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Effects of Silicone Breast Implants on Human Cell Types In Vitro: A Closer Look on Host and Implant. Aesthetic Plast Surg 2022; 46:2208-2217. [PMID: 35075507 DOI: 10.1007/s00266-021-02762-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/29/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Silicone (gel) breast implants (SBI) are used world-wide for breast augmentation, and reconstruction or to correct breast deformities. They consist of two compounds: an elastomer silicone shell (envelope) and a silicone gel filler (core). Breast Implant Illness (BII) is a term used for women with SBI, who suffer from various of symptoms including myalgia, arthralgia, fatigue, fever, dry eyes and/or dry mouth (sicca), as well as cognitive disturbances, which are rated by these woman as response to SBI. The pathogenesis of these adverse effects as well as the histocompatibility and the SBI-cell interaction of silicone and its surrounding tissue (implant-host tissue interface) is a subject of current research. The main purpose of this review is to provide an overview of the current knowledge regarding the effects of silicone (gel and elastomer surfaces) of a SBI on different human cell types from experimental - in vitro - models. METHODS A comprehensive research was conducted by two independent reviewers in March and July of 2020 in the PubMed, MEDLINE, and Cochrane databases. RESULTS A number of 1328 articles on this topic were initially identified, of which 62 could be finally included an analysed in this review. CONCLUSION SBI may lead to a physiologic pro-inflammatory and foreign body host response with fibrous encapsulation accompanied by a disturbed Th17/Treg balance and IL-17 production. No causal relationship is known for systemic symptoms and/or autoimmune outcomes in the context of BII. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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3D-Printed Gelatin Methacrylate Scaffolds with Controlled Architecture and Stiffness Modulate the Fibroblast Phenotype towards Dermal Regeneration. Polymers (Basel) 2021; 13:polym13152510. [PMID: 34372114 PMCID: PMC8347286 DOI: 10.3390/polym13152510] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 12/21/2022] Open
Abstract
Impaired skin wound healing due to severe injury often leads to dysfunctional scar tissue formation as a result of excessive and persistent myofibroblast activation, characterised by the increased expression of α-smooth muscle actin (αSMA) and extracellular matrix (ECM) proteins. Yet, despite extensive research on impaired wound healing and the advancement in tissue-engineered skin substitutes, scar formation remains a significant clinical challenge. This study aimed to first investigate the effect of methacrylate gelatin (GelMA) biomaterial stiffness on human dermal fibroblast behaviour in order to then design a range of 3D-printed GelMA scaffolds with tuneable structural and mechanical properties and understand whether the introduction of pores and porosity would support fibroblast activity, while inhibiting myofibroblast-related gene and protein expression. Results demonstrated that increasing GelMA stiffness promotes myofibroblast activation through increased fibrosis-related gene and protein expression. However, the introduction of a porous architecture by 3D printing facilitated healthy fibroblast activity, while inhibiting myofibroblast activation. A significant reduction was observed in the gene and protein production of αSMA and the expression of ECM-related proteins, including fibronectin I and collagen III, across the range of porous 3D-printed GelMA scaffolds. These results show that the 3D-printed GelMA scaffolds have the potential to improve dermal skin healing, whilst inhibiting fibrosis and scar formation, therefore potentially offering a new treatment for skin repair.
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Tolksdorf J, Horch RE, Grüner JS, Schmid R, Kengelbach-Weigand A, Schubert DW, Werner S, Schneidereit D, Friedrich O, Ludolph I. Size matters-in vitro behaviour of human fibroblasts on textured silicone surfaces with different pore sizes. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:23. [PMID: 32016560 PMCID: PMC6997250 DOI: 10.1007/s10856-020-6360-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/07/2020] [Indexed: 05/14/2023]
Abstract
Capsular contracture remains a challenge in plastic surgery and represents one of the most common postoperative complications following alloplastic breast reconstruction. The impact of the surface structure of silicone implants on the foreign body reaction and the behaviour of connective tissue-producing cells has already been discussed. The aim of this study was to investigate different pore sizes of silicone surfaces and their influence on human fibroblasts in an in vitro model. Four different textures (no, fine, medium and coarse texture) produced with the salt-loss technique, have been assessed in an in vitro model. Human fibroblasts were seeded onto silicone sheets and evaluated after 1, 4 and 7 days microscopically, with viability assay and gene expression analysis. Comparing the growth behaviour and adhesion of the fibroblasts on the four different textures, a dense cell layer, good adhesion and bridge-building ability of the cells could be observed for the fine and medium texture. Cell number and viability of the cells were increasing during the time course of experiments on every texture. TGFß1 was lowest expressed on the fine and medium texture indicating a trend for decreased fibrotic activity. For silicone surfaces produced with the salt-loss technique, we were able to show an antifibrotic effect of smaller sized pores. These findings underline the hypothesis of a key role of the implant surface and the pore size and pore structure in preventing capsular contracture.
