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The effect of human recombinant epidermal growth factor on capsule contraction in an irradiated rat model. EUROPEAN JOURNAL OF PLASTIC SURGERY 2023. [DOI: 10.1007/s00238-023-02055-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Angiotensin-Converting Enzyme Inhibitor Reduces Radiation-Induced Periprosthetic Capsular Fibrosis. J Surg Res 2021; 263:167-175. [PMID: 33667872 DOI: 10.1016/j.jss.2021.01.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The capsular contracture is one of the main complications after radiotherapy in patients with implant-based reconstruction. The aim of this study is to evaluate the efficacy of ramipril for the prevention of radiation-induced fibrosis around the silicone implant. MATERIALS AND METHODS Thirty Wistar rats in 5 groups were used. Group 1: implant; group 2: implant + radiation; group 3: ramipril + implant; group 4: ramipril + implant + radiation; group 5: sham. Ramipril treatment was started 5 d before surgery and continued for 12 wk after surgery. A mini silicone implant was placed in the back of the rats. A single fraction of 21.5 Gy radiation was applied. Tissues were examined histologically and immunohistochemically (TGF-β1, MMP-2, and TIMP-2 expression). The alteration of plasma TGF-β1 levels was examined before and after the experiment. RESULTS After applying implant or implant + radiation, capsular thickness, percentage of fibrotic area, tissue and plasma TGF-β1 levels significantly increased, and MMP-2/TIMP-2 ratio significantly decreased compared with the sham group. In ramipril-treated groups, the decrease in capsular thickness, fibrosis, TGF-β1 positivity, and an increase in MMP-2/TIMP-2 ratio were found significant. In the ramipril + implant + radiation group, the alteration values of TGF-β1 dramatically decreased. CONCLUSIONS Our results show that ramipril reduces radiation-induced fibrosis and contracture. The results of our study may be important for the design of the clinical trials required to investigate the effective and safe doses of ramipril, which is an inexpensive and easily tolerated drug, on humans.
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In Search of a Murine Model of Radiation-Induced Periprosthetic Capsular Fibrosis. Ann Plast Surg 2018; 80:S204-S210. [DOI: 10.1097/sap.0000000000001362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kim JB, Jeon HJ, Lee JW, Choi KY, Chung HY, Cho BC, Park SH, Park MH, Bae JS, Yang JD. A murine model of radiation-induced capsule-tissue reactions around smooth silicone implants. J Plast Surg Hand Surg 2018. [PMID: 29523044 DOI: 10.1080/2000656x.2018.1444617] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
As the availability of breast reconstruction using implants is becoming widespread and many implant recipients undergo radiation therapy, there is an increasing interest in understanding the potential complications associated with capsule-tissue interactions in response to irradiation. Accordingly, our medical institution designed an animal experiment to investigate the effects of irradiation on capsular contracture. A total of 40 mice (C57BL6) were divided into four groups according to whether or not they received irradiation and the time from implantation to irradiation. After each mouse received a specially-fabricated, 1.5 cm semi-spherical silicone implant inserted into the area below the panniculus carnosus, half of the mice were irradiated using singe administration of a 10 Gy dose of radiation (6 MeV). Subsequently, data from gross inspection, histological analysis and immunohistochemical analysis were obtained at one and three months postoperatively and analyzed. Changes that occurred near the capsule led to the phenomenon of contracture subsequent to encapsulation. Our findings suggest that the inflammation reaction occurring near the implant becomes aggravated by 'radiation toxicity' and creates an environment conducive to capsular contracture. The present study demonstrated the process by which the complication of capsular contracture may occur during the treatment of human breast cancer via radiotherapy. These findings may serve as the basis for research and development of future treatments of capsular contracture.
