Epidural fat mesenchymal stem cells: Important microenvironmental regulators in health, disease, and regeneration

• Published in: BioEssays Vol. 43; no. 2
• Main Authors: Shah, Sophia, Mudigonda, Sathvika, Mitha, Alim P., Salo, Paul, Krawetz, Roman J.
• Format: Journal Article
• Language: English
• Published: 01.02.2021
• Subjects: dural membranes; epidural fat; mesenchymal stem cells; spine microenvironment; tissue repair/maintenance
• ISSN: 0265-9247; 1521-1878
• DOI: 10.1002/bies.202000215

Mesenchymal stem cells (MSCs) are present in fat tissues throughout the body, yet little is known regarding their biological role within epidural fat. We hypothesize that debridement of epidural fat and/or subsequent loss of MSCs within this tissue, disrupts homeostasis in the vertebral environment resulting in increased inflammation, fibrosis, and decreased neovascularization leading to poorer functional outcomes post‐injury/operatively. Clinically, epidural fat is commonly considered a space‐filling tissue with limited functionality and therefore typically discarded during surgery. However, the presence of MSCs within epidural fat suggests that itis more biologically active than historically believed and may contribute to the regulation of homeostasis and regeneration in the dural environment. While the current literature supports our hypothesis, it will require additional experimentation to determine if epidural fat is an endogenous driver of repair and regeneration and if so, this tissue should be minimally perturbed from its original location in the spinal canal. Also see the video here https://youtu.be/MIol_IWK1os While mesenchymal stem cells (MSCs) have been characterized in many tissues throughout the body, only recently have they been identified in the epidural fat. We hypothesize that these epidural fat MSCs regulate inflammation and fibrosis while also contributing to the maintenance and repair of adjacent tissues such as the dura mater.