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Affiliation(s)
- Julia Tolksdorf
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Raymund E Horch
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Jasmin S Grüner
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Rafael Schmid
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Annika Kengelbach-Weigand
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Dirk W Schubert
- Institute of Polymer Materials, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Martensstrasse 7, 91058, Erlangen, Germany
| | - Siegfried Werner
- Institute of Polymer Materials, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Martensstrasse 7, 91058, Erlangen, Germany
| | - Dominik Schneidereit
- Institute of Medical Biotechnology, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 3, 91052, Erlangen, Germany
| | - Oliver Friedrich
- Institute of Medical Biotechnology, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 3, 91052, Erlangen, Germany
| | - Ingo Ludolph
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany.
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4
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Squamous cell carcinoma following multiple revision breast surgeries with massive chest wall reconstruction via flow-through double ALT free flaps. EUROPEAN JOURNAL OF PLASTIC SURGERY 2019. [DOI: 10.1007/s00238-019-01525-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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5
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Ludolph I, Gruener J, Kengelbach-Weigand A, Fiessler C, Horch R, Schmitz M. Long-term studies on the integration of acellular porcine dermis as an implant shell and the effect on capsular fibrosis around silicone implants in a rat model. J Plast Reconstr Aesthet Surg 2019; 72:1555-1563. [DOI: 10.1016/j.bjps.2019.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 03/20/2019] [Accepted: 04/23/2019] [Indexed: 01/19/2023]
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6
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Bernardini R, Varvaras D, D'Amico F, Bielli A, Scioli MG, Coniglione F, Rossi P, Buonomo OC, Petrella G, Mattei M, Orlandi A. Biological acellular pericardial mesh regulated tissue integration and remodeling in a rat model of breast prosthetic implantation. J Biomed Mater Res B Appl Biomater 2019; 108:577-590. [PMID: 31094057 DOI: 10.1002/jbm.b.34413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/15/2019] [Accepted: 04/25/2019] [Indexed: 12/29/2022]
Abstract
The use of biological meshes has proven beneficial in surgical restriction and periprosthetic capsular contracture following breast prosthetic-reconstruction. Three different types (smooth, texturized, and polyurethane) of silicone round mini prostheses were implanted under rat skin with or without two different bovine acellular pericardial biological meshes (APMs, BioRipar, and Tutomesh). One hundred eighty-six female rats were divided into 12 groups, sacrificed after 3, 6, and 24 weeks and tissue samples investigated by histology and immunohistochemistry. Implantation of both APMs, with or without prostheses, reduced capsular α-SMA expression and CD3+ inflammatory cell infiltration, increasing capillary density and cell proliferation, with some differences. In particular, Tutomesh was associated with higher peri-APM CD3+ inflammation, prosthetic capsular dermal α-SMA expression and less CD31+ vessels and cell proliferation compared with BioRipar. None differences were observed in tissue integration and remodeling following the APM + prostheses implantation; the different prostheses did not influence tissue remodeling. The aim of our study was to investigate if/how the use of different APMs, with peculiar intrinsic characteristics, may influence tissue integration. The structure of APMs critically influenced tissue remodeling after implantation. Further studies are needed to develop new APMs able to optimize tissue integration and neoangiogenesis minimizing periprosthetic inflammation and fibrosis.
