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Sala L, Ciniselli CM, Bozzi F, Summo V, Bonini C, Brich S, Bertolotti A, Trupia DV, Volpi CC, Pizzamiglio S, Paolini B, Aiello A, Apolone G, Verderio P, Cortinovis U. Periprosthetic effusions surrounding breast expander: a flow cytometric, immunohistochemical and molecular characterization. Tumori 2024; 110:49-59. [PMID: 37574933 DOI: 10.1177/03008916231189532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
INTRODUCTION The synthesis of the periprosthetic capsule during implant-based breast reconstruction is the result of a coordinate cascade of inflammatory events ending in a fibrous tissue deposition around the expander or implant. Although the development of small volumes of fluid is one of the complications of prosthetic-based breast reconstruction, the characterization of the periprosthetic effusions coupled with the micro-textured devices, that have been recently introduced after the recall of macro-textured ones, is still lacking. The investigation of these periprosthetic effusions and paired capsules in terms of immunological content were the primary and secondary aims of the present study, respectively. METHODS For this, 68 women, 41 of whom had periprosthetic effusions at the time of expander replacement with implant, were recruited. For each case, capsule and healthy dermal tissues were taken and for women with periprosthetic effusion, peripheral blood was also collected. Periprosthetic effusions and peripheral blood were characterized by cytometry while capsules and dermal tissues by immunohistochemistry and Nanostring analysis. RESULTS The results showed an increase of Th1, Th2 lymphocytes and a HLA-DR+bright CD16+ cells (likely representing monocytes-derived macrophages) in periprosthetic effusions in respect to peripheral blood. These pro-inflammatory cells were counterbalanced by the gain of suppressive CD4 Treg cells. In the corresponding capsules, immunohistochemistry revealed the absence of Th1 cells and the presence of tissutal FOXP3 Treg. No significant difference in expression of inflammatory-related genes between capsules and dermal tissues was present. CONCLUSIONS These results suggest the presence of a Treg-controlled inflammation in both periprosthetic effusions and capsules.
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Affiliation(s)
- Laura Sala
- Department of Plastic Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Chiara Maura Ciniselli
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Fabio Bozzi
- Department of Diagnostics Innovation, Pathology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Valeria Summo
- Department of Plastic Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Chiara Bonini
- Unit of laboratory Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Lombardia, Italy
| | - Silvia Brich
- Department of Diagnostics Innovation, Pathology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Alessia Bertolotti
- Department of Diagnostics Innovation, Pathology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Desiré Viola Trupia
- Department of Diagnostics Innovation, Pathology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Chiara Costanza Volpi
- Department of Diagnostics Innovation, Pathology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Sara Pizzamiglio
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Biagio Paolini
- Department of Diagnostics Innovation, Pathology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Antonella Aiello
- Department of Diagnostics Innovation, Pathology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Paolo Verderio
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
| | - Umberto Cortinovis
- Department of Plastic Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Lombardia, Italy
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