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Erschienen in: Aesthetic Plastic Surgery 1/2013

01.02.2013 | Original Article

New Insights into Lidocaine and Adrenaline Effects on Human Adipose Stem Cells

verfasst von: Anne-Claire Girard, Michael Atlan, Karima Bencharif, Manoj Kumar Gunasekaran, Pierre Delarue, Olivier Hulard, Christian Lefebvre-d’Hellencourt, Regis Roche, Laurence Hoareau, Franck Festy

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 1/2013

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Abstract

Background

Adipose stem cells have gained great interest in plastic and reconstructive surgery with their ability to improve engraftment after fat transfer for soft tissue filling. It is therefore essential to know the effect of the drugs commonly used during the lipoaspiration procedure, such as lidocaine and adrenaline. Indeed, these drugs are infiltrated at the fat donor site for local anesthesia and for reduction of bleeding. This study analyzed the effects of these drugs on the viability of adipose-derived stem cells and on their inflammatory status.

Methods

Adipose-derived stem cells from lipoaspirates were grown in culture before being treated with different clinical doses of lidocaine at different times of exposure (1–24 h), and with adrenaline (1 μg/mL). Cytotoxicity was measured by lactate dehydrogenase assay and by flow cytometry with annexin V/propidium iodide staining. In parallel, the secretion of the proinflammatory cytokines tumor necrosis factor-alpha (TNFα), interleukin-6 (IL-6), and monocyte chemotactic protein-1 (MCP-1) was tested by enzyme-linked immunoassay.

Results

Lidocaine affected cell viability after 24 h, even when the cells were exposed for only 1 or 2 h. Apoptosis was not involved in lidocaine cytotoxicity. Regarding inflammation, no TNFα was produced, and lidocaine decreased the levels of IL-6 and MCP-1 in a dose-dependent manner. In contrast, adrenaline did not influence cell viability or cytokine secretions.