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Affiliation(s)
- Roberta Bernardini
- Centro Servizi Interdipartimentale-STA, University of Rome "Tor Vergata", Rome, Italy
| | - Dimitrios Varvaras
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Federico D'Amico
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandra Bielli
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maria Giovanna Scioli
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Filadelfo Coniglione
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy.,Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, Tirana, Albania
| | - Piero Rossi
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Oreste C Buonomo
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppe Petrella
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Maurizio Mattei
- Centro Servizi Interdipartimentale-STA, University of Rome "Tor Vergata", Rome, Italy.,Department of Biology, University of Rome "Tor Vergata", Italy
| | - Augusto Orlandi
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, Tirana, Albania
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Abstract
PURPOSE OF REVIEW Breast implant-associated anaplastic large cell lymphoma (BI-ALCL) is a rare form of lymphoma arising adjacent to a breast implant. We aim to review the pathogenesis and clinico-biological features of BI-ALCL. RECENT FINDINGS BI-ALCL is a new provisional entity in the 2017 updated WHO classification. Among several hypotheses, BI-ALCL development seems to be determined by the interaction of immune response related to implant products and additional genetic events. SUMMARY BI-ALCL is an uncommon T-cell lymphoma which is increasingly diagnosed since its first description in 1997 with 500 estimated cases worldwide. Two BI-ALCL subtypes correlating with clinical presentation have been described. Although most BI-ALCL patients with tumor cell proliferation restricted to the periprosthetic effusion and capsule have excellent outcomes, other patients presenting with a tumor mass, may have a more aggressive disease. The pathogenesis of BI-ALCL remains elusive. It is postulated that local chronic inflammation elicitated by bacterial infection or implant products may promote the activation and proliferation of T cells. Additional genetic events resulting in the activation JAK/STAT pathway are also incriminated. Further investigations are needed to better characterize the pathogenesis of this disease in order to determine the potential risk to develop BI-ALCL after surgical implants.
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Yoo BY, Kim BH, Lee JS, Shin BH, Kwon H, Koh WG, Heo CY. Dual surface modification of PDMS-based silicone implants to suppress capsular contracture. Acta Biomater 2018; 76:56-70. [PMID: 29908334 DOI: 10.1016/j.actbio.2018.06.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/26/2018] [Accepted: 06/12/2018] [Indexed: 12/19/2022]
Abstract
In this study, we report a new physicochemical surface on poly(dimethylsiloxane) (PDMS)-based silicone implants in an effort to minimize capsular contracture. Two different surface modification strategies, namely, microtexturing as a physical cue and multilayer coating as a chemical cue, were combined to achieve synergistic effects. The deposition of uniformly sized microparticles onto uncured PDMS surfaces and the subsequent removal after curing generated microtextured surfaces with concave hemisphere micropatterns. The size of the individual micropattern was controlled by the microparticle size. Micropatterns of three different sizes (37.16, 70.22, and 97.64 μm) smaller than 100 μm were produced for potential application to smooth and round-shaped breast implants. The PDMS surface was further chemically modified by layer-by-layer (LbL) deposition of poly-l-lysine and hyaluronic acid. Short-term in vitro experiments demonstrated that all the PDMS samples were cytocompatible. However, lower expression of TGF-β and α-SMA, the major profibrotic cytokine and myofibroblast marker, respectively, was observed in only multilayer-coated PDMS samples with larger size micropatterns (70.22 and 97.64 μm), thereby confirming the synergistic effects of physical and chemical cues. An in vivo study conducted for 8 weeks after implantation in rats also indicated that PDMS samples with larger size micropatterns and multilayer coating most effectively inhibited capsular contracture based on analyses of tissue inflammation, number of macrophage, fibroblast and myofibroblast, TGF-β expression, collagen density, and capsule thickness. STATEMENT OF SIGNIFICANCE Although poly(dimethylsiloxane) (PDMS)-based silicone implants have been widely used for various applications including breast implants, they usually cause typical side effects called as capsular contracture. Prior studies have shown that microtexturing and surface coating could reduce capsular contracture. However, previous methods are limited in their scope for application, and it is difficult to obtain FDA approval because of the large and nonuniform size of the microtexture as well as the use of toxic chemical components. Herein, those issues could be addressed by creating a microtexture of size less than 100 m, with a narrow size distribution and using layer-by-layer deposition of a biocompatible polymer without using any toxic compounds. Furthermore, this is the first attempt to combine microtexture with multilayer coating to obtain synergetic effects in minimizing the capsular contracture.
