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01-08-2010 | Original Article

Activation of human mononuclear cells by porcine biologic meshes in vitro

Authors: S. B. Orenstein, Y. Qiao, U. Klueh, D. L. Kreutzer, Y. W. Novitsky

Published in: Hernia | Issue 4/2010

Abstract

Introduction

While porcine-based biologic meshes are increasingly used for hernia repair, little data exist on tissue responses to such products. Host foreign body reaction, local inflammation, and wound healing are principally controlled by monocytes/macrophages (M/MØs). Exaggerated activation of M/MØs may deleteriously influence mesh integration and remodeling. We hypothesized that common porcine meshes induce the differential activation of M/MØs in vitro.

Materials and methods

Samples of four acellular porcine-derived meshes, CollaMend™ (CM; C.R. Bard/Davol), Permacol™ (PC; TSL/Covidien), Strattice™ (ST; LifeCell), and Surgisis^® (SS; Cook Biotech), were exposed to mononuclear cells derived from the peripheral blood of six healthy subjects. Following a 7-day incubation period, supernatants were assayed for interleukin-1beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and vascular endothelial growth factor (VEGF) using a multiplex bead-based immunoassay system. The four groups were compared using analysis of variance (ANOVA) and Student’s t-test.

Results

Each mesh type induced differential mononuclear cell activation in vitro. The mean IL-1β expressions for CM (7,195 pg/ml) and PC (4,215 pg/ml) were significantly higher compared to ST and SS (123 and 998 pg/ml, respectively; P < 0.05). Similar trends were also seen for IL-6 (range 445–70,729 pg/ml), IL-8 (range 11,640–1,045,938 pg/ml), and VEGF (range 686–7,133 pg/ml).

Conclusion

For the first time, we demonstrated that porcine meshes induce M/MØ activation in vitro. CM and PC (chemically crosslinked dermis) induced significantly higher cytokine expression compared to ST (non-crosslinked dermis) and SS (small intestine submucosa). These differences are likely related to proprietary processing methods and/or the extent of collagen crosslinking. Further understanding of immunologic effects of porcine-derived biologic meshes will not only allow for a comparison between existing products, but it may also lead to mesh modifications and improvement of their clinical performance.

Usher FC, Ochsner J, Tuttle LL Jr (1958) Use of marlex mesh in the repair of incisional hernias. Am Surg 24:969–974PubMed

Bachman S, Ramshaw B (2008) Prosthetic material in ventral hernia repair: how do I choose? Surg Clin North Am 88:101–112, ixCrossRefPubMed

Udwadia TE (2006) Inguinal hernia repair: the total picture. J Min Access Surg 2:144–146CrossRef

Jin J, Rosen MJ, Blatnik J, McGee MF, Williams CP, Marks J, Ponsky J (2007) Use of acellular dermal matrix for complicated ventral hernia repair: does technique affect outcomes? J Am Coll Surg 205:654–660CrossRefPubMed

Milburn ML, Holton LH, Chung TL, Li EN, Bochicchio GV, Goldberg NH, Silverman RP (2008) Acellular dermal matrix compared with synthetic implant material for repair of ventral hernia in the setting of peri-operative Staphylococcus aureus implant contamination: a rabbit model. Surg Infect (Larchmt) 9:433–442CrossRef

Saettele TM, Bachman SL, Costello CR, Grant SA, Cleveland DS, Loy TS, Kolder DG, Ramshaw BJ (2007) Use of porcine dermal collagen as a prosthetic mesh in a contaminated field for ventral hernia repair: a case report. Hernia 11:279–285CrossRefPubMed

Bellows CF, Albo D, Berger DH, Awad SS (2007) Abdominal wall repair using human acellular dermis. Am J Surg 194:192–198CrossRefPubMed

Hiles M, Record Ritchie RD, Altizer AM (2009) Are biologic grafts effective for hernia repair?: a systematic review of the literature. Surg Innov 16:26–37CrossRefPubMed

Schuster R, Singh J, Safadi BY, Wren SM (2006) The use of acellular dermal matrix for contaminated abdominal wall defects: wound status predicts success. Am J Surg 192:594–597CrossRefPubMed

10.

Shaikh FM, Giri SK, Durrani S, Waldron D, Grace PA (2007) Experience with porcine acellular dermal collagen implant in one-stage tension-free reconstruction of acute and chronic abdominal wall defects. World J Surg 31:1966–1972; discussion 1973–1974, 1975CrossRefPubMed

11.