Conclusions

Adipose tissue should be handled appropriately to remove lidocaine and adrenaline, with such procedures as washing and centrifugation. This study provides new insights into the use of lidocaine and adrenaline for fat transfer or stem cell isolation from lipoaspirates.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Gimble JM, Guilak F, Bunnell BA (2010) Clinical and preclinical translation of cell-based therapies using adipose tissue-derived cells. Stem Cell Res Ther 1:19PubMedCrossRef Gimble JM, Guilak F, Bunnell BA (2010) Clinical and preclinical translation of cell-based therapies using adipose tissue-derived cells. Stem Cell Res Ther 1:19PubMedCrossRef
2.
Zurück zum Zitat Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH (2001) Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 7:211–228PubMedCrossRef Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH (2001) Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 7:211–228PubMedCrossRef
3.
Zurück zum Zitat Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295PubMedCrossRef Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295PubMedCrossRef
4.
Zurück zum Zitat Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118:108S–120SPubMedCrossRef Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118:108S–120SPubMedCrossRef
5.
Zurück zum Zitat Moseley TA, Zhu M, Hedrick MH (2006) Adipose-derived stem and progenitor cells as fillers in plastic and reconstructive surgery. Plast Reconstr Surg 118:121S–128SPubMedCrossRef Moseley TA, Zhu M, Hedrick MH (2006) Adipose-derived stem and progenitor cells as fillers in plastic and reconstructive surgery. Plast Reconstr Surg 118:121S–128SPubMedCrossRef
6.
Zurück zum Zitat Tabit CJ, Slack GC, Fan K, Wan DC, Bradley JP (2011) Fat grafting versus adipose-derived stem cell therapy: distinguishing indications, techniques, and outcomes. Aesthetic Plast Surg 36(3):704–713PubMedCrossRef Tabit CJ, Slack GC, Fan K, Wan DC, Bradley JP (2011) Fat grafting versus adipose-derived stem cell therapy: distinguishing indications, techniques, and outcomes. Aesthetic Plast Surg 36(3):704–713PubMedCrossRef
7.
Zurück zum Zitat Matsumoto D, Sato K, Gonda K, Takaki Y, Shigeura T, Sato T, Aiba-Kojima E, Iizuka F, Inoue K, Suga H, Yoshimura K (2006) Cell-assisted lipotransfer: supportive use of human adipose-derived cells for soft tissue augmentation with lipoinjection. Tissue Eng 12:3375–3382PubMedCrossRef Matsumoto D, Sato K, Gonda K, Takaki Y, Shigeura T, Sato T, Aiba-Kojima E, Iizuka F, Inoue K, Suga H, Yoshimura K (2006) Cell-assisted lipotransfer: supportive use of human adipose-derived cells for soft tissue augmentation with lipoinjection. Tissue Eng 12:3375–3382PubMedCrossRef
8.
Zurück zum Zitat Yoshimura K, Sato K, Aoi N, Kurita M, Hirohi T, Harii K (2007) Cell-assisted lipotransfer for cosmetic breast augmentation: Supportive use of adipose-derived stem/stromal cells. Aesthetic Plast Surg 32:48–55PubMedCrossRef Yoshimura K, Sato K, Aoi N, Kurita M, Hirohi T, Harii K (2007) Cell-assisted lipotransfer for cosmetic breast augmentation: Supportive use of adipose-derived stem/stromal cells. Aesthetic Plast Surg 32:48–55PubMedCrossRef
9.
Zurück zum Zitat Yoshimura K, Asano Y, Aoi N, Kurita M, Oshima Y, Sato K, Inoue K, Suga H, Eto H, Kato H, Harii K (2010) Progenitor-enriched adipose tissue transplantation as rescue for breast implant complications. Breast J 16:169–175PubMedCrossRef Yoshimura K, Asano Y, Aoi N, Kurita M, Oshima Y, Sato K, Inoue K, Suga H, Eto H, Kato H, Harii K (2010) Progenitor-enriched adipose tissue transplantation as rescue for breast implant complications. Breast J 16:169–175PubMedCrossRef
10.
