The authors wish to acknowledge and thank those additional research personnel that contributed to the development of the described protocol and its isolation of ASCs, including: Dr. H. Peter Lorenz, MD, Dr. Hiroshi Muzuno, MD, Dr. Jerry Huang, MD, Dr. Adam Katz, MD, Dr. William Futrell, MD, Dr. Rong Zhang, DDS, PhD, Dr. Larissa Rodriguez, MD, Dr. Zeni Alfonso, PhD, and Dr. John Fraser, PhD. The results presented were funded, in part, by research grants from the National Institutes of Health, including the NIAMS and NIDCR Institutes.

<ol>
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E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Distinct+stem+cells+subpopulations+isolated+from+human+adipose+tissue+exhibit+different+chondrogenic+and+osteogenic+differentiation+potential.">Distinct stem cells subpopulations isolated from human adipose tissue exhibit different chondrogenic and osteogenic differentiation potential.</a> Stem Cell Rev. 7 (1), 64-76 (2011).</li><li>Heydarkhan-Hagvall, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+Adipose+Stem+Cells:+A+Potential+Cell+Source+for+Cardiovascular+Tissue+Engineering.">Human Adipose Stem Cells: A Potential Cell Source for Cardiovascular Tissue Engineering.</a> Cells Tissues Organs. 187 (4), 263-274 (2008).</li><li>Jack, G. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Processed+lipoaspirate+cells+for+tissue+engineering+of+the+lower+urinary+tract:+implications+for+the+treatment+of+stress+urinary+incontinence+and+bladder+reconstruction.">Processed lipoaspirate cells for tissue engineering of the lower urinary tract: implications for the treatment of stress urinary incontinence and bladder reconstruction.</a> J Urol. 174 (5), 2041-2045 (2005).</li><li>Banas, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rapid+hepatic+fate+specification+of+adipose-derived+stem+cells+and+their+therapeutic+potential+for+liver+failure.">Rapid hepatic fate specification of adipose-derived stem cells and their therapeutic potential for liver failure.</a> J Gastroenterol Hepatol. 24 (1), 70-77 (2009).</li><li>Schreml, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Harvesting+human+adipose+tissue-derived+adult+stem+cells:+resection+versus+liposuction.">Harvesting human adipose tissue-derived adult stem cells: resection versus liposuction.</a> Cytotherapy. 11 (7), 947-957 (2009).</li><li>Oedayrajsingh-Varma, M. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adipose+tissue-derived+mesenchymal+stem+cell+yield+and+growth+characteristics+are+affected+by+the+tissue-harvesting+procedure.">Adipose tissue-derived mesenchymal stem cell yield and growth characteristics are affected by the tissue-harvesting procedure.</a> Cytotherapy. 8 (2), 166-177 (2006).</li><li>Ahmad, J., Eaves, F. F., Rohrich, R. J., Kenkel, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+American+Society+for+Aesthetic+Plastic+Surgery+(ASAPS)+survey:+current+trends+in+liposuction.">The American Society for Aesthetic Plastic Surgery (ASAPS) survey: current trends in liposuction.</a> Aesthet Surg J. 31 (2), 214-224 (2011).</li><li>Tierney, E. P., Kouba, D. J., Hanke, C. 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The authors of this manuscript are co-inventors on a patent owned by The Regents of the University of California and licensed to Cytori Therapeutics.

Adipose tissue for the isolation of ASCs can come in many forms: from solid pieces of tissue obtained through resection or lipoplasty to smaller pieces obtained through either syringe extraction or suction-assisted lipoplasty (i.e. liposuction ). Whether more SVF cells (and thereby ASCs) can be obtained from resected or aspirated adipose samples is unclear as conflicting studies have been presented 16, 17. It is possible that either form of adipose tissue is more than suitable for the isolation of SVF...

