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In vivo characterisation of the inflammatory reaction following mesh implantation in transgenic mice models

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Abstract

Introduction

Hernia repair with prosthetic meshes represents one of the most common surgical procedures in the field of surgery. This intervention is always associated with an ensuing inflammatory response, angiogenesis and fibrotic encapsulation forming a foreign body granuloma (FBG) around the mesh fibres. Several studies have described this inflammatory reaction by characterising inflammatory cell infiltrate around the FBG after mesh explantation. However, very little is known about the real-time progression of such an inflammatory response. The aim of this study was to investigate the feasibility of monitoring the ongoing inflammatory response to mesh implantation using bioluminescence in vivo.

Materials and methods

Three luciferase transgenic mice strains (FVB/N-Tg(Vegfr2-luc)-Xen, BALB/C-Tg(NFκB-RE-luc)-Xen and Tg(INS/EpRE-Luc)T20Rbl) were used. Mice were anaesthetized with 2 % isoflurane, and two incisions were made on the left and right sides of the abdomen of the mice. A 1-cm2 propylene mesh was implanted subcutaneously in the right incision wound of each mouse, and the left wound served as control. Two hundred microliters of D-luciferin was injected into the mice, and bioluminescence measurements were done prior to the surgical intervention and subsequently every 3 days. After mesh explantation, histological analysis was done. Statistical analysis was done using prism GraphPad software.

Results

Bioluminescence results revealed different time points of maximum signal for the different mice strains. VEGFR2 gene expression peaked on day 6, NFkB on day 12 and ARE on day 3 post mesh implantation. We also observed much higher bioluminescent signal around the FBG surrounding the mesh as compared to the control wound, with p < 0.05 for all the different mice strains.

Conclusion

Our results prove the possibility of monitoring the inflammatory reaction after mesh implantation in vivo using bioluminescence signal release. This provides a novel method of accessing and accurately describing the ongoing inflammatory response over a given period of time.

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Acknowledgements

The project is co-funded by the European Union (European Regional Development Fund—investing in your future) and the German federal state North Rhine-Westphalia (NRW).

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Authors and Affiliations

  1. Department of General, Visceral- and Transplantation Surgery, University Hospital of the RWTH, Pauwelsstr. 30, 52074, Aachen, Germany

    N. Fet, P. H. Alizai, U. P. Neumann & U. Klinge

  2. Institute of Laboratory Animal Science and Experimental Surgery, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany

    N. Fet & R. H. Tolba

  3. Department of Anatomy and Cell Biology, University Hospital Aachen, Wendlingweg 2, 52074, Aachen, Germany

    A. Fragoulis, C. Wruck & T. Pufe

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  1. N. Fet
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Correspondence to U. Klinge.

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Fet, N., Alizai, P.H., Fragoulis, A. et al. In vivo characterisation of the inflammatory reaction following mesh implantation in transgenic mice models. Langenbecks Arch Surg 399, 579–588 (2014). https://doi.org/10.1007/s00423-014-1192-8

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