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Hernández Martinez VM, Garcia Benavides L, Totsuka Sutto SE, Cardona Muñoz EG, Campos Bayardo TI, Pascoe Gonzalez S. Effectiveness of degradable and non-degradable implants to close large septal perforations in an experimental model. J Plast Surg Hand Surg 2016; 50:222-6. [PMID: 26982891 DOI: 10.3109/2000656x.2016.1152973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Reparation of large nasal septum perforations continues to be challenging. Bipedicled mucoperichondrial and inter-positional grafts currently show the most promising results. New implants have emerged to be used as a support membrane to carry on the mucosal cells, taking advantage of the innate proliferative properties of the mucosal tissue. Objective To compare the effectiveness of two kinds of material; non-absorbable dimethylsiloxane (silicone elastomers) and absorbable porcine small intestinal submucosa (Surgisis), both used as an inter-positional graft without neighbouring flaps to close nasal septal perforations in an experimental model. Methods Fifteen dogs were divided into three groups. One group received Surgisis, the other sheets of dimethylsiloxane and the last group a sham group. The dogs were followed for 6 weeks. Results The initial perforation of the nasal septum showed complete mucosal closure in the dimethylsiloxane group. The Surgisis group, on the other hand, had a smaller reduction than that at the beginning (final mean area = 23.0 ± 5.4 mm(2) (p < 0.05); however, complete closure was not achieved. Sham animals showed an inconstant and slight reduction in dimension from 100 mm(2) to 70 ± 16 mm(2) of mucosa and cartilage, but closure was not achieved. A significantly higher number of capillaries were observed in the Surgisis group compared to the dimethylsiloxane group (p < 0.05) without differences in inflammation, fibrosis, or necrosis. Conclusions The non-absorbable implant; dimethylsiloxane facilitates a better closure of the nasal septum.
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Affiliation(s)
- Victor M Hernández Martinez
- a Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS , Universidad de Guadalajara , Guadalajara Jalisco , México
| | - Leonel Garcia Benavides
- a Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS , Universidad de Guadalajara , Guadalajara Jalisco , México
| | - Sylvia E Totsuka Sutto
- a Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS , Universidad de Guadalajara , Guadalajara Jalisco , México
| | - Ernesto G Cardona Muñoz
- a Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS , Universidad de Guadalajara , Guadalajara Jalisco , México
| | - Tania Isabel Campos Bayardo
- a Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS , Universidad de Guadalajara , Guadalajara Jalisco , México
| | - Sara Pascoe Gonzalez
- a Instituto de Terapéutica Experimental y Clínica, Departamento de Fisiología, CUCS , Universidad de Guadalajara , Guadalajara Jalisco , México
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Laurent C, Delas A, Gaulard P, Haioun C, Moreau A, Xerri L, Traverse-Glehen A, Rousset T, Quintin-Roue I, Petrella T, Emile JF, Amara N, Rochaix P, Chenard-Neu MP, Tasei AM, Menet E, Chomarat H, Costes V, Andrac-Meyer L, Michiels JF, Chassagne-Clement C, de Leval L, Brousset P, Delsol G, Lamant L. Breast implant-associated anaplastic large cell lymphoma: two distinct clinicopathological variants with different outcomes. Ann Oncol 2015; 27:306-14. [PMID: 26598546 DOI: 10.1093/annonc/mdv575] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/11/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND ALK-negative anaplastic large cell lymphoma associated with breast implant (i-ALCL) has been recently recognized as a distinct entity. Among 43 830 lymphomas registered in the French Lymphopath network since 2010, 300 breast lymphomas comprising 25 peripheral T-cell lymphomas (PTCL) were reviewed. Among PTCL, ALK-negative ALCL was the most frequent and all of them were associated with breast implants. PATIENTS AND METHODS Since 2010, all i-ALCL cases were collected from different institutions through Lymphopath. Immuno-morphologic features, molecular data and clinical outcome of 19 i-ALCLs have been retrospectively analyzed. RESULTS The median age of the patients was 61 years and the median length between breast implant and i-ALCL was 9 years. Most implants were silicone-filled and textured. Implant removal was performed in 17 out of 19 patients with additional treatment based on mostly CHOP or CHOP-like chemotherapy regimens (n = 10/19) or irradiation (n = 1/19). CHOP alone or ABVD following radiation without implant removal have been given in two patients. The two clinical presentations, i.e. effusion and less frequently tumor mass correlated with distinct histopathologic features: in situ i-ALCL (anaplastic cell proliferation