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Published in: Langenbeck's Archives of Surgery 4/2007

01-07-2007 | Original Article

Improved collagen type I/III ratio at the interface of gentamicin-supplemented polyvinylidenfluoride mesh materials

Authors: Karsten Junge, Uwe Klinge, Raphael Rosch, Petra Lynen, Marcel Binnebösel, Joachim Conze, Peter R. Mertens, Robert Schwab, Volker Schumpelick

Published in: Langenbeck's Archives of Surgery | Issue 4/2007

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Abstract

Background

Formation of recurrent inguinal and incisional hernia shows an underlying defect in the wound-healing process with an insufficient quality of scar formation. Even after mesh repair an altered collagen formation and insufficient mesh integration has been found as main reason for recurrences. Therefore, the development of bioactive mesh materials to achieve a local modification of the scar formation to improve patients outcome is advisable.

Materials and methods

A polyvinylidenfluoride mesh material (PVDF) was constructed and surface modified by plasma-induced graft polymerization of acrylic acid (PVDF + PAAc). Surface supplementation was sought by binding of gentamicin to the provided active sites of the grafted mesh surfaces (PVDF+PAAc+Gentamicin). In vivo modulation of collagen formation was evaluated in a standardized animal model where an abdominal wall replacement was performed in 45 Sprague–Dawley rats. Seven, 21, and 90 days after mesh implantation, collagen/protein ratio and the collagen type I/III ratio as well as the expression of type I alpha 1 collagen mRNA (SYBR Green real-time RT-PCR) were analyzed at the perifilamentary region. Additionally, expression of matrix metalloproteinases (MMP-8/-13) has been investigated immunohistochemically.

Results

Implantation of the PVDF + PAAc + Gentamicin mesh induced a significantly decreased expression of MMP-8 and MMP-13 at the interface 21 and 90 days after implantation compared to the other groups. Whereas no significant effect was observed comparing the overall collagen/protein ratio, the quality of collagen formation expressed by the collagen type I/III ratio showed significantly higher ratios around the PVDF + PAAc + Gentamicin mesh 21 and 90 days after implantation. Correspondingly, an up to 5.3-fold expression of type I alpha 1 collagen mRNA was found.