Badylak SF (2004) Xenogeneic extracellular matrix as a scaffold for tissue reconstruction. Transpl Immunol 12:367–377CrossRefPubMed

12.

Badylak SF, Valentin JE, Ravindra AK, McCabe GP, Stewart-Akers AM (2008) Macrophage phenotype as a determinant of biologic scaffold remodeling. Tissue Eng Part A 14:1835–1842CrossRefPubMed

13.

Gordon S, Taylor PR (2005) Monocyte and macrophage heterogeneity. Nat Rev Immunol 5:953–964CrossRefPubMed

14.

Schachtrupp A, Klinge U, Junge K, Rosch R, Bhardwaj RS, Schumpelick V (2003) Individual inflammatory response of human blood monocytes to mesh biomaterials. Br J Surg 90:114–120CrossRefPubMed

15.

Schutte RJ, Parisi-Amon A, Reichert WM (2009) Cytokine profiling using monocytes/macrophages cultured on common biomaterials with a range of surface chemistries. J Biomed Mater Res A 88:128–139PubMed

16.

Anderson JM, Rodriguez A, Chang DT (2008) Foreign body reaction to biomaterials. Semin Immunol 20:86–100CrossRefPubMed

17.

Barrientos S, Stojadinovic O, Golinko MS, Brem H, Tomic-Canic M (2008) Growth factors and cytokines in wound healing. Wound Repair Regen 16:585–601CrossRefPubMed

18.

Schutte RJ, Xie L, Klitzman B, Reichert WM (2009) In vivo cytokine-associated responses to biomaterials. Biomaterials 30:160–168CrossRefPubMed

19.

Orenstein S, Qiao Y, Kaur M, Klueh U, Kreutzer D, Novitsky Y (2010) In vitro activation of human peripheral blood mononuclear cells induced by human biologic meshes. J Surg Res 158:10–14CrossRefPubMed

20.

Orenstein SB, Qiao Y, Kaur M, Klueh U, Kreutzer DL, Novitsky YW (2009) Human monocyte activation by biologic and biodegradable meshes in vitro. Surg Endosc (in press)

21.

Usher FC (1959) Further observations on the use of marlex mesh: a new technique for the repair of inguinal hernias. Am Surg 25:792–795PubMed

22.

Usher FC, Hill JR, Ochsner JL (1959) Hernia repair with Marlex mesh. A comparison of techniques. Surgery 46:718–724PubMed

23.

Johnson J, Roth JS, Hazey JW, Pofahl WE (2004) The history of open inguinal hernia repair. Curr Surg 61:49–52CrossRefPubMed

24.

Jansen PL, Mertens Pr P, Klinge U, Schumpelick V (2004) The biology of hernia formation. Surgery 136:1–4CrossRefPubMed

25.

Kaback LA, Smith TJ (1999) Expression of hyaluronan synthase messenger ribonucleic acids and their induction by interleukin-1beta in human orbital fibroblasts: potential insight into the molecular pathogenesis of thyroid-associated ophthalmopathy. J Clin Endocrinol Metab 84:4079–4084CrossRefPubMed

26.

Sandor M, Xu H, Connor J, Lombardi J, Harper JR, Silverman RP, McQuillan DJ (2008) Host response to implanted porcine-derived biologic materials in a primate model of abdominal wall repair. Tissue Eng Part A 14:2021–2031CrossRefPubMed

27.

Xu H, Wan H, Sandor M, Qi S, Ervin F, Harper JR, Silverman RP, McQuillan DJ (2008) Host response to human acellular dermal matrix transplantation in a primate model of abdominal wall repair. Tissue Eng Part A 14:2009–2019CrossRefPubMed

28.

Chaplin JM, Costantino PD, Wolpoe ME, Bederson JB, Griffey ES, Zhang WX (1999) Use of an acellular dermal allograft for dural replacement: an experimental study. Neurosurgery 45:320–327CrossRefPubMed

29.

Tarhan E, Cakmak O, Ozdemir BH, Akdogan V, Suren D (2008) Comparison of AlloDerm, fat, fascia, cartilage, and dermal grafts in rabbits. Arch Facial Plast Surg 10:187–193CrossRefPubMed

30.

