Pro - inflammatory cytokines and metalloproteinase activation in polypropylene mesh implant in rat subcutaneous tissue

Abstract

Aims and Objectives:Polypropylene meshes have been increasingly adopted for correction of pelvic organ prolapse due to its lower recurrence rate when compared to surgeries without meshes. The study of the interaction of these materials with the host tissue may contribute to the development of materials with best biocompatibility and, consequently, less complication rates.Materials and Methods:The present study compares the inflammatory reaction of standard-weight (SW) and lightweight (LW) meshes (72 g/m216g/m2 respectively), implanted in the abdomen of 20 adult rats, which were euthanized in four or 30 days. Quantification of pro-inflammatory markers, IL-1 and TNF-α, and of metalloproteinases, MMP2 and MMP3, were carried out through immunohistochemistry with AxioVision® software.Results:There were no significant differences in the quantification of IL-1 and TNF-α in LW versus SW meshes. However, IL-1 quantification increased along time (30 days >4 days, p=0.0269). Also, MMP-2 quantification was similar to SW and LW and both presented a significant increase along time (30 days >4 days, p <0.0001). MMP-3 quantification also showed no difference between the SW and LW groups, but increased along time (30 days >4 days, p=0.02).Conclusions:Mesh's density did not influence the quantification of pro-inflammatory cytokines IL-1 and TNF-α and metalloproteinases 2 and 3. The increased expression of IL-1, MMP-2 and MMP-3 over time could represent a longstanding inflammatory response after PP mesh implantation. Possibly, the occurrence of adverse events following PP prosthetic implants can be influenced by other factors, not solely related to the amount of implanted material.

Wound Healing Promotion by Hyaluronic Acid: Effect of Molecular Weight on Gene Expression and In Vivo Wound Closure

“…We observed an upregulation of MMP-2 in NHDF, consistent with the known upregulation of elastase-type endopeptidases in human skin fibroblast upon HA exposure [ 20 ]. Moreover, MMP-2 is known to be highly expressed by fibroblasts during the inflammation phase, which is critical for further tissue maturation [ 21 ]. TGF-β1 promotes the proliferation, collagen formation and differentiation of dermal fibroblasts and can stimulate fibroblast migration by up regulation of MMPs such as MMP-2 [ 22 ].…”

Cranioplasty for Skull Defects With Polypropylene Abdominal Wall Mesh

“…Much of the seroma gets absorbed and does not require intraoperative placement of a drain. However, in cases when it occurs postoperatively it can be adequately treated by aseptic aspiration 8. In this series, we did not place drains intraoperatively in any case and no case showed postoperative collection.…”

“…Latest mesh designs take the configuration of large pore weave and/or a composite of absorbable and nonabsorbable materials to reduce the tissue–mesh interface and decrease the amount of tissue inflammatory response after application 7. As a response of inflammation, seroma collection formation depends on the mesh–tissue area of interference 8. Much of the seroma gets absorbed and does not require intraoperative placement of a drain.…”

“…However, polypropylene-induced in situ inflammation is a well-documented complication. It induces histochemical reactivity of the proinflammatory cytokines interleukin-1 and tumor necrosis factor-α and metalloproteinase-2 and metalloproteinase-3 8. Latest mesh designs take the configuration of large pore weave and/or a composite of absorbable and nonabsorbable materials to reduce the tissue–mesh interface and decrease the amount of tissue inflammatory response after application 7.…”

“…Because of the soft flexibility nature of the polypropelene mesh it is not able to grant hard support and protection against head traumas in cases of large defects. Moreover, the intense inflammation and extensive fibrosis formation around the mesh lead to excessive adherence to the dura, which has increased the risk of bleeding in the cases where wound re-exploration are indicated 3,8. Thus, we recommend that polypropylene mesh may be an option for the reconstruction of small-sized or medium-sized cranial defects in rural practice, in situations when other materials are not available.…”