Systemic Inflammatory Reaction After Silicone Breast Implant

Abstract

The most common complication of silicone breast implants is capsular contracture (massive scar formation around the implant). We postulate that capsular contracture is always a sequel to inflammatory processes, with both innate and adaptive immune mechanisms participating. In general, fibroblasts and macrophages have been used as cell types to evaluate in vitro the biocompatibility of breast implant surfaces. Moreover, also T cells have been found at the implant site at the initial stage of fibrous capsule formation. However, only few studies have addressed the influence of surfaces with different textures on T-cell responses. The aim of the present study was to investigate the immune response of human peripheral blood mononuclear cells (PBMC) to commercially available silicone breast implants in vitro. PBMC from healthy female blood donors were cultured on each silicone surface for 4 days. Proliferation and phenotype of cultured cells were assessed by flow cytometry. Cytokine levels were determined by multiplex and real-time assay. We found that silicone surfaces do not induce T-cell proliferation, nor do they extensively alter the proportion of T cell subsets (CD4, CD8, naïve, effector memory). Interestingly, cytokine profiling identified matrix specific differences, especially for IL-6 and TNF-α on certain surface topographies that could lead to increased fibrosis.

Adsorbed fibrinogen leads to improved bone regeneration and correlates with differences in the systemic immune response

“…To the best of our knowledge this is the first study where the systemic immune response is taken into account for evaluating the performance of a biomaterial intended for bone regeneration. The study of the systemic response is common in immunology [58,59], and some characterization of systemic markers has been performed for the response to breast silicon implants in humans [60]. Nonetheless, the study of the systemic immune response to implants is still much neglected.…”

Interleukin 17 and senescent cells regulate the foreign body response to synthetic material implants in mice and humans

“…Medical implants derived from synthetic materials can be associated with the FBR that not only impairs implant function and longevity but may also affect the host. There are anecdotal reports of systemic illnesses associated with orthopedic and soft tissue implants, most notably breast implant syndrome (44,45). With only local inflammatory components considered relevant to the FBR, direct correlation of implant responses with systemic immune pathologies has been difficult to connect.…”

Histological evaluation of capsules formed by silicon implants coated with polyurethane foam and with a textured surface in rats

“…Currently, the most performed plastic surgery worldwide is breast augmentation 1 . Scales et al 2 defined the properties of an ideal implant: no physical change in tissue; chemically inert; non carcinogenic; non allergic or foreign body reactive; mechanical forces resilience; and made into the desired shape.…”