Zurück zum Zitat Zhu M, Zhou Z, Chen Y, Schreiber R, Ransom JT, Fraser JK, Hedrick MH, Pinkernell K, Kuo HC (2010) Supplementation of fat grafts with adipose-derived regenerative cells improves long-term graft retention. Ann Plast Surg 64:222–228PubMedCrossRef Zhu M, Zhou Z, Chen Y, Schreiber R, Ransom JT, Fraser JK, Hedrick MH, Pinkernell K, Kuo HC (2010) Supplementation of fat grafts with adipose-derived regenerative cells improves long-term graft retention. Ann Plast Surg 64:222–228PubMedCrossRef
11.
Zurück zum Zitat Tiryaki T, Findikli N, Tiryaki D (2011) Staged stem cell-enriched tissue (SET) injections for soft tissue augmentation in hostile recipient areas: a preliminary report. Aesthetic Plast Surg 35:965–971PubMedCrossRef Tiryaki T, Findikli N, Tiryaki D (2011) Staged stem cell-enriched tissue (SET) injections for soft tissue augmentation in hostile recipient areas: a preliminary report. Aesthetic Plast Surg 35:965–971PubMedCrossRef
12.
Zurück zum Zitat Maurice JM, Gan Y, Ma Fx, Chang YC, Hibner M, Huang Y (2010) Bupivacaine causes cytotoxicity in mouse C2C12 myoblast cells: involvement of ERK and Akt signaling pathways. Acta Pharmacol Sinica 31:493–500CrossRef Maurice JM, Gan Y, Ma Fx, Chang YC, Hibner M, Huang Y (2010) Bupivacaine causes cytotoxicity in mouse C2C12 myoblast cells: involvement of ERK and Akt signaling pathways. Acta Pharmacol Sinica 31:493–500CrossRef
13.
Zurück zum Zitat Cummins TR (2007) Setting up for the block: the mechanism underlying lidocaine’s use-dependent inhibition of sodium channels. J Physiol 582(Pt 1):11PubMedCrossRef Cummins TR (2007) Setting up for the block: the mechanism underlying lidocaine’s use-dependent inhibition of sodium channels. J Physiol 582(Pt 1):11PubMedCrossRef
14.
Zurück zum Zitat Bernards CM, Kopacz DJ (1999) Effect of epinephrine on lidocaine clearance in vivo: a microdialysis study in humans. Anesthesiology 91:962–968PubMedCrossRef Bernards CM, Kopacz DJ (1999) Effect of epinephrine on lidocaine clearance in vivo: a microdialysis study in humans. Anesthesiology 91:962–968PubMedCrossRef
15.
Zurück zum Zitat Fedder C, Beck-Schimmer B, Aguirre J, Hasler M, Roth-Z’graggen B, Urner M, Kalberer S, Schlicker A, Votta-Velis G, Bonvini JM, Graetz K, Borgeat A (2010) In vitro exposure of human fibroblasts to local anaesthetics impairs cell growth. Clin Exp Immunol 162:280–288PubMedCrossRef Fedder C, Beck-Schimmer B, Aguirre J, Hasler M, Roth-Z’graggen B, Urner M, Kalberer S, Schlicker A, Votta-Velis G, Bonvini JM, Graetz K, Borgeat A (2010) In vitro exposure of human fibroblasts to local anaesthetics impairs cell growth. Clin Exp Immunol 162:280–288PubMedCrossRef
16.
Zurück zum Zitat Grishko V, Xu M, Wilson G, Pearsall AW (2010) Apoptosis and mitochondrial dysfunction in human chondrocytes following exposure to lidocaine, bupivacaine, and ropivacaine. J Bone Joint Surg Am Vol 92:609–618CrossRef Grishko V, Xu M, Wilson G, Pearsall AW (2010) Apoptosis and mitochondrial dysfunction in human chondrocytes following exposure to lidocaine, bupivacaine, and ropivacaine. J Bone Joint Surg Am Vol 92:609–618CrossRef
17.
Zurück zum Zitat Jacobs TF, Vansintjan PS, Roels N, Herregods SS, Verbruggen G, Herregods LL, Almqvist KF (2011) The effect of lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study. Knee Surg Sports Traumatol Arthrosc 19:1206–1213PubMedCrossRef Jacobs TF, Vansintjan PS, Roels N, Herregods SS, Verbruggen G, Herregods LL, Almqvist KF (2011) The effect of lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study. Knee Surg Sports Traumatol Arthrosc 19:1206–1213PubMedCrossRef
18.
Zurück zum Zitat Large V, Reynisdottir S, Eleborg L, van Harmelen V, Strommer L, Arner P (1997) Lipolysis in human fat cells obtained under local and general anesthesia. Int J Obes Relat Metab Disord 21:78–82PubMedCrossRef Large V, Reynisdottir S, Eleborg L, van Harmelen V, Strommer L, Arner P (1997) Lipolysis in human fat cells obtained under local and general anesthesia. Int J Obes Relat Metab Disord 21:78–82PubMedCrossRef
19.
