ASC: chameleon cells in action?

#ASC #BreastCancerAwareness   Adipose tissue–derived stromal cells (ASC) play a key role in many physiopathological processes, ranging from tissue repair to immune regulation and chronic inflammatory responses, as observed in metabolic diseases, fibrosis, and certain cancers. Long considered a homogeneous population, these cells actually display marked heterogeneity, both phenotypically and functionally.   This complexity represents a major limitation to their clinical use: the incomplete characterization of ASC subpopulations, their variable behavior in inflammatory contexts, and their capacity for tissue migration remain poorly understood. The main challenge is to decipher how these cells adapt to their environment and how their functions evolve in response to local signals, in order to optimize their therapeutic potential.   In this context, this study was initiated to synthesize current knowledge on cellular heterogeneity and trafficking mechanisms of ASC. The work draws on the latest data from imaging, single-cell transcriptomics, and preclinical models, with the objective of guiding the development of more targeted and personalized strategies in regenerative and immunomodulatory medicine.     Are all ASCs really the same?   Among the studies reviewed, several used advanced techniques such as flow cytometry, single-cell transcriptomics (scRNA-seq), and murine cell-tracing models to characterize ASC subpopulations and analyze their trafficking patterns in various pathological contexts.   These analyses revealed distinct transcriptional profiles reflecting specialized functions, notably in inflammation, angiogenesis, fibrosis, or maintenance of metabolic homeostasis. Moreover, data show that certain ASCs, under the influence of inflammatory signals such as TNF-α or IL-1β, adopt a transient proinflammatory phenotype while retaining functional plasticity, particularly in differentiation and tissue repair. Their targeted recruitment to inflamed or tumor tissues depends on the expression of chemokine receptors, specific integrins, and signals emitted by the local microenvironment. Imaging techniques have confirmed the active mobility of these cells, modulated by tissue type and pathological state.     From simple cells to intelligent therapeutic tools   Adipose stromal cells (ASCs), long viewed as a uniform population, are now revealed as a complex and dynamic network endowed with remarkable functional plasticity and context-dependent migratory capacity, varying with the tissue or inflammatory environment. One of the major challenges now is to decipher this heterogeneity in order to transform these cells into targeted therapeutic tools capable of adapting to the specific needs of each pathology.   This review highlights the importance of better characterizing ASC subpopulations by integrating molecular, functional, and contextual data to better predict their in vivo behavior and harness their potential in regenerative medicine, immunomodulation, or oncology.   However, the limitations of this study persist and justify further research. These should focus on the standardization of phenotypic markers, functional validation in in vivo models, and a deeper exploration of their role in chronic pathologies—particularly inflammatory, tumor, and fibrotic diseases. The development of real-time tracking technologies, coupled with the use of cellular liquid biopsies, could open the way to a personalized use of ASCs as intelligent therapeutic vectors, capable of acting in a targeted and context-dependent manner.