Individual inflammatory response of human blood monocytes to mesh biomaterials

Abstract

Background: Alloplastic implants such as those employed in hernia repair induce distinct local inflammation and seroma production. As monocytes take a key position in the inflammatory foreign body reaction, their specific release of cytokines was investigated in vitro after incubation with alloplastic materials.Methods: Human blood monocytes were isolated from buffy coats of 42 healthy blood donors. Cells were cultivated in polystyrene culture wells (4 × 10 6 cells/well) on polypropylene-polyglactin mesh, on polytetrafluoroethylene, in control wells with the addition of 1 µg lipopolysaccharide (LPS) and on pure polystyrene. Supernatant was taken after 1 h and 5 days, and concentrations of tumour necrosis factor (TNF) α, interleukin (IL) 6 and IL-10 were determined. Donors were defined as 'high' or 'low' responders when concentrations of TNF-α were above the 75th or below the 25th percentiles, respectively. Results:In contact with biomaterials, the monocytes liberated TNF-α, IL-6 and IL-10, similar to levels observed after stimulation with LPS. Median cytokine concentrations were not normally distributed and were influenced by donor, timepoint and applied stimulus. One donor matched the criteria for low responder and three for high responder. Conclusion:The individual was identified as an independent factor for the inflammatory response of monocytes to biomaterials. Moreover, high and low responders could be identified. The variability of cytokine release and the lack of a normal distribution suggest that a larger sample size should be used in future studies of cellular response.

Impact of Different Texture of Polypropylene Mesh on the Inflammatory Response

“…Different factors can influence the acute inflammatory response to prosthesis implantation. Patients themselves have been identified as an independent factor in the inflammatory response of monocytes to biomaterials and have been classified as low and high responders (2). Other factors that influence the inflammatory reaction are density (10), size (11) and the physical characteristics of the prosthesis such as texture and porosity of each biomaterial (12)(13)(14).…”

Incidence of Chronic Pain After İngunial Hernia Repair

“…Herniotomi operasyonlarında kullanılan mesh'in fiksasyonu sırasında operasyon alanından geçen sinirlerde yaralanma olabileceği gibi, mesh'in yarattığı enflamasyona karşı da sinir hasarı olabileceği belirtilmektedir. [17,18] Buna karşılık 2612 hasta üzerinde yapılan bir araştırmada mesh kullanılan hastalar ile kullanılmayan hastalar arasında kronik ağrının görülme sıklığı yönünden anlamlı bir fark bulunamamıştır.…”

“…Herni operasyonu sonrası kronik ağrı gelişen hastaların çoğunda ameliyat öncesi başağrısı, irritabl kolon sendromu veya sırt ağrısı olduğu saptanmıştır. [14][15][16][17][18][19][20][21][22] Başka bir çalışmada ameliyat öncesi dönemde ağrısı olmayan ve herni operasyonu geçiren kişilerin bir yıllık takipleri sonrası ağrı skorları ameliyat öncesi dönemde ağrısı olanlara göre belirgin derecede dü-şük çıkmıştır. [23] Çalışmamızda ameliyat öncesi ağ-rısı olanlarda kronik ağrı gelişimi insidansı %21.8 olarak bulunmuştur.…”

Transvaginal mesh repair of anterior and posterior vaginal wall prolapse: a clinical and ultrasonographic study

“…It has been shown that, in the abdominal wall, mesh retraction is related to the degree of tissue inflammation around the mesh after implantation 14 . This host reaction depends on both biocompatibility of the foreign material and the patient's immune system 15 . It is known to take place in the first few weeks but can last as long as 12 months after surgery 16 .…”