Conclusion

The present data confirm that a surface modification of PVDF mesh samples using plasma-induced graft polymerization of acrylic acid and supplementation of gentamicin is able to improve scar quality and mesh integration.
Literature
1.
go back to reference Flum DR, Horvath K, Koepsell T (2003) Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 237(1):129–135PubMedCrossRef Flum DR, Horvath K, Koepsell T (2003) Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 237(1):129–135PubMedCrossRef
2.
go back to reference Jansen PL, Mertens PP, Klinge U, Schumpelick V (2004) The biology of hernia formation. Surgery 136(1):1–4PubMedCrossRef Jansen PL, Mertens PP, Klinge U, Schumpelick V (2004) The biology of hernia formation. Surgery 136(1):1–4PubMedCrossRef
3.
go back to reference Basson MD (2003) Invited research review: Cell–matrix interactions in the gut epithelium. Surgery 133(3):263–267PubMedCrossRef Basson MD (2003) Invited research review: Cell–matrix interactions in the gut epithelium. Surgery 133(3):263–267PubMedCrossRef
4.
go back to reference Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ, Pascual G, Guerrero A et al (2001) Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression. Ann Surg 233(2):287–291PubMedCrossRef Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ, Pascual G, Guerrero A et al (2001) Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression. Ann Surg 233(2):287–291PubMedCrossRef
5.
go back to reference Zheng H, Si Z, Kasperk R, Bhardwaj R, Schumpelick V, Klinge U et al (2002) Recurrent inguinal hernia: disease of the collagen matrix? World J Surg 26:401–408PubMedCrossRef Zheng H, Si Z, Kasperk R, Bhardwaj R, Schumpelick V, Klinge U et al (2002) Recurrent inguinal hernia: disease of the collagen matrix? World J Surg 26:401–408PubMedCrossRef
6.
go back to reference Rosch R, Klinge U, Si Z, Junge K, Klosterhalfen B, Schumpelick V (2002) A role for the collagen I/III and MMP−1/−13 genes in primary inguinal hernia? BMC Med Genet 3(1):2PubMedCrossRef Rosch R, Klinge U, Si Z, Junge K, Klosterhalfen B, Schumpelick V (2002) A role for the collagen I/III and MMP−1/−13 genes in primary inguinal hernia? BMC Med Genet 3(1):2PubMedCrossRef
7.
go back to reference Rosch R, Junge K, Lynen P, Mertens PR, Klinge U, Schumpelick V (2003) Hernia—a collagen disease? Eur Surg 35:11–15CrossRef Rosch R, Junge K, Lynen P, Mertens PR, Klinge U, Schumpelick V (2003) Hernia—a collagen disease? Eur Surg 35:11–15CrossRef
8.
go back to reference Junge K, Klinge U, Klosterhalfen B, Rosch R, Stumpf M, Schumpelick V (2002) Review of wound healing with reference to an unrepairable abdominal hernia. Eur J Surg 168(2):67–73PubMedCrossRef Junge K, Klinge U, Klosterhalfen B, Rosch R, Stumpf M, Schumpelick V (2002) Review of wound healing with reference to an unrepairable abdominal hernia. Eur J Surg 168(2):67–73PubMedCrossRef
9.
go back to reference Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B et al (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389(1):17–22PubMedCrossRef Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B et al (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389(1):17–22PubMedCrossRef
10.
go back to reference Junge K, Rosch R, Klinge U, Krones C, Klosterhalfen B, Mertens PR et al (2005) Gentamicin supplementation of polyvinylidenfluoride mesh materials for infection prophylaxis. Biomaterials 26(7):787–793PubMedCrossRef Junge K, Rosch R, Klinge U, Krones C, Klosterhalfen B, Mertens PR et al (2005) Gentamicin supplementation of polyvinylidenfluoride mesh materials for infection prophylaxis. Biomaterials 26(7):787–793PubMedCrossRef
11.
go back to reference Gupta B, Plummer C, Bisson I, Frey P, Hilborn J (2002) Plasma-induced graft polymerization of acrylic acid onto poly(ethylene terephthalate) films: characterization and human smooth muscle cell growth on grafted films. Biomaterials 23(3):863–871PubMedCrossRef Gupta B, Plummer C, Bisson I, Frey P, Hilborn J (2002) Plasma-induced graft polymerization of acrylic acid onto poly(ethylene terephthalate) films: characterization and human smooth muscle cell growth on grafted films. Biomaterials 23(3):863–871PubMedCrossRef
