Similar to neoplasia, the human white adipose tissue (WAT) shows in vivo a robust angiogenic switch when the growth rate exceeds a given expansion threshold. Also, antiangiogenic drugs have been found to inhibit WAT development in postnatal mice. Human WAT is very rich in CD45-CD34+ progenitors that express high levels of angiogenesis-related genes and can generate in culture endothelial cells and tubes as efficiently as mesenchymal cells. Compared to the bone marrow, WAT contains >250 times more CD45-CD34+ progenitors with endothelial differentiation potential. The coinjection of human WAT-derived CD45-CD34+ progenitors from lipotransfer procedures contributed to tumor vascularization and significantly increased tumor growth and metastases in several orthotopic models of human breast cancer in immunodeficient NSG mice. These data nicely complement the recent observation from the Kolonin laboratory that in mouse models WAT cells are mobilized and recruited by experimental tumors to promote cancer progression. Autologous lipotransfer for tissue/organ reconstruction is used in patients who had surgical removal of breast and other types of cancer. We have recently reported a study of 321 consecutive patients operated for primary breast cancer who subsequently underwent a lipotransfer procedure, compared with two matched patients with similar characteristics who did not undergo lipotransfer. In this study, the lipotransfer group exhibited a higher risk of local events compared to the controls when the analysis was limited to intraepithelial neoplasia. A second data revision after prolonged follow-up confirmed this significant difference. The dissection of the different roles of purified populations of WAT-derived progenitors and mature cells seems urgent to clarify which WAT cell populations can be used safely for tissue/organ reconstruction in cancer patients.
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