O164 Mechanistic insight into autologous fat grafting (AFG) as treatment for radiation-induced fibrosis (RIF) of the skin: a systematic review

Abstract Introduction RIF of the skin is a common yet devastating side effect radiotherapy. The condition significantly worsens quality life causing both cosmetic and functional impairment, with no effective treatment. Surgical reconstruction AFG shows great promise due to its anti-fibrotic effects, but underlying mechanisms remain unclear. We systematically review literature identify possible therapeutic targets. Methods A systematic search was conducted using PubMed, SCOPUS, Cochrane databases. In-vitro in-vivo studies were included radiation adipose tissue fractions or isolated cell groups. Data regarding intervention, types, experimental model, protocol, outcomes collected. Study assessed. Results 26 met inclusion criteria; 8 in-vitro co-culture models 21 experiments. Adipose-derived stem cells (ADSCs) ADSC conditioned medium most commonly used while ADSC, stromal vascular fraction, whole fat microfat in-vivo. ADSCs modulated inflammation, vascularisation, apoptosis, extracellular matrix remodelling. This decreased collagen levels through attenuation TGFβ/SMAD-axis, inhibition fibroblast-to-myofibroblast-transition, recruitment inflammation-resolving M2-Macrophages. role modulating vascularisation remains Secretion HGF, FGF2, VEGF, IL6 amongst others by suggested for these effects. Conclusion combination remodelling, immunomodulation, re-vascularisation are central mechanistic features after AFG, however, several key phenomena unexplained. Investigation pathways may drug targets treating other fibrotic diseases.