12.
go back to reference Lopez-De Leon A, Rojkind M (1985) A simple micromethod for collagen and total protein determination in formalin-fixed paraffin-embedded sections. J Histochem Cytochem 33(8):737–743PubMed Lopez-De Leon A, Rojkind M (1985) A simple micromethod for collagen and total protein determination in formalin-fixed paraffin-embedded sections. J Histochem Cytochem 33(8):737–743PubMed
13.
go back to reference Junqueira LC, Cossermelli W, Brentani R (1978) Differential staining of collagens type I, II and III by Sirius Red and polarization microscopy. Arch Histol Jpn 41(3):267–274PubMed Junqueira LC, Cossermelli W, Brentani R (1978) Differential staining of collagens type I, II and III by Sirius Red and polarization microscopy. Arch Histol Jpn 41(3):267–274PubMed
14.
go back to reference Junge K, Klinge U, Klosterhalfen B, Mertens PR, Rosch R, Schachtrupp A et al (2002) Influence of mesh materials on collagen deposition in a rat model. J Invest Surg 15(6):319–328PubMedCrossRef Junge K, Klinge U, Klosterhalfen B, Mertens PR, Rosch R, Schachtrupp A et al (2002) Influence of mesh materials on collagen deposition in a rat model. J Invest Surg 15(6):319–328PubMedCrossRef
15.
go back to reference O’Meara SM, Cullum NA, Majid M, Sheldon TA (2001) Systematic review of antimicrobial agents used for chronic wounds. Br J Surg 88(1):4–21PubMedCrossRef O’Meara SM, Cullum NA, Majid M, Sheldon TA (2001) Systematic review of antimicrobial agents used for chronic wounds. Br J Surg 88(1):4–21PubMedCrossRef
16.
go back to reference Guo Y, Xie C, Rodriguez RM, Light RW (2005) Factors related to recurrence of spontaneous pneumothorax. Respirology 10(3):378–384PubMedCrossRef Guo Y, Xie C, Rodriguez RM, Light RW (2005) Factors related to recurrence of spontaneous pneumothorax. Respirology 10(3):378–384PubMedCrossRef
17.
go back to reference Gilbert AI, Felton LL (1993) Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 177(2):126–130PubMed Gilbert AI, Felton LL (1993) Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 177(2):126–130PubMed
18.
go back to reference Hanssen AD, Spangehl MJ (2004) Practical applications of antibiotic-loaded bone cement for treatment of infected joint replacements. Clin Orthop Relat Res (427):79–85PubMedCrossRef Hanssen AD, Spangehl MJ (2004) Practical applications of antibiotic-loaded bone cement for treatment of infected joint replacements. Clin Orthop Relat Res (427):79–85PubMedCrossRef
19.
go back to reference Tweed C (2005) Prevention of surgical wound infection: prophylactic antibiotics in colorectal surgery. J Wound Care 14(5):202–205PubMed Tweed C (2005) Prevention of surgical wound infection: prophylactic antibiotics in colorectal surgery. J Wound Care 14(5):202–205PubMed
20.
21.
go back to reference Tekos A, Prodromaki E, Papadimou E, Pavlidou D, Tsambaos D, Drainas D (2003) Aminoglycosides suppress tRNA processing in human epidermal keratinocytes in vitro. Skin Pharmacol Appl Skin Physiol 16(4):252–258PubMedCrossRef Tekos A, Prodromaki E, Papadimou E, Pavlidou D, Tsambaos D, Drainas D (2003) Aminoglycosides suppress tRNA processing in human epidermal keratinocytes in vitro. Skin Pharmacol Appl Skin Physiol 16(4):252–258PubMedCrossRef
22.
go back to reference Sacha PT, Zaremba ML, Jakoniuk P (1999) The influence of antibiotics on phagocytic and bacteriocidal activity of rabbit peritoneal macrophages stimulated by filtrates of cultured t-lymphocytes. Med Dosw Mikrobiol 51(3–4):399–412PubMed Sacha PT, Zaremba ML, Jakoniuk P (1999) The influence of antibiotics on phagocytic and bacteriocidal activity of rabbit peritoneal macrophages stimulated by filtrates of cultured t-lymphocytes. Med Dosw Mikrobiol 51(3–4):399–412PubMed
23.
go back to reference Keeling KM, Bedwell DM (2002) Clinically relevant aminoglycosides can suppress disease-associated premature stop mutations in the IDUA and P53 cDNAs in a mammalian translation system. J Mol Med 80(6):367–376PubMedCrossRef Keeling KM, Bedwell DM (2002) Clinically relevant aminoglycosides can suppress disease-associated premature stop mutations in the IDUA and P53 cDNAs in a mammalian translation system. J Mol Med 80(6):367–376PubMedCrossRef
