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Investigating the Influence of Tranexamic Acid on Adipocyte Differentiation in an In Vitro Model
Giorgianna Ellis1,2, BA, Tiffany DeSouza2, BS, Jahnavi Challagonda1, BA, Anam J. Furrukh1,2, Alex Joo1,2, MD, Sneha Palmieri1, MD, Silvia Corvera2, MD, Janice Lalikos1 MD 1Division of Plastic Surgery, University of Massachusetts Chan Medical School, Worcester MA 2Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester MA
Background: Tranexamic acid (TXA) has gained momentum in plastic surgery for its ability to improve procedural outcomes by mitigating blood loss, hematoma formation, swelling, and bruising, notably in tumescent solution for liposuction and fat grafting. Our study examines whether TXA affects mesenchymal progenitor cell differentiation towards mature adipocytes with normal structure and function, and the implications for fat graft survival. Methods: Adipose tissue explants from human subcutaneous fat were cultured in a 3D system with varied TXA concentrations (Vehicle, 100 µg/mL, 1000 µg/mL). Capillary sprouting was recorded from day 4 to day 12. After 14 days, human Adipose Capillary Associated Progenitor Cells (hACAPs) were isolated and maintained in 2D cultures at the same concentrations, with growth rate assessed through two expansions. Cells then underwent adipogenic differentiation for 10 days using MDI media (insulin, dexamethasone, 3-Isobutyl-1-methylxanthine), and a subset was subsequently treated with Forskolin, a thermogenesis activator. Differentiation was assessed via rt-qPCR and lipid droplet imaging. Results: Capillary sprouting, cell yields, and growth rates were equivalent across all groups. Cell morphology and lipid droplet accumulation were unchanged after MDI treatment. Expression of adipogenic genes AdipoQ, PLIN1, and FABP4 was similar after 10 days of differentiation, as was expression of UCP1, LINC473, and DIO2 following forskolin-induced thermogenic activation. Conclusion: These data suggest TXA does not compromise adipocyte differentiation or thermogenic responsiveness. TXA appears to exert, at most, a transient effect on early explant sprouting while preserving downstream progenitor function and adipocyte biology, suggesting early vascular remodeling and later adipocyte survival may be governed by distinct mechanisms.
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