confined to the fibrous capsule) and infiltrative i-ALCL (pleomorphic cells massively infiltrating adjacent tissue with eosinophils and sometimes Reed-Sternberg-like cells mimicking Hodgkin lymphoma). Malignant cells were CD30-positive, showed a variable staining for EMA and were ALK negative. Most cases had a cytotoxic T-cell immunophenotype with variable T-cell antigen loss and pSTAT3 nuclear expression. T-cell receptor genes were clonally rearranged in 13 out of 13 tested cases. After 18 months of median follow-up, the 2-year overall survival for in situ and infiltrative i-ALCL was 100% and 52.5%, respectively. CONCLUSIONS In situ i-ALCLs have an indolent clinical course and generally remain free of disease after implant removal. However, infiltrative i-ALCLs could have a more aggressive clinical course that might require additional therapy to implant removal.
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Affiliation(s)
- C Laurent
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse INSERM, U.1037, Centre de recherche en cancérologie de Toulouse-Purpan, Toulouse
| | - A Delas
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse
| | - P Gaulard
- Department of Pathology, AP-HP, Groupe hospitalier Henri Mondor-Albert Chenevier, Créteil INSERM U955, Université Paris-Est, Créteil
| | - C Haioun
- INSERM U955, Université Paris-Est, Créteil Lymphoid Malignancies Unit, AP-HP, Groupe hospitalier Henri Mondor-Albert Chenevier, Créteil
| | - A Moreau
- Department of Pathology, Centre Hospitalier Hôtel Dieu, Nantes
| | - L Xerri
- Department of Pathology, Institut Paoli-Calmettes, Marseille
| | | | - T Rousset
- Department of Pathology, Hôpital Gui de Chauliac-Saint Eloi, Montpellier
| | - I Quintin-Roue
- Department of Pathology, Centre Hospitalier de Brest, Brest, France
| | - T Petrella
- Département de Pathologie, Montréal, Canada
| | - J F Emile
- Department of Pathology, Hôpital Ambroise Paré, Boulogne
| | - N Amara
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse
| | - P Rochaix
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse
| | | | - A M Tasei
- Department of Pathology, Centre Hospitalier Henri Duffaut, Avignon
| | - E Menet
- Department of Pathology, Hôpital René Huguenin, Saint Cloud
| | | | - V Costes
- Department of Pathology, Hôpital Gui de Chauliac-Saint Eloi, Montpellier
| | | | - J F Michiels
- Department of Pathology, Centre Hospitalier Pasteur L'Archet, Nice
| | | | - L de Leval
- Pathology institut of Lausanne, Centre Hospitalier Universitaire Vaudois, Suisse, Lausanne, Switzerland
| | - P Brousset
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse INSERM, U.1037, Centre de recherche en cancérologie de Toulouse-Purpan, Toulouse
| | - G Delsol
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse INSERM, U.1037, Centre de recherche en cancérologie de Toulouse-Purpan, Toulouse
| | - L Lamant
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse INSERM, U.1037, Centre de recherche en cancérologie de Toulouse-Purpan, Toulouse
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11
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Anaplastic large cell lymphoma (ALCL) and breast implants: breaking down the evidence. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2014; 762:123-32. [PMID: 25475421 DOI: 10.1016/j.mrrev.2014.08.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 08/12/2014] [Accepted: 08/13/2014] [Indexed: 01/31/2023]
Abstract
Systemic anaplastic large cell lymphoma (ALCL) is a distinct disease classification provisionally sub-divided into ALCL, Anaplastic Lymphoma Kinase (ALK)(+) and ALCL, ALK(-) entities. More recently, another category of ALCL has been increasingly reported in the literature and is associated with the presence of breast implants. A comprehensive review of the 71 reported cases of breast implant associated ALCL (iALCL) is presented indicating the apparent risk factors and main characteristics of this rare cancer. The average patient is 50 years of age and most cases present in the capsule surrounding the implant as part of the periprosthetic fluid or the capsule itself on average at 10 years post-surgery suggesting that iALCL is a late complication. The absolute risk is low ranging from 1:500,000 to 1:3,000,000 patients with breast implants per year. The majority of cases are ALK-negative, yet are associated with silicone-coated implants suggestive of the mechanism of tumorigenesis which is discussed in relation to chronic inflammation, immunogenicity of the implants and sub-clinical infection. In particular, capsulotomy alone seems to be sufficient for the treatment of many cases suggesting the implants provide the biological stimulus whereas others require further treatment including chemo- and radiotherapy although reported cases remain too low to recommend a therapeutic approach. However, CD30-based therapeutics might be a future option.
