Adipose-derived regenerative cells (ADRCs) in regenerative medicine: Current advances and future directions

Adipose-derived regenerative cells (ADRCs) have emerged as a transformative tool in regenerative medicine, offering multifaceted therapeutic potential due to their accessibility, immunocompatibility, and regenerative capabilities. Derived from subcutaneous adipose tissue, ADRCs comprise a heterogeneous population of mesenchymal stromal cells, endothelial progenitors, and immunomodulatory cells, which synergistically promote tissue repair through angiogenesis, inflammation modulation, and anti-fibrosis. Clinically, ADRCs have demonstrated efficacy across diverse applications, including soft tissue reconstruction, chronic wound healing, cardiovascular and ischemic disease, reproductive dysfunctions, urogenital disorders, skeletal tissue engineering, and fibrotic conditions. Innovations in automated isolation systems, have revolutionized ADRCs preparation by enabling standardized, closed-loop processing with high cell viability (>85%) and reduced contamination risks, facilitating same-day bedside administration. Despite promising outcomes, challenges persist in clinical translation, including variability in cell yield due to isolation methods, regulatory ambiguities, and limited long-term safety data. Standardization of protocols, biomarker-driven patient stratification, and cost-effective scalability remain critical for widespread adoption. Emerging strategies integrating biomaterials and genetic engineering represent pivotal future directions to advance therapeutic precision. This review synthesizes the biological foundations, clinical advancements, and translational hurdles of ADRCs, underscoring their potential to redefine regenerative therapies while emphasizing the need for interdisciplinary collaboration to achieve precision medicine goals.