Modification of Collagen Formation by Mesenchymal Stem Cells Isolated from Human Adipose Tissue in Culture and after Autotransplantation for Abdominal Hernia Plasty

Abstract

Mesenchymal stem cells from the adipose tissue of patients with postoperative hernias produce excessive amounts of collagen III, which shifts the balance between type III and type I collagens. The proposed technique of pretransplantation preparation allows in vitro stimulation collagen formation processes with predominant activation of collagen I synthesis and normalization of proportion between different collagen types. Abdominal wall repair with polypropylene surgical mesh in combination with autotransplantation of mesenchymal stem cells reduced the collagen III to collagen I ratio due to activation of collagen I synthesis and suppression of collagen III production, which had a positive effect on the structure of in vivo formed connective tissue.

Plasma-Activated Polypropylene Mesh-Gelatin Scaffold Composite as Potential Implant for Bioactive Hernia Treatment

“…GEL scaffolds cytotoxicity was monitored in direct contact testing system according to ISO 10993, using human adipose derived stem cells (ASC) as potential cell source for treating abdominal hernias . All protocols for obtaining samples of adipose tissue were reviewed and approved by the National Medical Ethics Committee (code 21/09/07).…”

Coatings for Permanent Meshes Used to Enhance Healing in Abdominal Hernia Repair: A Scoping Review

“…Biological coating with mesenchymal stem cells notably reduced inflammation and foreign body reactions, though they had minimal impact on other healing metrics. 19,20,[24][25][26][27]69,72 Conversely, platelet-rich plasma coatings enhanced tissue ingrowth, collagen deposition, and neovascularization, with mixed effects on inflammation and foreign body reactions. 10,12,60,61,68,71 The effect of fibroblast cell coatings on cell ingrowth differed based on their placement (underlay vs onlay) but generally improved collagen deposition and neovascularization.…”

“…The two most investigated coatings were mesenchymal stem cells and platelet-rich plasma. Mesenchymal stem cells were a focus in eight studies, 19,20,[24][25][26][27]69,72 but they were derived from different sources such as adipose tissue, 25,26,72 bone marrow, 19,27,69 endometrial tissue, 20 and unspecified origin. 24 The observed effects of the mesenchymal stem cells varied based on their origin and not all studies analysed all of the following parameters.…”

Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio‐Functionality to Meshes

“…This option would bring remarkable advantages, as an intra‐operative seeding technology of mesh could therefore be envisioned. However, one must consider that cells isolated from patients affected by soft‐tissue prolapse express altered genotype, notably with regard to angiogenesis or collagen expression (low ratio collagen type I/type III), which could threaten long‐term graft integration. To tackle this problem, in vitro re‐programming of autologous cells using specific growing conditions prior to re‐transplantation with PP mesh has been conducted on patients and revealed beneficial outcomes compared to conventional acellular mesh therapy .…”

“…However, one must consider that cells isolated from patients affected by soft‐tissue prolapse express altered genotype, notably with regard to angiogenesis or collagen expression (low ratio collagen type I/type III), which could threaten long‐term graft integration. To tackle this problem, in vitro re‐programming of autologous cells using specific growing conditions prior to re‐transplantation with PP mesh has been conducted on patients and revealed beneficial outcomes compared to conventional acellular mesh therapy . In addition, in situ re‐stimulation of the patient's own cells by local gene delivery from activated mesh would deserve more attention in the future, as it has already shown remarkable results in other collagen expression‐related diseases …”