# Comparative evaluation of hypoxia preconditioned serum (HPS) and platelet-rich plasma (PRP) on preadipocyte survival and adipogenic differentiation

## TL;DR

This study compares how hypoxia preconditioned serum and platelet-rich plasma affect preadipocyte survival and fat cell formation, finding that hypoxia preconditioned serum performs better.

## Contribution

The study introduces hypoxia preconditioned serum as a superior alternative to platelet-rich plasma for enhancing preadipocyte adipogenic differentiation.

## Key findings

- HPS contains higher levels of key growth factors like Adiponectin, IGF-1, and VEGF-A compared to PRP and NS.
- HPS-40% induced the strongest adipogenic differentiation, with increased lipid droplet formation and gene upregulation.
- NS-40% resulted in the highest cell proliferation, but HPS showed superior differentiation potential.

## Abstract

Lipofilling is a widely used technique in plastic and reconstructive surgery, but its long-term success is often limited by unpredictable fat graft resorption. Optimizing the adipogenic environment through bioactive factors may enhance graft survival and volume retention. This study investigates the adipogenic potential of Hypoxia Preconditioned Serum (HPS) and Platelet-rich Plasma (PRP), in comparison to normal serum (NS).

Cytokine profiles of HPS, PRP, and NS from 10 donors were analyzed. Human preadipocytes (n = 3) were cultured with low (10%) and high (40%) concentrations of these secretomes. Proliferation, cytotoxicity (LDH assay), lipid droplet formation (Oil Red O staining), and gene expression (qPCR) of adipogenic markers (PPARgamma, C/EBPalpha, FABP4, Adiponectin, LPL) were assessed after 2 and 4 days.

HPS contained significantly higher levels of Adiponectin, IGF-1, bFGF, VEGF-A, and PDGF-BB compared with PRP and NS, while Leptin was lower in HPS and PRP than in NS. All conditions increased proliferation on day 4, with the highest cell counts in NS-40%. No treatment-related cytotoxicity was observed. HPS-40% induced the strongest adipogenic differentiation, evidenced by increased lipid droplet formation and upregulation of all measured adipogenic genes by day 4.

These findings suggest that HPS enhance the proliferation, survival, and differentiation of preadipocytes. Validation in in vivo models and clinical studies will be necessary to confirm its potential efficacy in enhancing graft survival and volume retention.