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Affiliation(s)
- Jae Bong Kim
- a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Hyeon Jun Jeon
- a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Jeong Woo Lee
- a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Kang Young Choi
- a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Ho Yun Chung
- a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Byung Chae Cho
- a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Shin-Hyung Park
- b Department of Radiation Oncology, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Min Hee Park
- c Department of Physiology, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Jae-Sung Bae
- c Department of Physiology, School of Medicine , Kyungpook National University , Daegu , Korea
| | - Jung Dug Yang
- a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea
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Huang X, Zhou Y, Liu W, Li H, Liang X, Jin R, Du H, He J, Chai B, Duan R, Li Q. Identification of hub genes related to silicone-induced immune response in rats. Oncotarget 2017; 8:99772-99783. [PMID: 29245939 PMCID: PMC5725130 DOI: 10.18632/oncotarget.21546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/21/2017] [Indexed: 12/18/2022] Open
Abstract
Silicone implants are used widely in the field of plastic surgery and are used in a large population. However, their safety profile, especially the silicone-induced immune response, has been a major concern for plastic surgeons for decades. It has been hypothesized that there is a cause and effect relation between silicone and immunity, but this is controversial. The objective of the present study was to determine the hub genes and key pathways related to silicone implant–induced immune responses in a rat model. In addition to cluster and enrichment analyses, we used weighted gene co-expression network analysis (WGCNA) to examine the gene expression profiles in a systematic context. A total five genes (Fes, Aif1, Gata3, Tlr6, Tlr2) were identified as hub genes that are most likely related to the silicone-induced immune response, four of which (Aif1, Gata3, Tlr6, Tlr2) have been associated with autoimmunity as target genes or disease markers. The Toll-like receptor signaling pathway (p < 0.01, fold enrichment: 7.01) and systemic lupus erythematosus signaling pathway (p < 0.05, fold enrichment: 5.01), which are considered strongly associated with autoimmunity, were significantly enriched in the silicone-implanted skin samples. The results indicate that silicone implants might trigger the localized immune response, as various immune reaction genes were detected after silicone implantation. The identified five hub genes will hopefully serve as novel therapeutic targets for silicone-related complications and the associated autoimmune diseases.
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Affiliation(s)
- Xiaolu Huang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Yiwen Zhou
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Wenhui Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Haizhou Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Xiao Liang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Rui Jin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Hengyu Du
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Jizhou He
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Bangda Chai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Ran Duan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R.China
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VIEIRA VILBERTOJ, D'ACAMPORA ARMANDO, NEVES FERNANDAS, MENDES PAULOR, VASCONCELLOS ZULMARADE, NEVES RODRIGOD, FIGUEIREDO CLAUDIAP. Capsular Contracture In Silicone Breast Implants: Insights From Rat Models. AN ACAD BRAS CIENC 2016; 88:1459-70. [DOI: 10.1590/0001-3765201620150874] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/04/2016] [Indexed: 01/19/2023] Open
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de Monès E, Schlaubitz S, Oliveira H, d'Elbée JM, Bareille R, Bourget C, Couraud L, Fricain JC. Comparative study of membranes induced by PMMA or silicone in rats, and influence of external radiotherapy. Acta Biomater 2015; 19:119-27. [PMID: 25770925 DOI: 10.1016/j.actbio.2015.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 02/27/2015] [Accepted: 03/05/2015] [Indexed: 12/11/2022]
Abstract
The induced membrane technique has been used for long bone defect reconstruction after traumatism. One of the major drawbacks of this method is the difficult removal of the polymethyl methacrylate spacer after membrane formation. We therefore replaced the stiff PMMA spacer with a semi-flexible medical grade silicone spacer. This study aimed to compare subcutaneously formed membranes, induced by PMMA and silicone, in the irradiated or not irradiated areas within 28 rats that received the spacers. Histological analysis was performed to evaluate the composition of the membrane and to quantify the amount of vessels. Histomorphometric measurements were used to evaluate membranes' thickness, while fibrosis and inflammation were scored. The expression of VEGF and BMP-2 in lysates of the crushed membranes was determined by Western blotting. ALP expression was analyzed in HBMSC cultures in contact with the same lysates. Non-irradiated membranes induced by the two spacer types were non-inflammatory, fibrous and organized in layers. Irradiation did not change the macroscopic properties of membranes that were induced by silicone, while PMMA induced membranes were sensitive to the radiotherapy, resulting in thicker, strongly inflammatory membranes. Irradiated membranes showed an overall reduced osteogenic potential. Medical grade silicone is safe for the use in radiotherapy and might therefore be of great advantage for patients in need of cancer treatment.
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Affiliation(s)
- Erwan de Monès
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Department of Otolaryngology - Head and Neck Surgery, Univ. Bordeaux, Place Amélie Raba Léon, F-33000 Bordeaux, France
| | - Silke Schlaubitz
- Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Bordeaux University Hospital, CIC 1401, PTIB, Xavier Arnozan Hospital, Avenue Haut Lévêque, F-33000 Bordeaux, France
| | - Hugo Oliveira
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Jean-Marie d'Elbée
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Reine Bareille
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Chantal Bourget
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Lionel Couraud
- Bordeaux University Hospital, CIC 1401, PTIB, Xavier Arnozan Hospital, Avenue Haut Lévêque, F-33000 Bordeaux, France
| | - Jean-Christophe Fricain
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Department of Dentistry, Univ. Bordeaux, Place Amélie Raba Léon, F-33000 Bordeaux, France.
