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01-10-2010 | Original Article

Effects of mast cell modulation on early host response to implanted synthetic meshes

Authors: S. B. Orenstein, E. R. Saberski, U. Klueh, D. L. Kreutzer, Y. W. Novitsky

Published in: Hernia | Issue 5/2010

Abstract

Introduction

Mast cells (MCs) and their products (e.g., histamine, serotonin, heparin, prostaglandins, cytokines, etc.) play key roles in controlling local inflammation, wound healing, and foreign body reactions in vivo. Investigation of the role of MCs in mediating local tissue responses to synthetic hernia meshes has been very limited to date. We aimed to determine the effects of MCs/MC products in mice undergoing synthetic mesh implantation.

Materials and methods

Circular samples (5 mm) of heavyweight microporous polypropylene (Trelex^®), midweight microporous polypropylene (ProLite™), lightweight macroporous polypropylene with poliglecaprone (Ultrapro™), and 3-dimensional macroporous polyester (Parietex™) meshes were implanted subcutaneously in C57BL/6 J mice with and without cromolyn (MC stabilizer/suppressant) treatment (50 mg/kg, daily IP). Two weeks post-implantation, all meshes were explanted and evaluated histologically using H&E and trichrome stains.

Results

Chronic inflammation was focused around individual mesh fibers; inter-fiber inflammation and fibrosis diminished as mesh porosity increased. MC accumulation was seen at the periphery of inflammatory reactions, and in association with mesh-induced fibrosis and neovascularization. Cromolyn treatment resulted in significantly decreased fibrotic responses to all four meshes and reduced inflammation induced by Trelex^®, ProLite™, and Parietex™ meshes but not Ultrapro™.

Conclusion

We demonstrated that MCs play important roles in mesh-induced host tissue reactions. Blocking MC degranulation decreased early inflammation and fibrosis induced by most synthetic meshes in this study. Further evaluation and understanding of the role of MCs in mesh-induced tissue reactions will provide new therapeutic approaches to enhance the biocompatibility of surgical meshes and ultimately improve clinical outcomes in patients undergoing hernia repair with synthetic biomaterials.

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Title: Effects of mast cell modulation on early host response to implanted synthetic meshes
Authors: S. B. Orenstein
E. R. Saberski
U. Klueh
D. L. Kreutzer
Y. W. Novitsky
Publication date: 01-10-2010
Publisher: Springer-Verlag
Published in: Hernia / Issue 5/2010
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-010-0680-1

At a glance: The STEP trials

Springer Medicine

Effects of mast cell modulation on early host response to implanted synthetic meshes

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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