In 2001, a putative population of multipotent stem cells from adipose tissue was described in the journal Tissue Engineering 1. These cells were given the name Processed Lipoaspirate or PLA cells due to their derivation from processed lipoaspirate tissue obtained through cosmetic surgery. The isolation method described in this article was based on existing enzymatic strategies for the isolation of the stromal vascular fraction (SVF) from adipose tissue 2. The SVF has been defined as a minimally processed population of red blood cells, fibroblasts, endothelial cells, smooth muscle cells, pericytes and pre-adipocytes that have yet to adhere to a tissue culture substrate 2, 3. Culturing of this SVF over time is proposed to eliminate many of these contaminating cell populations and result in an adherent, fibroblastic population. These fibroblasts have been identified in the literature for the last 40 years as being pre-adipocytes. However, our research group demonstrated that these cells possessed mesodermal multipotency and renamed the adherent SVF population as PLA cells. Subsequent studies by numerous other research groups have added to this potential, suggesting both endodermal and ectodermal potentials (for review see 4). Since that time, numerous additional terms for these cells have appeared in the literature. In order to provide some type of consensus, the term Adipose-derived Stem Cells or ASCs was adopted at the 2nd annual IFATS conference. As such, the term ASC will be used in this article. 
The protocol described in this article is a relatively simple procedure that requires standard laboratory equipment and uses simple reagents such as phospho-buffered saline, standard tissue culture media reagents and collagenase. It can produce large numbers of ASCs depending on the amount of starting adipose tissue volume and subsequent culture time. However, the processing of such a large amount of adipose tissue can present some physical issues that can be mitigated to a degree using this protocol. Furthermore, this protocol does require sterile tissue culture facilities and approved biosafety hoods, thereby necessitating the use of an approved tissue culture facility. This requirement can also decrease the utility of the ASC population in clinical applications unless they are isolated in good manufacturing practice (GMP)-approved facilities designed for the isolation and expansion of materials for clinical use. As an alternative, automated systems that can isolate ASCs in a closed system in the operating theatre would avoid this key issue and allow for the immediate use of ASCs without any need for subsequent in vitro expansion. To date, there are six automated systems that are available commercially for the isolation of cells from human tissue. These systems may make it possible to isolate a significant number of ASCs from large amounts of adipose tissue immediately following its harvest. These ASCs could then be reintroduced into the patient for a variety of regenerative purposes without the patient ever having to leave the operating room. In addition to this protocol describing the manual isolation of ASCs, a protocol for automated isolation of ASCs using the Celution System is also given in a companion article.

<table border="1">
	<tbody>
		<tr>
			<td>
				&nbsp;</td>
			<td>
				&nbsp;</td>
			<td>
				&nbsp;</td>
			<td>
				Reagent</td>
		</tr>
		<tr>
			<td>
				DMEM (Dulbecco&#39;s Modification of Eagle&#39;s Medium)</td>
			<td>
				Mediatech Cellgro</td>
			<td>
				10-013-CV</td>
			<td>
				with 4.5 g/ml glucose, L-glutamine, sodium pyruvate</td>
		</tr>
		<tr>
			<td>
				Penicillin/Streptomycin</td>
			<td>
				Mediatech Cellgro</td>
			<td>
				30-002-CI</td>
			<td>
				10,000 IU/ml penicillin/10,000 &mu;g/ml streptomycin</td>
		</tr>
		<tr>
			<td>
				Amphotericin B</td>
			<td>
				Mediatech Cellgro</td>
			<td>
				30-003-CF</td>
			<td>
				250 &mu;g/ml amphotericin B</td>
		</tr>
		<tr>
			<td>
				10X PBS (Phospho-buffered Saline)</td>
			<td>
				Mediatech Cellgro</td>
			<td>
				25-053-CI</td>
			<td>
				without calcium, without magnesium</td>
		</tr>
		<tr>
			<td>
				Trypsin/EDTA</td>
			<td>
				Mediatech Cellgro</td>
			<td>
				20-031-CV</td>
			<td>
				0.25 % trypsin/2.21mM EDTA</td>
		</tr>
		<tr>
			<td>
				Collagenase type IA (from Clostridium histolyticum)</td>
			<td>
				Sigma</td>
			<td>
				C2674</td>
			<td>
				crude preparation; &lt;125 collagen digestion units/mg solid</td>
		</tr>
		<tr>
			<td>
				FBS (Fetal Bovine Serum) heat inactivated</td>
			<td>
				Gemini Bioproducts</td>
			<td>
				100106</td>
			<td>
				USDA source, heat inactivated</td>
		</tr>
		<tr>
			<td>
				10 ml serological pipettes</td>
			<td>
				Genesee Scientific</td>
			<td>
				12-104</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				25 ml serological pipettes</td>
			<td>
				Genesee Scientific</td>
			<td>
				12-106</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				50 ml polypropylene centrifuge tubes</td>
			<td>
				Genesee Scientific</td>
			<td>
				21-106</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				100 mm tissue culture dishes</td>
			<td>
				Genesee Scientific</td>
			<td>
				25-202</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				150 mm tissue culture dishes</td>
			<td>
				Genesee Scientific</td>
			<td>
				25-203</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				500 ml Stericup Filter Units</td>
			<td>
				Millipore</td>
			<td>
				SCGPU05RE</td>
			<td>
				PES membrane, 0.22 &mu;m pore</td>
		</tr>
		<tr>
			<td>
				Cell strainers</td>
			<td>
				FisherBrand</td>
			<td>
				22-363-549</td>
			<td>
				100 &mu;m nylon mesh</td>
		</tr>
		<tr>
			<td>
				dexamethasone - water soluble</td>
			<td>
				Sigma</td>
			<td>
				D-2915</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				L-ascorbic-acid 2 phosphate</td>
			<td>
				Sigma</td>
			<td>
				A-8960</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				&beta;-glycerophosphate disodium salt</td>
			<td>
				Sigma</td>
			<td>
				G-9422</td>
			<td>
				also known as glycerophosphate</td>
		</tr>
		<tr>
			<td>
				insulin</td>
			<td>
				Sigma</td>
			<td>
				I-6634</td>
			<td>
				made from bovine pancreas</td>
		</tr>
		<tr>
			<td>
				indomethacin</td>
			<td>
				Sigma</td>
			<td>
				I-7378</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				apo-transferrin</td>
			<td>
				Sigma</td>
			<td>
				T-4382</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				TGF&beta;1</td>
			<td>
				R&amp;D Systems</td>
			<td>
				240-B-002</td>
			<td>
				recombinant human</td>
		</tr>
		<tr>
			<td>
				Oil Red O</td>
			<td>
				Sigma</td>
			<td>
				O-0625</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				Alcian Blue</td>
			<td>
				Sigma</td>
			<td>
				A-5268</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				Silver nitrate</td>
			<td>
				Sigma</td>
			<td>
				S-0319</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				Hydrochloric acid</td>
			<td>
				Fisher Scientific</td>
			<td>
				A144</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				Paraformaldehyde</td>
			<td>
				Fisher Scientific</td>
			<td>
				30525-89-4</td>
			<td>
				supplied as a 16 % stock</td>
		</tr>
		<tr>
			<td>
				&nbsp;</td>
			<td>
				&nbsp;</td>
			<td>
				&nbsp;</td>
			<td>
				[header]</td>
		</tr>
		<tr>
			<td>
				&nbsp;</td>
			<td>
				&nbsp;</td>
			<td>
				&nbsp;</td>
			<td>
				Equipment Needed</td>
		</tr>
		<tr>
			<td>
				Class II A/B Biosafety hood</td>
			<td>
				Thermo Scientific</td>
			<td>
				&nbsp;</td>
			<td>
				ensure hood has vacuum lines for aspiration</td>
		</tr>
		<tr>
			<td>
				Benchtop centrifuge</td>
			<td>
				Hermle Labnet</td>
			<td>
				Z383</td>
			<td>
				Swing-out rotor for 50 ml tubes required, capable of 1200 x g</td>
		</tr>
		<tr>
			<td>
				Water bath</td>
			<td>
				Fisher Scientific Isotemp</td>
			<td>
				S52602Q</td>
			<td>
				5-10L capacity, capable of 37 C</td>
		</tr>
		<tr>
			<td>
				Automated Pipette Aids</td>
			<td>
				Drummond Pipette Aid XL</td>
			<td>
				4-000-105</td>
			<td>
				&nbsp;</td>
		</tr>
		<tr>
			<td>
				CO2 Incubator</td>
			<td>
				Thermo Scientific</td>
			<td>
				Forma 310</td>
			<td>
				direct heat or water jacketed</td>
		</tr>
	</tbody>
</table>