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Wang SL, Shi XH, Yang Z, Zhang YM, Shen LR, Lei ZY, Zhang ZQ, Cao C, Fan DL. Osteopontin (OPN) is an important protein to mediate improvements in the biocompatibility of C ion-implanted silicone rubber. PLoS One 2014; 9:e98320. [PMID: 24911051 PMCID: PMC4049582 DOI: 10.1371/journal.pone.0098320] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 05/01/2014] [Indexed: 01/15/2023] Open
Abstract
Medical device implants are drawing increasing amounts of interest from modern medical practitioners. However, this attention is not evenly spread across all such devices; most of these implantable devices can cause adverse reactions such as inflammation, fibrosis, thrombosis, and infection. In this work, the biocompatibility of silicone rubber (SR) was improved through carbon (C) ion implantation. Scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD) results confirmed that these newly generated carbon-implanted silicone rubbers (C-SRs) had large, irregular peaks and deep valleys on their surfaces. The water contact angle of the SR surface decreased significantly after C ion implantation. C ion implantation also changed the surface charge distribution, silicone oxygen rate, and chemical-element distribution of SR to favor cell attachment. The dermal fibroblasts cultured on the surface C-SR grew faster and showed more typical fibroblastic shapes. The expression levels of major adhesion proteins, including talin-1, zyxin, and vinculin, were significantly higher in dermal fibroblasts cultured on C-SR coated plates than in dermal fibroblasts cultured on SR. Those same dermal fibroblasts on C-SRs showed more pronounced adhesion and migration abilities. Osteopontin (OPN), a critical extracellular matrix (ECM) protein, was up-regulated and secreted from dermal fibroblasts cultured on C-SR. Matrix metalloproteinase-9 (MMP-9) activity was also increased. These cells were highly mobile and were able to adhere to surfaces, but these abilities were inhibited by the monoclonal antibody against OPN, or by shRNA-mediated MMP-9 knockdown. Together, these results suggest that C ion implantation significantly improves SR biocompatibility, and that OPN is important to promote cell adhesion to the C-SR surface.