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Sapountzis S, Kim JH, Francescato Veiga D, Masako Ferreira L. The effect of Zafirlukast on capsule formation in post-radiation silicone implants. Med Hypotheses 2012; 78:787-9. [PMID: 22465464 DOI: 10.1016/j.mehy.2012.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 12/17/2011] [Accepted: 03/08/2012] [Indexed: 02/06/2023]
Abstract
Currently, breast cancer represents the most common indication for mastectomy with negative influence on personal perception, sexuality and partnership. Since the introduction of breast implants, silicone, and saline breast implantation have become one of the most common procedures performed by plastic surgeons, not only for aesthetic reasons but also for reconstructive purposes. These women will ultimately be faced with the prospect of capsular contracture. This is especially true in patients receiving radiation therapy, where irradiation increases the risk of complications, capsular contracture and may compromise a favorable aesthetic result. Despite the capsular contracture is the most common complication for both aesthetic and reconstructive breast surgery, the treatment have remained unsolved. Leukotriene antagonists (LTRAs) have emerged as effective prophylactic agents in the management of reactive airway diseases, and recently they have used as an off label prophylactic agent against the capsular contracture after breast augmentation. However up to now there is no any experimental research or clinical study in the medical literature about the effect of Zafirlukast on the capsular formation around irradiated silicone implants.
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Affiliation(s)
- Stamatis Sapountzis
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, 2 Yuh-Der Road, Taichung City, Taiwan.
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Bettendorf O, Schmidt H, Eltze E, Rody A, Herchenröder F, Jackisch C, Böcker W, Pfleiderer B. Quantitative measurement of telomerase activity and localization of its catalytic subunit (hTERT) in chronic inflammation of capsule formation around various model implants and in sarcomas in a rat model. J Biomed Mater Res A 2008; 85:646-50. [PMID: 17806120 DOI: 10.1002/jbm.a.31613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Telomerase is upregulated in some preneoplastic lesions and overexpressed in the majority of malignant tumors, but absent in most nonneoplastic somatic tissues. We analyzed telomerase activity using TRAP-assay in capsule tissues in a rat model with chronic inflammation and in tumor, and visualized the catalytic subunit of telomerase (hTERT) by immunhistochemistry. Significant elevated telomerase activity was found in tumor tissue compared with nonneoplastic tissue (p = 0.047). Cases with a strong inflammation in capsule tissue showed a specific telomerase activity. In these cases, there were no significant differences in telomerase activities compared with malignant tumor tissue. We demonstrate elevated telomerase activity and its diagnostic limits around model implants in a rat model, and visualize its expression not only in malignant tissue but also in inflammatory cells. So the quantitative measurement of telomerase activity should not be applied in general as a marker for malignancy in capsule tissue.
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Affiliation(s)
- O Bettendorf
- Institute of Pathology, University of Münster, Domagkstrasse 17, D-48149 Münster, Germany.
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Abstract
BACKGROUND Pirfenidone (PFD), a new antifibrotic and antiinflammatory agent, prevents and resolves fibrous tissue. This study evaluated the effect of PFD on adverse events in mammary implants using an animal model. Mammary implantation, the most frequent aesthetic surgery, may present several complications after surgery such as swelling, capsule contracture, hardness, and pain. METHODS Wistar rats underwent submammary implantation with either smooth or textured silicone gel implants and were administrated 200 mg/kg of PFD daily. The control group received saline. The animals were killed at 8 weeks. The capsular tissue of both implants was removed for histologic and molecular analyses. RESULTS Typical postaugmentation periimplant capsules with opacity on adjacent tissues developed 8 weeks after silicone implantation. No significant differences were observed between the textured and smooth implants in any analyzed parameter. Clearly, PFD reduced capsule thickness around submmamary tissue, fibroblast-like cell proliferation, and recruitment of inflammatory cells. The total cell numbers per field were reduced as well. In contrast, the control group presented abundant mononuclear cell infiltration and fibroblast-like cell proliferation. The total content of collagen in the PFD group was 50% less than in the control group. Fibroblast cells displayed 45% less activated phenotype in the PFD group than in the control group, as determined by immunohistochemistry techniques. In the PFD animals, transforming growth factor-beta (TGF-beta) decreased 85% and collagen 1 gene expression 60%, compared with the control group. CONCLUSION The findings show a positive effect of PFD on mammary contracture in 10 rats. Despite the small number of animals, the differences found in 10 control rats encourage the authors to propose a larger study later and to suggest PFD as a potential preventive strategy in human mammary implantation surgery.
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