ADSCs are mesenchymal multipotent progenitor cells with the capacity to self-renew and differentiate into several cell lineages. These cells can be harvested from the stromal vascular fraction (SVF) of adipose tissue during a lipoaspiration procedure1. ADSCs have emerged as an ideal stem cell type to use in regenerative medicine because these cells are abundant, minimally invasive to harvest, easily accessible, and well characterized2. Stem cell therapy offers a possible avenue for wound healing by stimulating cell migration, proliferation, neovascularization, and reducing inflammation within wounds3,4. Roughly 80% of the regenerative capacity of ADSCs is attributable to paracrine signaling via their secretome5. Previously, it was suggested a direct local injection of stem cells or growth factors into damaged tissue could illicit sufficient in vivo repair mechanisms6,7,8. However, this approach faced several challenges, such as poor survival and reduced stem cell engraftment within damaged tissues as a result of the inflammatory environment 9. Furthermore, one of the reasons cited was a lack of an extracellular matrix to support the survival and functionality of the transplanted cells10. To overcome these challenges, emphasis is now being placed on the development of biomaterial carriers to support stem cell viability and function.
Three-dimensional (3D) cell culture enhances cell-to-cell and cell-to-matrix interaction in vitro to provide an environment that better resembles the in vivo environment11. Hydrogels have been extensively studied as a class of biomaterial carriers that provide a 3D environment for stem cell culture. These structures are made of water and crosslinked polymers12. Encapsulation of ADSCs in hydrogel has virtually no cytotoxic effect on the cells during culture while maintaining the viability of the cells6. Stem cells cultured in 3D demonstrate enhanced retention of their stemness and improved differentiation capacity13. Similarly, hydrogel-seeded ADSCs demonstrated increased viability and accelerated wound closure in animal models14. Furthermore, hydrogel encapsulation significantly increases the engraftment and retention of ADSCs in wounds15,16. TrueGel3D is made of a polymer, either polyvinyl alcohol or dextran, solidified by a crosslinker, either cyclodextrin or polyethylene glycol17. The gel is a synthetic hydrogel that does not contain any animal products that may interfere with the experiments or trigger an immune reaction during the transplantation of the gel into a patient while effectively mimicking an extracellular matrix18. The gel is fully customizable by altering the composition and individual components. It can house different stem cells and support the differentiation of several cell types by adjusting the stiffness of the gel19. Attachment sites can be created through the addition of peptides20. The gel is degradable by the secretion of metalloproteases, allowing for cell migration21. Lastly, it is clear and allows for imaging techniques.
PBM is a minimally invasive and easily performed form of low-level laser therapy used to stimulate intracellular chromophores. Different wavelengths elicit different effects on cells22. Light in the red to near-infrared range stimulates increased adenosine triphosphate (ATP) and reactive oxygen species (ROS) production by enhancing flux through the electron transport chain23. Light in the blue and green ranges stimulates light-gated ion channels, allowing for the non-specific influx of cations, such as calcium and magnesium, into cells, which is known to enhance differentiation24. The net effect is the generation of secondary messengers that stimulate the transcription of factors triggering downstream cellular processes such as migration, proliferation, and differentiation25. PBM can be used to pre-condition cells to proliferate or differentiate before transplanting the cells into an adverse environment, e.g., damaged tissue26. Pre- and post-transplant PBM (630 nm and 810 nm) exposure of ADSCs significantly enhanced the viability and function of these cells in vivo in a diabetic rat model27. Regenerative medicine requires an adequate number of cells for effective repair of tissues28. In 3D cell culture, ADSCs have been associated with slower proliferation rates compared to two-dimensional cell culture6. However, PBM can be used to augment the 3D cell culture process of ADSCs by enhancing viability, proliferation, migration, and differentiation29,30.