Insulin promotes ADSC differentiation after fat grafting

Background: Adipose-derived stem cells (ADSCs) are used to enhance fat graft survival. However, the mechanism of action of grafted ADSCs is controversial. The grafted ADSCs can be replaced by connective tissue or survive at the recipient site and differentiate. Insulin is a powerful agent used to induce the differentiation of ADSCs to adipocytes. To elucidate the fate of grafted ADSCs in nonvascularized fat grafts with or without insulin. Methods: Fat was harvested from a female human donor who underwent reduction mammoplasty. Also, we isolated and cultured ADSCs expressing green fluorescent protein (GFP) from transgenic Sprague-Dawley rats. The experiment was performed on the backs of thirty nude mice. The injection of free fat graft, the ADSCs, phosphate-buffered saline (PBS) and insulin was performed on the 4 para-vertebral points of the back of each mouse as follows: group A (control group) received adipose tissue and PBS; group B received adipose tissue and ADSCs (5×105 cells/100l); group C received adipose tissue, ADSCs, and PBS; and group D received adipose tissue, ADSCs, and insulin. GFP expression was evaluated using an in vivo imaging system. The volume of transplanted fat was evaluated at 8 weeks after graft with six histologic parameters. The fat graft was immunostained with GFP, DAPI and perilipin. Statistical analysis was performed using a one-way ANOVA test. Results: The fat graft volume was significantly higher in group D (P

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