Khor E (1997) Methods for the treatment of collagenous tissues for bioprostheses. Biomaterials 18:95–105CrossRefPubMed

31.

Schmidt CE, Baier JM (2000) Acellular vascular tissues: natural biomaterials for tissue repair and tissue engineering. Biomaterials 21:2215–2231CrossRefPubMed

32.

Gouk SS, Lim TM, Teoh SH, Sun WQ (2008) Alterations of human acellular tissue matrix by gamma irradiation: histology, biomechanical property, stability, in vitro cell repopulation, and remodeling. J Biomed Mater Res B Appl Biomater 84:205–217PubMed

33.

Mosser DM (2003) The many faces of macrophage activation. J Leukoc Biol 73:209–212CrossRefPubMed

34.

Mosser DM, Edwards JP (2008) Exploring the full spectrum of macrophage activation. Nat Rev Immunol 8:958–969CrossRefPubMed

35.

Mosser DM, Zhang X (2008) Activation of murine macrophages. Curr Protoc Immunol Chapter 14: Unit 14.2

36.

Zhang X, Goncalves R, Mosser DM (2008) The isolation and characterization of murine macrophages. Curr Protoc Immunol Chapter 14: Unit 14.1

37.

Badylak SF, Gilbert TW (2008) Immune response to biologic scaffold materials. Semin Immunol 20:109–116PubMed

38.

Gilbert TW, Sellaro TL, Badylak SF (2006) Decellularization of tissues and organs. Biomaterials 27:3675–3683PubMed

39.

Ansaloni L, Cambrini P, Catena F, Di Saverio S, Gagliardi S, Gazzotti F, Hodde JP, Metzger DW, D’Alessandro L, Pinna AD (2007) Immune response to small intestinal submucosa (surgisis) implant in humans: preliminary observations. J Invest Surg 20:237–241CrossRefPubMed

40.

Ansaloni L, Catena F, Coccolini F, Gazzotti F, D’Alessandro L, Pinna AD (2009) Inguinal hernia repair with porcine small intestine submucosa: 3-year follow-up results of a randomized controlled trial of Lichtenstein’s repair with polypropylene mesh versus surgisis inguinal hernia matrix. Am J Surg 198:303–312CrossRefPubMed

41.

Franklin ME Jr, Treviño JM, Portillo G, Vela I, Glass JL, González JJ (2008) The use of porcine small intestinal submucosa as a prosthetic material for laparoscopic hernia repair in infected and potentially contaminated fields: long-term follow-up. Surg Endosc 22:1941–1946CrossRefPubMed

42.

Pu LL (2005) Small intestinal submucosa (Surgisis) as a bioactive prosthetic material for repair of abdominal wall fascial defect. Plast Reconstr Surg 115:2127–2131CrossRefPubMed

43.

Ayubi FS, Armstrong PJ, Mattia MS, Parker DM (2008) Abdominal wall hernia repair: a comparison of Permacol and Surgisis grafts in a rat hernia model. Hernia 12:373–378CrossRefPubMed

44.

Trabuco EC, Zobitz ME, Klingele CJ, Gebhart JB (2007) Effect of host response (incorporation, encapsulation, mixed incorporation and encapsulation, or resorption) on the tensile strength of graft-reinforced repair in the rat ventral hernia model. Am J Obstet Gynecol 197:638.e1–638.e6CrossRef

45.

Xu H, Wan H, Zuo W, Sun W, Owens RT, Harper JR, Ayares DL, McQuillan DJ (2009) A porcine-derived acellular dermal scaffold that supports soft tissue regeneration: removal of terminal galactose-alpha-(1,3)-galactose and retention of matrix structure. Tissue Eng Part A 15:1807–1819CrossRefPubMed

46.

Connor J, McQuillan D, Sandor M, Wan H, Lombardi J, Bachrach N, Harper J, Xu H (2009) Retention of structural and biochemical integrity in a biological mesh supports tissue remodeling in a primate abdominal wall model. Regen Med 4:185–195CrossRefPubMed

Title: Activation of human mononuclear cells by porcine biologic meshes in vitro
Authors: S. B. Orenstein
Y. Qiao
U. Klueh
D. L. Kreutzer
Y. W. Novitsky
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: Hernia / Issue 4/2010
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-010-0634-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Activation of human mononuclear cells by porcine biologic meshes in vitro

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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