Zurück zum Zitat Shoshani O, Berger J, Fodor L, Ramon Y, Shupak A, Kehat I, Gilhar A, Ullmann Y (2005) The effect of lidocaine and adrenaline on the viability of injected adipose tissue: an experimental study in nude mice. J Drugs Dermatol 4:311–316PubMed Shoshani O, Berger J, Fodor L, Ramon Y, Shupak A, Kehat I, Gilhar A, Ullmann Y (2005) The effect of lidocaine and adrenaline on the viability of injected adipose tissue: an experimental study in nude mice. J Drugs Dermatol 4:311–316PubMed
20.
Zurück zum Zitat Keck M, Janke J, Ueberreiter K (2009) Viability of preadipocytes in vitro: the influence of local anesthetics and pH. Dermatol Surg 35:1251–1257PubMedCrossRef Keck M, Janke J, Ueberreiter K (2009) Viability of preadipocytes in vitro: the influence of local anesthetics and pH. Dermatol Surg 35:1251–1257PubMedCrossRef
21.
Zurück zum Zitat Keck M, Zeyda M, Gollinger K, Burjak S, Kamolz LP, Frey M, Stulnig TM (2010) Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes. Plast Reconstr Surg 126:1500–1505PubMedCrossRef Keck M, Zeyda M, Gollinger K, Burjak S, Kamolz LP, Frey M, Stulnig TM (2010) Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes. Plast Reconstr Surg 126:1500–1505PubMedCrossRef
22.
Zurück zum Zitat Boselli E, Duflo F, Debon R, Allaouchiche B, Chassard D, Thomas L, Portoukalian J (2003) The induction of apoptosis by local anesthetics: a comparison between lidocaine and ropivacaine (table of contents). Anesth Analg 96:755–756PubMedCrossRef Boselli E, Duflo F, Debon R, Allaouchiche B, Chassard D, Thomas L, Portoukalian J (2003) The induction of apoptosis by local anesthetics: a comparison between lidocaine and ropivacaine (table of contents). Anesth Analg 96:755–756PubMedCrossRef
23.
Zurück zum Zitat Keck M, Zeyda M, Burjak S, Kamolz LP, Selig H, Stulnig TM, Frey M (2012) Coenzyme q10 does not enhance preadipocyte viability in an in vitro lipotransfer model. Aesthetic Plast Surg 36:453–457PubMedCrossRef Keck M, Zeyda M, Burjak S, Kamolz LP, Selig H, Stulnig TM, Frey M (2012) Coenzyme q10 does not enhance preadipocyte viability in an in vitro lipotransfer model. Aesthetic Plast Surg 36:453–457PubMedCrossRef
24.
Zurück zum Zitat Bartynski J, Marion MS, Wang TD (1990) Histopathologic evaluation of adipose autografts in a rabbit ear model. Otolaryngol Head Neck Surg 102:314–321PubMed Bartynski J, Marion MS, Wang TD (1990) Histopathologic evaluation of adipose autografts in a rabbit ear model. Otolaryngol Head Neck Surg 102:314–321PubMed
25.
Zurück zum Zitat Murumalla R, Bencharif K, Gence L, Bhattacharya A, Tallet F, Gonthier MP, Petrosino S, di Marzo V, Cesari M, Hoareau L, Roche R (2011) Effect of the cannabinoid receptor-1 antagonist SR141716A on human adipocyte inflammatory profile and differentiation. J Inflamm Lond 8:33PubMedCrossRef Murumalla R, Bencharif K, Gence L, Bhattacharya A, Tallet F, Gonthier MP, Petrosino S, di Marzo V, Cesari M, Hoareau L, Roche R (2011) Effect of the cannabinoid receptor-1 antagonist SR141716A on human adipocyte inflammatory profile and differentiation. J Inflamm Lond 8:33PubMedCrossRef
26.
Zurück zum Zitat Festy F, Hoareau L, Bes-Houtmann S, Pequin AM, Gonthier MP, Munstun A, Hoarau JJ, Cesari M, Roche R (2005) Surface protein expression between human adipose tissue-derived stromal cells and mature adipocytes. Histochem Cell Biol 124:113–121PubMedCrossRef Festy F, Hoareau L, Bes-Houtmann S, Pequin AM, Gonthier MP, Munstun A, Hoarau JJ, Cesari M, Roche R (2005) Surface protein expression between human adipose tissue-derived stromal cells and mature adipocytes. Histochem Cell Biol 124:113–121PubMedCrossRef
27.