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Affiliation(s)
- Shao-liang Wang
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Xiao-hua Shi
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Zhi Yang
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Yi-ming Zhang
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Li-ru Shen
- Southwestern Institute of Physics, Chengdu, Sichuan, People's Republic of China
| | - Ze-yuan Lei
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Zhi-qing Zhang
- Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Cong Cao
- Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, People's Republic of China
- * E-mail: (CC); (DF)
| | - Dong-li Fan
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
- * E-mail: (CC); (DF)
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Schubert DW, Kaschta J, Horch RE, Walter BL, Daenicke J. On the failure of silicone breast implants: new insights by mapping the mechanical properties of implant shells. POLYM INT 2013. [DOI: 10.1002/pi.4619] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Dirk W Schubert
- Friedrich-Alexander University Erlangen-Nuremberg; Institute of Polymer Materials; Martensstraße 7 91058 Erlangen Germany
| | - Joachim Kaschta
- Friedrich-Alexander University Erlangen-Nuremberg; Institute of Polymer Materials; Martensstraße 7 91058 Erlangen Germany
| | - Raymund E Horch
- Friedrich-Alexander University Erlangen-Nuremberg; Plastisch- und Handchirurgische Klinik; Krankenhausstraße 12 91054 Erlangen Germany
| | - Bastian L Walter
- Friedrich-Alexander University Erlangen-Nuremberg; Institute of Polymer Materials; Martensstraße 7 91058 Erlangen Germany
| | - Jonas Daenicke
- Friedrich-Alexander University Erlangen-Nuremberg; Institute of Polymer Materials; Martensstraße 7 91058 Erlangen Germany
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14
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Experimental total wrapping of breast implants with acellular dermal matrix: a preventive tool against capsular contracture in breast surgery? J Plast Reconstr Aesthet Surg 2013; 66:1382-9. [PMID: 23764323 DOI: 10.1016/j.bjps.2013.05.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 05/05/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Capsular contracture remains a hitherto unsolved complication after implantation of silicone gel-filled breast prostheses. Based on clinical and experimental data, the use of an acellular dermal matrix as a sheath around implants may lead to lesser capsular contracture acting as a proposed biological environment mimicking wound bed tissue. The aim of our study was to analyse the tissue reaction after implantation of silicone prosthesis with and without an envelope of acellular dermal matrix. METHODS Implantation of 60 silicone prostheses in the back of Lewis rats were carried out, randomly paired taking one rat from group A and one from group B. Group A included implants completely enveloped with xenogenic acellular dermis and group B undraped silicone implants. At 3, 6 and 12 weeks postoperatively, the samples were explanted and subjected to histological and immunohistochemical evaluation. RESULTS A new myofibroblast tissue layer was identified in proximity to the implant in both groups. The thickness of the layer in group A was continuously thinner than in group B regarding the different explantation time points. Implants completely wrapped with acellular dermal matrix showed significantly lesser inflammatory signs at 3 and 12 weeks after implantation compared to controls. Cell proliferation after 12 weeks was significantly decreased in group A. CONCLUSION The slight myofibroblast layer and reduced rate of inflammation and proliferation in the treatment group show a positive effect of total acellular dermal matrix envelope and hypothesise the decrease of capsular contracture in long-term periods.
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15
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Systemic inflammatory reaction after silicone breast implant. Aesthetic Plast Surg 2011; 35:789-94. [PMID: 21424173 DOI: 10.1007/s00266-011-9688-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 02/22/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Systemic inflammation after augmentation mammaplasty with modern silicone implants is not currently recognized. In a prospective controlled study, C-reactive protein and other variables were monitored, aiming to test this hypothesis in a young cohort of patients. METHODS Females (18-30 years old, BMI = 18.5-30 kg/m(2), N = 52) were consecutively recruited for breast implant (n = 24, Group I) and for abdominal liposuction (n = 28, Group II/Controls). Patients were interviewed at baseline and followed until 6 months after operation. Variables included demographic and clinical information, surgical outcome, inflammatory markers and autoantibodies. RESULTS Operations were well tolerated, without surgical or infectious complications. Mean prosthesis size was 258 ± 21 ml (range = 220-280) and mean aspirate of liposuction was 1972 ± 499 ml (range = 1200-3000). Preoperative, 2-month, and 6-month C-reactive protein concentrations for breast implant patients were 1.3 ± 1.2, 4.8 ± 3.0, and 4.3 ± 6.4 mg/l and for liposuction 3.5 ± 2.7, 3.5 ± 2.1, and 2.2 ± 2.2 mg/l, respectively. Change at 2 months was significant (p = 0.001). Autoantibody investigation failed to reveal remarkable aberrations, except for anticardiolipin elevation, which was nearly symmetrical in the two groups. CONCLUSION C-reactive protein levels increased after operation and correlated with proinflammatory and procoagulatory indices. A mild increase in anticardiolipin IgM occurred but differences between populations were lacking. Despite excellent cosmetic outcomes and lack of complications, acute phase reaction could signal ongoing immunogenicity of silicone and long-term monitoring is recommended.
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