Definition and Overview
The stromal vascular fraction (SVF) is a heterogeneous cell mixture obtained by processing adipose tissue through enzymatic digestion (collagenase treatment) or mechanical separation. SVF contains the following cell groups:
- Adipose-derived mesenchymal stem cells (AD-MSC)
- endothelial progenitor cells
- hematopoietic progenitor cells
- tissue macrophages and immune cells
- Pericytes
Research has shown that adipose tissue contains about 500 to 2,000 times more mesenchymal stem cells than bone marrow, which has the advantage of securing abundant stem cell raw materials through minimally invasive methods.
Mechanism of Action
Anti-inflammatory and immunomodulatory
AD-MSCs secrete anti-inflammatory cytokines such as interleukin-10 (IL-10) and TGF-β, and suppress inflammatory cytokines (TNF-α, IL-1β, and IL-6). The effect of alleviating autoimmune responses by regulating the activity of T cells and natural killer cells (NK cells) is being studied.
Promote angiogenesis
It promotes angiogenesis in the damaged area through the secretion of endothelial progenitor cells and vascular endothelial growth factor (VEGF). Improved blood flow contributes to tissue regeneration and recovery from painful areas.
Supports nerve regeneration
AD-MSCs support a nerve regenerative environment by secreting neurotrophic factors (BDNF, NGF, GDNF). Preclinical research results that contribute to the recovery of nerve function in small fiber neuropathy and peripheral nerve injury models have been reported.
Application field
musculoskeletal system
Clinical research is underway for degenerative arthritis (knee, hip joint), rotator cuff damage, and spinal disc degeneration. There are small studies reporting improvements in pain and function after intra-articular injection of autologous SVF.
chronic pain
Research is underway on nerve regeneration and anti-inflammatory effects for intractable chronic pain conditions such as fibromyalgia, complex regional pain syndrome (CRPS), and small fiber neuropathy.
autonomic dysfunction
In chronic symptoms related to autonomic dysfunction, the possibility of autonomic recovery through the anti-inflammatory and nerve regenerative effects of SVF is being explored. However, the accumulation of clinical evidence in this field is in its early stages.
Skin regeneration and shaping
In studies related to delayed wound healing, scarring, and facial aging, skin regeneration effects have been reported when SVF and PRP are combined.
Procedure
1. Fat collection: 20 to 100 mL of fat tissue is collected from the abdomen and thighs through a small incision under local anesthesia. 2. SVF isolation: cells separated by enzyme (collagenase) treatment or mechanical methods, concentrated by centrifugation 3. Injection: Inject into the treatment area (intra-articular, intravenous, around nerves, etc.) on the same day. 4. Recovery: Usually possible as an outpatient treatment on the same day, stabilization of the harvested area for 24 to 48 hours
Safety and rationale
Because autologous cells are used, there is no immune rejection, and overall safety was confirmed in a meta-analysis of mesenchymal stem cell clinical studies (2,696 people). Common adverse reactions include pain, swelling, and bruising at the treatment site.
For most indications, there are many small-scale studies or preclinical studies, and standardized evidence is continuously accumulated through large-scale randomized controlled clinical trials.