Zurück zum Zitat Girard AC, Loyher PL, Bencharif K, Balat M, Lefebvre d’Hellencourt C, Delarue P, Hulard O, Roche R, Hoareau L, Festy F (2011) Lidocaine: an attractive local anesthetic for lipoaspiration procedure in stem cells regenerative medicine. Paper presented at the 2011 annual meeting of the international federation for adipose therapeutics and science, Miami Beach Girard AC, Loyher PL, Bencharif K, Balat M, Lefebvre d’Hellencourt C, Delarue P, Hulard O, Roche R, Hoareau L, Festy F (2011) Lidocaine: an attractive local anesthetic for lipoaspiration procedure in stem cells regenerative medicine. Paper presented at the 2011 annual meeting of the international federation for adipose therapeutics and science, Miami Beach
28.
Zurück zum Zitat Moore JH Jr, Kolaczynski JW, Morales LM, Considine RV, Pietrzkowski Z, Noto PF, Caro JF (1995) Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Aesthetic Plast Surg 19:335–339PubMedCrossRef Moore JH Jr, Kolaczynski JW, Morales LM, Considine RV, Pietrzkowski Z, Noto PF, Caro JF (1995) Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Aesthetic Plast Surg 19:335–339PubMedCrossRef
29.
Zurück zum Zitat Hoareau L, Bencharif K, Gence L, Girard AC, Delarue P, Hulard O, Festy F, Roche R (2012) Washing or centrifugating the fat? SICAAAMS 2012, Geneva Hoareau L, Bencharif K, Gence L, Girard AC, Delarue P, Hulard O, Festy F, Roche R (2012) Washing or centrifugating the fat? SICAAAMS 2012, Geneva
30.
Zurück zum Zitat Kurita M, Matsumoto D, Shigeura T, Sato K, Gonda K, Harii K, Yoshimura K (2008) Influences of centrifugation on cells and tissues in liposuction aspirates: optimized centrifugation for lipotransfer and cell isolation. Plast Reconstr Surg 121:1033–1041 discussion 1042–1033PubMedCrossRef Kurita M, Matsumoto D, Shigeura T, Sato K, Gonda K, Harii K, Yoshimura K (2008) Influences of centrifugation on cells and tissues in liposuction aspirates: optimized centrifugation for lipotransfer and cell isolation. Plast Reconstr Surg 121:1033–1041 discussion 1042–1033PubMedCrossRef
31.
Zurück zum Zitat Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367PubMed Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367PubMed
32.
Zurück zum Zitat Hollmann MW, Durieux ME (2000) Local anesthetics and the inflammatory response: a new therapeutic indication? Anesthesiology 93:858–875PubMedCrossRef Hollmann MW, Durieux ME (2000) Local anesthetics and the inflammatory response: a new therapeutic indication? Anesthesiology 93:858–875PubMedCrossRef
33.
Zurück zum Zitat Li CY, Tsai CS, Hsu PC, Chueh SH, Wong CS, Ho ST (2003) Lidocaine attenuates monocyte chemoattractant protein-1 production and chemotaxis in human monocytes: possible mechanisms for its effect on inflammation. Anesth Analg 97:1312–1316PubMedCrossRef Li CY, Tsai CS, Hsu PC, Chueh SH, Wong CS, Ho ST (2003) Lidocaine attenuates monocyte chemoattractant protein-1 production and chemotaxis in human monocytes: possible mechanisms for its effect on inflammation. Anesth Analg 97:1312–1316PubMedCrossRef
34.
Zurück zum Zitat Wang HL, Zhang WH, Lei WF, Zhou CQ, Ye T (2011) The inhibitory effect of lidocaine on the release of high-mobility group box 1 in lipopolysaccharide-stimulated macrophages. Anesth Analg 112:839–844PubMedCrossRef Wang HL, Zhang WH, Lei WF, Zhou CQ, Ye T (2011) The inhibitory effect of lidocaine on the release of high-mobility group box 1 in lipopolysaccharide-stimulated macrophages. Anesth Analg 112:839–844PubMedCrossRef
35.
Zurück zum Zitat Boni R (2010) Tumescent liposuction: efficacy of a lower lidocaine dose (400 mg/l). Dermatology 220:223–225PubMedCrossRef Boni R (2010) Tumescent liposuction: efficacy of a lower lidocaine dose (400 mg/l). Dermatology 220:223–225PubMedCrossRef
Metadaten
Titel
New Insights into Lidocaine and Adrenaline Effects on Human Adipose Stem Cells
verfasst von
Anne-Claire Girard
Michael Atlan
Karima Bencharif
Manoj Kumar Gunasekaran
Pierre Delarue
Olivier Hulard
Christian Lefebvre-d’Hellencourt
Regis Roche
Laurence Hoareau
Franck Festy
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 1/2013
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-012-9988-9

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