal Stem Cells (MSC). When the wall of a capillary suffers a trauma, pericytes are released into the interstitial space and become MSC. These stem cells are able to release growth factors and anti-inflammatory cytokines, accelerating and improving the process of wound healing. 
Figure 1: Pericytes, the MSC precursors, around a capillary
AT is the ideal source for obtaining stem cells; not only because of the high concentration of MSC, but also because it can be easily extracted with minimal invasive surgery: lipoaspiration. 
Which is the most effective way to obtain those MSC? Lipogems ®
The most used techniques for fat grafting have been compared in clinical trials, and Lipogems® showed to be the method with the best washing quality, the easiest to graft and the best one to preserve the structural integrity of the MSC. 
Lipogems®, result of Dr. Carlo Tremolada’s patents, is a disposable medical device, authorized by the FDA, which optimizes the lipoaspirate intended for autologous implantation. It consists in a closed circuit, in absence of air, which processes the lipoaspirate reducing 10 times the dimensions of the adipose tissue clusters (from 3mm to 0,3mm); therefore the superficial area is highly increased, over 6000 times. It generates Micro-Fragmented Adipose Tissue (MFAT), preserving the structural integrity and the biological activities of each cell. 
Figure 2: Lipogems device
This device is based on the use of mild mechanical forces, which allows cleaning the lipoaspirate from impurities with pro-inflammatory effects such as oily residues, blood and dead cells. This technology improves and optimizes the natural properties of adipose tissue. It does not require enzymes, additives, or centrifugations. The MFAT is only immersed in physiological solution, which protects the cells from possible damage. The intact stem cells are minimally manipulated, and therefore they are able to preserve all their natural biological properties.
Figure 3: In red: completely intact clusters of MFAT after being processed by Lipogems®. In green: the pericytes.
Benefits of MFAT injections [6,7]
Reduce risk of sepsis due to their antibacterial role
Increase the release of growth factors and reparative cytokines
Induce angiogenesis: the formation of new blood vessel
Reduce pain and recovery time
Promote wound healing by increasing cell migration, differentiation and proliferation
Clinical applications of Lipogems®
As the main function of the MFAT injections is to improve the regenerative process, they have many current implementations in different fields, such as:
Orthopedics: osteoarthritis, cartilage defect repair, joint arthritis, osteochondritis, tendinopathies. 
Plastic Surgery and Aesthetic Medicine: lifting, blepharoplasty, breast augmentation, anti-age treatments, and treatments for scars and burns. [3,4]
Oral and Maxillofacial Surgery: temporomandibular joint arthrocentesis, mandibular reconstruction. 
Vascular Surgery: diabetic foot ulcerations, chronic ulcerations.
Coloproctology: perianal fistulas, Crohn’s disease, fecal incontence. 
Gynecology: urogenital atrophy, vulvovaginal dystrophy, urinary incontence. 
Lipogems® future perspective
It is important to highlight that this is a reliable method which has shown biological activities in both in vitro and in vivo assays. Moreover, it is supported by over 100 peer reviewed publications.
Nowadays, several clinical trials are being carried out to track new possibilities to implement this innovative therapeutic strategy in new fields. Therefore, we can conclude that Lipogems®, with only 8 years of implementation, is the new advanced key in the field of tissue regeneration. Looking prospectively, we can see how promising Lipogems® is, and its potential growth in almost every field of health sciences.
If you want to know more about the Lipogems procedure, watch the tutorial at: https://www.lipogems.com/lipogems-tutorial/
If you are interested in other sources of stem cells, you can read our article of Plant Stem Cells at: https://www.emotion-master-studentproject.eu/post/plant-stem-cells-a-magic-wand-in-cosmetics
Key words: Lipogems – adipose tissue- regenerative medicine- tissue regeneration- wound healing- Mesenchymal stem cells- microfragmented adipose tissue
 Dinh-Toi Chu, Thuy Nguyen Thi Phuong, et al., “Adipose Tissue Stem Cells for Therapy: An Update on the Progress of Isolation, Culture, Storage, and Clinical Application” J. Clin. Med. 2019, 8(7), 917
 D. Widera, “Recent Advances in Translational Adipose-Derived Stem Cell Biology” Biomolecules 2021, 11(11), 1660
 C. Tremolada, V. Colombo and C. Ventura “Adipose Tissue and Mesenchymal Stem Cells: State of the Art and Lipogems® Technology Development” Curr Stem Cell Rep 2016
 S. Giannini, “La Medicina Rigenerativa in Ortopedia.” Publish date of book is tentative for February 2022.
 V. Coccè, A. Brini et al., “A Nonenzymatic and Automated Closed-Cycle Process for the Isolation of Mesenchymal Stromal Cells in Drug Delivery Applications” Stem Cells International Volume 2018
 S. Nava, V. Sordi et al., “Long-Lasting Anti-Inflammatory Activity of Human Microfragmented Adipose Tissue” Stem Cells International Volume 2019
 A. Franz, W. Wood and P. Martin “Fat Body Cells Are Motile and Actively Migrate to Wounds to Drive Repair and Prevent Infection” 2018, Developmental Cell 44, 460–470
 D. Primorac, V. Molnar, et al., ”Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies’ Guidelines” Pharmaceuticals,Volume14, 2021
 S. Sembronio, A. Tel et al., “Temporomandibular Joint Arthrocentesis and Microfragmented Adipose Tissue Injection for the Treatment of Internal Derangement and Osteoarthritis: A Randomized Clinical Trial” Journal of Oral and Maxillofacial Surgery. Volume 79, 2021
 G. Gallo, V. Tiesi, et al., ”Mesenchymal Stromal Cell Therapy in the Management of Perianal Fistulas in Crohn’s Disease: An Up-To-Date Review”, Medicina 2020, 56, 563
L. Stark, M. Razzaque, et al., ”Safety and Feasibility of Autologous Micro-Fragmented Adipose Tissue Injections for the Treatment of Vaginal Atrophy, Vulvovaginal Dystrophy, and Stress Urinary Incontinence: An Observational Case Series” EMJ Urol. 2020; 8:29-37.