	&nbsp;

manual isolation of adipose-derived stem cells from human lipoaspirates

In 2001, researchers at the University of California, Los Angeles, described the isolation of a new population of adult stem cells from liposuctioned adipose tissue that they initially termed Processed Lipoaspirate Cells or PLA cells. Since then, these stem cells have been renamed as Adipose-derived Stem Cells or ASCs and have gone on to become one of the most popular adult stem cells populations in the fields of stem cell research and regenerative medicine. Thousands of articles now describe the use of ASCs in a variety of regenerative animal models, including bone regeneration, peripheral nerve repair and cardiovascular engineering. Recent articles have begun to describe the myriad of uses for ASCs in the clinic. The protocol shown in this article outlines the basic procedure for manually and enzymatically isolating ASCs from large amounts of lipoaspirates obtained from cosmetic procedures. This protocol can easily be scaled up or down to accommodate the volume of lipoaspirate and can be adapted to isolate ASCs from fat tissue obtained through abdominoplasties and other similar procedures.

The protocol outline above describes a manual, enzymatic method for the isolation of an SVF from a large volume lipoaspirate sample. Within this SVF are numerous cell populations, including the ASC. Numerous studies propose that culturing this SVF under standard tissue culture conditions will select for an adherent fibroblast population likely to be composed mainly of the ASC type. Consistent with this, we have shown, using flow cytometry and immunofluorescence, that cultured SVF pellets become essentially free of the ...

Watch this Scientific Journal Video about Manual Isolation of Adipose-derived Stem Cells from Human Lipoaspirates at JoVE.com

Manual Isolation of Adipose-derived Stem Cells from Human Lipoaspirates

In 2001, researchers at UCLA described the isolation of a population of adult stem cells, termed Adipose-derived Stem Cells or ASCs, from adipose tissue. This article outlines the isolation of ASCs from lipoaspirates using a manual, enzymatic digestion protocol using collagenase.

In 2001, researchers at the University of  California, Los Angeles, described the isolation of a new population of adult  stem cells from liposuctioned ...

manual-isolation-adipose-derived-stem-cells-from-human

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JoVE Journal

Biology

40.9K Views.  Cytori Therapeutics Inc. In 2001, researchers at UCLA described the isolation of a population of adult stem cells, termed Adipose-derived Stem Cells or ASCs, from adipose tissue. This article outlines the isolation of ASCs from lipoaspirates using a manual, enzymatic digestion protocol using collagenase.