Donor Obesity Significantly Impairs Adipose-Derived Stem Cell Function and Therapeutic Efficacy

Adipose-derived stem cells (ADSCs) are crucial for regenerative medicine and autologous fat transfer (AFT), possessing potent paracrine activity and multipotent differentiation capacity. AFT effectively improves tissue quality and volume, particularly in fibrotic conditions like radiation-induced fibrosis. However, the variable efficacy of ADSCs raises concerns, with donor characteristics, especially obesity, suspected to play a significant role in their functional integrity and therapeutic outcomes. This review synthesizes current knowledge on how donor obesity impacts ADSC function.

This review synthesizes existing literature on the influence of donor obesity on the function and therapeutic efficacy of adipose-derived stem cells (ADSCs). It specifically focuses on subcutaneous ADSCs, which are the primary harvest source for autologous fat transfer and other clinical regenerative applications. The authors examined how obesity-related factors affect ADSC properties, including their proliferation, differentiation capacity, paracrine activity, and overall regenerative potential, drawing from various preclinical and clinical studies.

This comprehensive review synthesizes extensive literature demonstrating that donor obesity significantly compromises the functional integrity of adipose-derived stem cells (ADSCs). Studies consistently show that ADSCs harvested from obese individuals exhibit impaired proliferative capacity, reduced differentiation potential into various lineages (adipogenic, osteogenic, chondrogenic), and altered paracrine activity. These deficits collectively diminish their therapeutic efficacy in regenerative applications. > The review highlights evidence indicating that ADSCs from obese donors often display increased senescence markers, heightened inflammatory profiles, and reduced angiogenic potential, making them less effective for procedures like autologous fat transfer. These functional impairments are attributed to the altered microenvironment of obese adipose tissue, characterized by chronic low-grade inflammation and metabolic dysregulation, which epigenetically and phenotypically modifies ADSCs. Consequently, the regenerative benefits typically observed with ADSCs, such as improved collagen remodeling and increased blood supply, are substantially attenuated when cells originate from obese donors.