Autologization of Exosomes with Deparenchymized Adipose Tissue: An Innovative Approach for Regenerative Medicine and Surgery.

Background: Among all regenerative applications developed in recent years, the use of exosomes has generated by far the greatest interest. Exosome products from allogeneic and xenogeneic sources are available on the market. A key challenge is controlling the effects of nonautologous exosomes. We hypothesized that combining exosomes with a patient's own extracellular matrix (ECM) can create "autologization," enabling control over their effects. This study aimed to provide the rationale and a guide for future research exploring the autologization of exosome applications using deparenchymized adipose tissue (DPAT).

Methods: DPAT adipose tissue was achieved using 1200-, 400-, and 35-micrometer blades in an ultrasharp blade system (Adinizer), and then "autologization" was achieved by combining the obtained DPAT with allogeneic exosomes. DPAT was evaluated histochemically, and exosomes were counted and analyzed with the Nanosight device.

Results: The DPAT process using ultrasharp blades is easily performed. DPAT obtained from adipose tissue was then combined with allogenic exosomes. It has been demonstrated histopathologically that adipocytes are eliminated in deparenchymized fat tissue, and only ECM and stromal cells remain. It has also been proven that the number of exosomes is not affected by the combination.

Conclusions: This study introduces two novel concepts previously unknown in the literature, "deparenchymization" and "autologization," representing an innovative approach in plastic surgery and regenerative medicine. Our novel approach enriches regenerative cells while preserving critical ECM signals, overcoming the limitations of existing isolation methods. Extensive research is still needed, but autologization using DPAT ECM holds great promise for translating exosome-based treatments into practice.