24.
go back to reference Wilschanski M, Yahav Y, Yaacov Y, Blau H, Bentur L, Rivlin J et al (2003) Gentamicin-induced correction of CFTR function in patients with cystic fibrosis and CFTR stop mutations. N Engl J Med 349(15):1433–1441PubMedCrossRef Wilschanski M, Yahav Y, Yaacov Y, Blau H, Bentur L, Rivlin J et al (2003) Gentamicin-induced correction of CFTR function in patients with cystic fibrosis and CFTR stop mutations. N Engl J Med 349(15):1433–1441PubMedCrossRef
25.
go back to reference Clancy JP, Bebok Z, Ruiz F, King C, Jones J, Walker L et al (2001) Evidence that systemic gentamicin suppresses premature stop mutations in patients with cystic fibrosis. Am J Respir Crit Care Med 163(7):1683–1692PubMed Clancy JP, Bebok Z, Ruiz F, King C, Jones J, Walker L et al (2001) Evidence that systemic gentamicin suppresses premature stop mutations in patients with cystic fibrosis. Am J Respir Crit Care Med 163(7):1683–1692PubMed
26.
go back to reference Geleilete TJ, Melo GC, Costa RS, Volpini RA, Soares TJ, Coimbra TM (2002) Role of myofibroblasts, macrophages, transforming growth factor-beta endothelin, angiotensin-II, and fibronectin in the progression of tubulointerstitial nephritis induced by gentamicin. J Nephrol 15(6):633–642PubMed Geleilete TJ, Melo GC, Costa RS, Volpini RA, Soares TJ, Coimbra TM (2002) Role of myofibroblasts, macrophages, transforming growth factor-beta endothelin, angiotensin-II, and fibronectin in the progression of tubulointerstitial nephritis induced by gentamicin. J Nephrol 15(6):633–642PubMed
27.
go back to reference Wrzesniok D, Buszman E, Karna E, Nawrat P, Palka J (2002) Melanin potentiates gentamicin-induced inhibition of collagen biosynthesis in human skin fibroblasts. Eur J Pharmacol 446(1–3):7–13PubMedCrossRef Wrzesniok D, Buszman E, Karna E, Nawrat P, Palka J (2002) Melanin potentiates gentamicin-induced inhibition of collagen biosynthesis in human skin fibroblasts. Eur J Pharmacol 446(1–3):7–13PubMedCrossRef
28.
go back to reference Asch HL, Farnham PJ (1978) Effects of gentamicin on trypsin, chymotrypsin, and collagenase. J Infect Dis 138(2):257–259PubMed Asch HL, Farnham PJ (1978) Effects of gentamicin on trypsin, chymotrypsin, and collagenase. J Infect Dis 138(2):257–259PubMed
29.
go back to reference Robson MC, Dubay DA, Wang X, Franz MG (2004) Effect of cytokine growth factors on the prevention of acute wound failure. Wound Repair Regen 12(1):38–43PubMedCrossRef Robson MC, Dubay DA, Wang X, Franz MG (2004) Effect of cytokine growth factors on the prevention of acute wound failure. Wound Repair Regen 12(1):38–43PubMedCrossRef
30.
go back to reference Dubay DA, Wang X, Kuhn MA, Robson MC, Franz MG (2004) The prevention of incisional hernia formation using a delayed-release polymer of basic fibroblast growth factor. Ann Surg 240(1):179–186PubMedCrossRef Dubay DA, Wang X, Kuhn MA, Robson MC, Franz MG (2004) The prevention of incisional hernia formation using a delayed-release polymer of basic fibroblast growth factor. Ann Surg 240(1):179–186PubMedCrossRef
31.
go back to reference Korenkov M, Yuecel N, Koebke J, Schierholz J, Morsczeck C, Tasci I et al (2005) Local administration of TGF-beta1 to reinforce the anterior abdominal wall in a rat model of incisional hernia. Hernia 9(3):252–258 Korenkov M, Yuecel N, Koebke J, Schierholz J, Morsczeck C, Tasci I et al (2005) Local administration of TGF-beta1 to reinforce the anterior abdominal wall in a rat model of incisional hernia. Hernia 9(3):252–258
Metadata
Title
Improved collagen type I/III ratio at the interface of gentamicin-supplemented polyvinylidenfluoride mesh materials
Authors
Karsten Junge
Uwe Klinge
Raphael Rosch
Petra Lynen
Marcel Binnebösel
Joachim Conze
Peter R. Mertens
Robert Schwab
Volker Schumpelick
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 4/2007
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-006-0138-1

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