In vitro activation of human leukocytes in response to contact with synthetic hernia meshes

Bryan, Nicholas; Ahswin, Helen; Smart, Neil J.; Bayon, Yves; Hunt, John A.

doi:10.1016/j.clinbiochem.2012.02.026

Cited by 16 publications

(11 citation statements)

References 35 publications

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“…4 While exact mechanism of development of chronic pain still remains a subject of debate, a growing body of evidence points toward oxidative stress as one of the major factors leading to the implant deterioration and chronic postoperative pain in hernioplasty. [5][6][7] It was reported 8,9 that reactive oxygen species (ROS), in particular superoxide and hydroxide radicals, cause the most harm to the material of the mesh. It was also shown 5,7 that hypochlorite ions (OCl 2 ) produced by enzyme myeloperoxidase present in neutrophils can contribute to the process of oxidative degradation of the implant.…”

Section: Introductionmentioning

confidence: 99%

Anti‐inflammatory coatings of hernia repair meshes: A pilot study

et al. 2017

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The current prevalence of postoperative chronic pain from hernioplasty procedures employing polymer mesh is close to 30%. Most of the researchers agree that oxidative stress, resulting from the release of oxidants and enzymes during acute inflammatory response, is a key factor in the development of posthernioplasty complications. This results in both the decrease of the biomechanical properties and stiffening of the polymer fibers of the mesh, leading to chronic pain. Moreover, enhanced activity of inflammatory cells can lead to an excessive deposition of connective tissue around the implant. In this study polypropylene hernia repair meshes coated with vitamin E (α-tocopherol), a known antioxidant, were prepared and characterized. The absorption isotherm of vitamin E on the mesh was characterized and a release profile study yielded a promising results, showing sustained release of the drug over a 10-day period. An animal study was conducted, and histological analysis five weeks after implantation exhibited a reduced host tissue response for a modified mesh as compared to a plain mesh, as evidenced by a higher mature collagen to immature collagen ratio, as well as lower level of fatty infiltrates, neovascularization and fibrosis in the case of modified mesh. These results support the use of α-tocopherol as a potential coating in attempt to reduce the extent of postoperative inflammation, and thereby improve long-term outcomes of hernioplasty. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 589-597, 2018.

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Section: Introductionmentioning

confidence: 99%

Anti‐inflammatory coatings of hernia repair meshes: A pilot study

et al. 2017

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“…Previous work has demonstrated greater amounts of in vivo leukocyte activation in response to PGA meshes vs a number of alternative polymeric biomaterials. These in vivo findings are also consistent with in vitro characterization of these materials previously published by our group, which demonstrated that the identical PGA polymer to that used in these in vivo studies stimulated a higher degree of leukocyte ROS production compared to PP and PET counterparts (Bryan et al ., ). However, the histopathology in the in vivo study herein only supported this work in part, showing similar levels of polymorphonuclear cells (PMN) and monocyte cells recruited to the PGA as the PET and PP materials, although image analysis did show greater CD68 expression in response to PGA at two time points throughout the study.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of six synthetic surgical meshes implanted subcutaneously in a rat model

Bryan

Ashwin

Chen

et al. 2013

J Tissue Eng Regen Med

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The long-term efficacy and mechanical integrity of implanted materials is largely determined by early host response. Therefore, implanting materials with well-characterized tissue responses provides the greatest chance of 'one-hit' surgical successes, without repeated interventions to replace, repair or remove non-compliant biomaterials. Six synthetic meshes were implanted subcutaneously in a rat model to deduce and quantify modulations in host response, based on material fabrication variables. The materials consisted of knitting variations of polypropylene (PP), polyethyleneterephthalate (PET) and polyglycolic acid (PGA) yarns and were implanted for 2, 5, 7, 14 and 28 days before fixation and both semi- and fully quantitative histopathology. In a subcutaneous niche, material weight did not influence foreign body response. PET stimulated earlier inflammation than PP and PGA, which normalized over 28 days. Multifilament meshes recruited foreign body giant cells, which were largely absent from monofilaments. Using CD68, PGA was demonstrated to be the greatest leukocyte-activating polymer at a number of the time points analysed. This research therefore highlights that underlying polymer composition may be more over-arching in deciding the inflammatory properties of surgical meshes, based on increased macrophagic responses to PGA vs alternative base polymers of comparable weights and porosities. Copyright © 2013 John Wiley & Sons, Ltd.

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“…Various compounds have been tested so far for mesh coating purposes, however, the majority in in vivo models, mostly after setting a pathological defect being repaired by the investigated meshes [9, 19–22]. Besides numerous in vivo experiments, Bryan and coworkers provide an in vitro model to facilitate mesh choice in uncomplicated hernia repair by quantitatively determining of neutrophil activation and degranulation in different mesh types [23]. Their approach represents one of the few in vitro assessment tools for meshes, currently available in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…This supports the thesis that coating with plasma may have an effect independent of the mesh; however, at least in vitro , all meshes could improve their performance but low ranked meshes could not increase their position compared to natively better positioned counterparts. The thesis of Bryan and coworkers can thereby be supported: mesh structure seems to be an important determinant of the in vitro performance in the native and coated configuration of a mesh [23]. Mesh related complications are known to be related to extensive local inflammation, representing the first step of a foreign body reaction [25].…”

Section: Discussionmentioning

confidence: 99%

Coating with Autologous Plasma Improves Biocompatibility of Mesh GraftsIn Vitro: Development Stage of a Surgical Innovation

Gerullis

Georgas

Eimer

et al. 2013

BioMed Research International

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Purpose. To investigate mesh coating modalities with autologous blood components in a recently developed in vitro test system for biocompatibility assessment of alloplastic materials. Materials and Methods. Seven different mesh types, currently used in various indications, were randomly investigated. Meshes were coated prior to cultivation with autologous peripheral blood mononuclear cells (PBMCs), platelets, and blood plasma. Pretreated meshes were incubated over 6 weeks in a minced tissue assay, representative for fibroblasts, muscle cells, and endothelial cells originating from 10 different patients. Adherence of those tissues on the meshes was microscopically investigated and semiquantitatively assessed using a previously described scoring system. Results. Coating with peripheral blood mononuclear cells did not affect the adherence score, whereas coating with platelets and blood plasma increased the score suggesting improved biocompatibility in vitro. The previous ranking of native meshes remained consistent after coating. Conclusion. Plasma coating of meshes improves their biocompatibility score in a novel in vitro test system.

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In vitro activation of human leukocytes in response to contact with synthetic hernia meshes

Cited by 16 publications

References 35 publications

Anti‐inflammatory coatings of hernia repair meshes: A pilot study

Anti‐inflammatory coatings of hernia repair meshes: A pilot study

Evaluation of six synthetic surgical meshes implanted subcutaneously in a rat model

Coating with Autologous Plasma Improves Biocompatibility of Mesh GraftsIn Vitro: Development Stage of a Surgical Innovation

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