Unveiling Telocyte Networks in the Human Superficial Fascia: A New Component of the Hypodermal Interstitial Microenvironment

The human superficial fascia (SF) is a dynamic layer within the hypodermis, increasingly recognized for its role in tissue repair, lymphatic drainage, and fascial dysfunctions. Yet the complete cellular landscape of SF remains largely uncharacterized. Telocytes (TCs) are specialized interstitial cells defined by long, moniliform telopodes, serving as “connecting cells” in various organs. This study provides the first identification of TCs in human SF using immunohistochemistry, confocal immunofluorescence, and transmission electron microscopy (TEM). CD34+ TCs were widespread across both adipose-rich and fibrous compartments of human SF. Confocal microscopy identified extensive three-dimensional networks of CD34+/PDGFRα+/LGR5+/CD31–/α-SMA–/c-kit– TCs, closely associated with CD34+/CD31+ microvessels and TH+ autonomic nerve fibers. Notably, TCs established strategic spatial relationships with D2-40+ lymphatics and c-kit+ mast cells, raising the possibility of a TC–mast cell functional tandem in interstitial fluid homeostasis. Furthermore, the expression of the stemness marker LGR5 positions TCs as an integral component of perivascular stem cell niches. TEM confirmed the presence of TCs ultrastructurally distinguished by characteristic telopodes. In conclusion, our findings suggest that TCs may act as important regulators of SF integrity and homeostasis. Their identification provides novel insights into fascial anatomy while uncovering potential therapeutic targets for conditions such as lymphedema and impaired wound healing.